Using grassroots wellness coaching to enhance reach and sustainability of behavioral weight management

利用基层健康辅导来提高行为体重管理的影响力和可持续性

• 批准号: 10609058
• 负责人: Jessica Gokee LaRose
• 金额: $ 31.05万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10609058
• 关键词: Address; Adult; Affect; African American; African American population; Aftercare; Age Years; Behavior; Behavior Therapy; Behavioral; Black race; Blood Pressure; Body Weight decreased; Body mass index; Clinic; Communities; Community Health Aides; Competence; Data; Development; Diet; Disadvantaged minority; Disparity; Dose; Economically Deprived Population; Effectiveness; Environment; Evidence based intervention; Focus Groups; Future; Group Meetings; Health; Health behavior change; Home; Individual; Intervention; Interview; Learning; Maintenance; Maps; Masks; Measures; Methods; Modeling; National Institute of Diabetes and Digestive and Kidney Diseases; Needs Assessment; Not Hispanic or Latino; Obesity; Outcome; Overweight; Participant; Patient Recruitments; Persons; Physical activity; Population; Poverty; Process; Public Health; Randomized; Research; Research Personnel; Research Project Grants; Resources; Risk Factors; Social Environment; Social Network; Surveys; Testing; Training; Translations; Underserved Population; United States; Visit; Weight; Weight maintenance regimen; acceptability and feasibility; behavioral outcome; cardiometabolic risk; cardiometabolism; clinically significant; community based participatory research; community setting; comorbidity; cost; design; diabetes prevention program; economic disparity; ethnic minority; evidence base; experience; fasting glucose; feasibility testing; follow-up; healthy lifestyle; implementation intervention; improved; informant; innovation; intervention delivery; lifestyle intervention; literacy; member; neighborhood disadvantage; novel; obesity management; obesity risk; obesity treatment; peer; pilot trial; poor health outcome; preventable death; programs; racial minority; randomized controlled design; randomized trial; recruit; response; satisfaction; social; socioeconomics; success; treatment program; underserved community; ward

ABSTRACT African American adults and adults from economically disadvantaged environments are at disproportionate risk for obesity yet are markedly underrepresented in traditional weight management trials and experience lower weight losses relative to their white and socioeconomically advantaged counterparts. Developing sustainable, community-based behavioral interventions to address the national obesity crisis is critical in order to mitigate the alarmingly poor health outcomes faced by underserved populations. Indeed, initiation and maintenance of healthy lifestyle behaviors presents unique challenges in underserved, economically disadvantaged communities, but traditional behavioral weight management delivery models largely disregard the social and cultural assets which exist within these community settings. Moreover, previously tested community-based interventions have not fully harnessed the potential of community members as agents of change within their social networks. Thus, the overall objective of this proposal is to test the feasibility, acceptability and preliminary effectiveness of a grassroots intervention delivery model which includes training community members to recruit and retain members of their social network and to deliver an evidence-based lifestyle intervention to reduce adiposity and improve cardiometabolic risk. The specific aims are: 1) to test the feasibility and acceptability of using house chats (home-based, peer-led focused discussions) as a model for intervention implementation in a real-world, community-based setting; and 2) to assess the preliminary effectiveness of the house chat intervention model for promoting change in behavioral (physical activity, diet) and physical (adiposity, fasting glucose, blood pressure) markers of cardiometabolic risk at post-treatment (12 weeks) and follow up (24 weeks); and 3) to systematically evaluate—using a mixed methods approach—the facilitators and barriers to sustainability of this model. The proposed pilot trial will utilize a group randomized controlled design wherein participants are assigned by ward to either intervention or delayed intervention control. A total of 10 house chat leaders (HCL) will be recruited and trained (5 HCL in each condition). HCL will recruit members of their social network (N=80, 18- 70 years of age) to participate in an 12-week lifestyle intervention delivered via weekly group meetings in the house chat leaders’ homes. In-person assessment visits will be conducted by masked research staff at 0, 12 weeks (post-treatment) and 24 weeks (follow-up). Satisfaction will be assessed in-person at 12 weeks (post- treatment) only via surveys and an exit interview. Facilitators and barriers to sustainability will be assessed via a mix of in-depth interviews (with house chat leaders), focus groups (with participants) and surveys (with both) at 24 weeks. The proposed intervention delivery model, which draws on community assets and builds capacity, could offer a viable approach to improve health outcomes for an underserved population. This pilot trial will provide the first evidence of feasibility and preliminary effectiveness, which will make a meaningful contribution to the field and inform a larger trial.

抽象的 非裔美国成年人和来自经济不利环境的成年人面临着不成比例的风险 肥胖症患者在传统体重管理试验中的代表性明显不足，并且经验较低 相对于白人和社会经济优势的体重减轻。 以社区为基础的行为干预措施解决全国肥胖危机对于缓解肥胖危机至关重要 事实上，服务不足的人群面临着令人震惊的不良健康结果。 健康的生活方式行为对服务不足、经济弱势群体提出了独特的挑战 社区，但传统的行为体重管理实施模式在很大程度上忽视了社会和 此外，先前测试过的基于社区的文化资产。 干预措施尚未充分发挥社区成员作为其内部变革推动者的潜力 因此，该提案的总体目标是测试可行性、可接受性和初步性。 基层干预实施模式的有效性，包括培训社区成员招募 并保留其社交网络的成员，并提供基于证据的生活方式干预，以减少 肥胖和改善心脏代谢风险的具体目标是：1）测试可行性和可接受性。 使用家庭聊天（以家庭为基础、由同伴主导的集中讨论）作为在社区中实施干预的模式 现实世界、基于社区的环境；2) 评估家庭聊天干预的初步效果 促进行为（身体活动、饮食）和身体（肥胖、空腹血糖、血糖）改变的模型 压力）治疗后（12 周）和随访（24 周）时心脏代谢风险的标志物；以及 3） 使用混合方法系统地评估这一可持续发展的促进因素和障碍 拟议的试点试验将采用分组随机对照设计，其中参与者是 由病房分配进行干预或延迟干预控制 总共 10 名家庭聊天领导者 (HCL)。 将招募和培训（每种情况 5 个 HCL）将招募其社交网络的成员（N=80, 18-）。 70 岁）参加为期 12 周的生活方式干预，通过每周小组会议在 家庭聊天领导者的家中将由蒙面的研究人员于 0 点、12 点进行现场评估访问。 周（治疗后）和 24 周（随访）将在 12 周（治疗后）亲自评估满意度。 仅通过调查和退出访谈来评估可持续发展的促进因素和障碍。 深度访谈（与家庭聊天领导者）、焦点小组（与参与者）和调查（两者）相结合， 拟议的干预实施模式利用社区资产并建设能力， 该试点试验将提供一种可行的方法来改善服务不足的人群的健康状况。 提供可行性和初步有效性的第一个证据，这将做出有意义的贡献 到现场并为更大规模的试验提供信息。