Unidas por la Vida: A Healthy Lifestyle Intervention for High-risk Latina Dyads

Unidas por la Vida：针对高危拉丁裔二人组的健康生活方式干预

基本信息

批准号：
9134129
负责人：
KAREN S ROOK
金额：
$ 58.18万
依托单位：
UNIVERSITY OF CALIFORNIA-IRVINE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-15 至 2019-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9134129
关键词：
Address Adolescent obesity Adult Adult Children Affect American Behavioral Belief Body Composition Body Weight Body Weight decreased Cellular Phone Cognitive Communities Data Daughter Development Diabetes Mellitus Diabetes prevention Diabetic mother Diet Dietary intake Economically Deprived Population Ethnic group Evaluation Family Family member Fatty acid glycerol esters Food Fostering Glycosylated hemoglobin A Goals Health Health behavior Health behavior change Individual Influentials Intervention Latina Latino Lead Learning Life Life Style Living Costs Low income Low-Density Lipoproteins Maintenance Measures Mediating Mediator of activation protein Medical Mexican Mexican Americans Modeling Mothers Non-Insulin-Dependent Diabetes Mellitus Obesity Overweight Participant Persons Phase Physical activity Physiological Pilot Projects Population Populations at Risk Prediabetes syndrome Preparation Process Psychological reinforcement Quality of life Randomized Reporting Resources Risk Risk Factors Sampling Source Support Groups Technology Testing Time Weight Weight Gain Woman arm base behavior change cardiometabolic risk clinically significant comparison group cost cost effective design diabetes prevention program diabetes risk effective intervention health disparity healthy lifestyle high risk improved intervention effect lifestyle intervention lifetime risk member mother-daughter relationship novel obesity in children parental involvement primary outcome programs secondary outcome sedentary lifestyle socioeconomics therapy design treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Approximately half of Mexican-American women report having a sedentary lifestyle, and nearly 78 percent are overweight or obese. Compared to women in all other ethnic groups, Mexican-American women have the highest lifetime risk of type 2 diabetes. The development of culturally appropriate lifestyle interventions for this population is an urgent priority, and the proposed study accordingly will investigate a novel dyadic intervention designed to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. The intervention, Unidas por la Vida (United for Life), capitalizes on the importance of the family in Latino culture to mobilize an existing family dyad as a source of mutual support that is likely to foster greater and longer-lasting healt behavior change. The study builds on a successful pilot study (R34 DK083500) that established the feasibility and acceptability of this dyadic behavioral lifestyle intervention in a high-risk sample of Mexican-American family members who share a risk for diabetes and its complications. The 16-week intervention was modeled after the Diabetes Prevention Program (DPP), but was adapted for use with mother- daughter pairs and to be community-based and, thus, more easily accessible to low-income Latinas. Preliminary data from the Unidas pilot study indicated that the dyadic intervention promoted significant weight loss. The proposed study extends the successful pilot study to: 1) target weight loss > 5 percent of baseline body weight and to foster maintenance using a tapered intervention, 2) add comparison groups that permit evaluation of the improvement uniquely associated with the partner intervention, and 3) assess theoretically derived mediators of the intervention. Participants (N=460 mother-adult daughter dyads) will be randomized into one of three conditions: 1) dyadic (mother-daughter) participation in a Unidas partner intervention (Arm 1); 2) individual participation (mothers alone; unrelated daughters alone) in a Unidas individual intervention (Arm 2); and 3) mother-daughter dyad in a usual care only condition (Arm 3). The primary outcome is weight loss. Secondary outcomes include physical activity, dietary intake, physiological measures (e.g. HbA1c, LDL), body composition, quality of life, cost, and process evaluation. It is hypothesized that both the partne and individual interventions will produce significantly greater weight loss at 6, 12, and 18 months following program initiation than will the usual care only condition, with women assigned to the partner intervention losing more weight and maintaining the weight loss longer than women assigned to the individual intervention.

描述（由申请人提供）：大约一半的墨西哥裔美国妇女报告有久坐的生活方式，近78％的人超重或肥胖。与所有其他种族的妇女相比，墨西哥裔美国妇女的终身风险最高。对该人群的文化生活方式干预的发展是紧急的重点，因此拟议的研究将研究旨在改善健康行为的新型二元干预措施，旨在改善同一家庭的两名高危成员的体重减轻：患有2型糖尿病的母亲及其超重/肥胖的成人女儿，患有糖尿病风险。干预措施是Unidas por la Vida（统一的生命），利用了家庭在拉丁裔文化中的重要性，以动员现有的家庭二元组作为相互支持的来源，这可能会促进更大，更持久的疗法行为的改变。这项研究以成功的试点研究（R34 DK083500）为基础，该研究确立了这种二元行为行为生活方式干预的可行性和可接受性，这些干预措施是墨西哥裔美国家庭成员的高风险样本，这些墨西哥裔美国人有糖尿病及其并发症的风险。这项为期16周的干预是根据糖尿病预防计划（DPP）建模的，但适用于母女对，并以社区为基础，因此更容易适合低收入拉丁裔。 UNIDAS试验研究的初步数据表明，二元干预促进了重大体重减轻。拟议的研究将成功的试点研究扩展到：1）目标体重减轻> 5％的基线体重的5％，并使用锥形干预措施来促进维护，2）添加比较组，以评估与伴侣干预的唯一相关的改进； 3）评估干预措施的理论上衍生的介体。参与者（n = 460个母校女儿二元组）将被随机分为三个条件之一：1）二元（母女）参加UNIDAS伴侣干预（ARM 1）； 2）在UNIDAS的个人干预中（ARM 2），个人参与（单独的母亲；单独的女儿）； 3）母女二元在通常的护理状态下（手臂3）。主要结果是减肥。次要结果包括体育锻炼，饮食摄入，生理措施（例如HBA1C，LDL），身体成分，生活质量，成本和过程评估。假设Partne和个人干预措施在6、12和18个月时都会显着增加体重减轻遵循计划的启动，而不是通常的护理状况，妇女分配给伴侣干预措施减轻体重更多，减肥的时间比分配给个人干预的妇女更长。