Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.
Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, United States.
Contemp Clin Trials. 2016 Mar;47:22-31. doi: 10.1016/j.cct.2015.12.004. Epub 2015 Dec 4.
US immigrants often have escalating cardiovascular risk. Barriers to optimal physical activity and diet have a significant role in this risk accumulation.
We developed a physical activity and nutrition intervention with immigrant and refugee families through a community-based participatory research approach. Work groups of community members and health scientists developed an intervention manual with 12 content modules that were based on social-learning theory. Family health promoters from the participating communities (Hispanic, Somali, Sudanese) were trained to deliver the intervention through 12 home visits during the first 6 months and up to 12 phone calls during the second 6 months. The intervention was tested through a randomized community-based trial with a delayed-intervention control group, with measurements at baseline, 6, 12, and 24 months. Primary measurements included accelerometer-based assessment of physical activity and 24-hour dietary recall. Secondary measures included biometrics and theory-based instruments.
One hundred fifty-one individuals (81 adolescents, 70 adults; 44 families) were randomized. At baseline, mean (SD) time spent in moderate-to-vigorous physical activity was 64.7 (30.2) minutes/day for adolescents and 43.1 (35.4) minutes/day for adults. Moderate dietary quality was observed in both age groups. Biometric measures showed that 45.7% of adolescents and 80.0% of adults were overweight or obese. Moderate levels of self-efficacy and social support were reported for physical activity and nutrition.
Processes and products from this program are relevant to other communities aiming to reduce cardiovascular risk and negative health behaviors among immigrants and refugees.
This trial was registered at Clinicaltrials.gov (NCT01952808).
美国移民的心血管风险通常逐渐上升。在这种风险积累中,身体活动和饮食方面的障碍起着重要作用。
我们通过社区参与式研究方法,为移民和难民家庭制定了一项身体活动和营养干预措施。社区成员和健康科学家工作组开发了一本干预手册,其中包含 12 个内容模块,这些模块基于社会学习理论。来自参与社区(西班牙裔、索马里裔、苏丹裔)的家庭健康促进人员接受了培训,以便在最初的 6 个月内通过 12 次家访,以及在随后的 6 个月内通过最多 12 次电话,来提供干预措施。该干预措施通过一项随机社区为基础的试验进行了测试,该试验设有延迟干预对照组,在基线、6、12 和 24 个月时进行测量。主要测量包括基于加速度计的身体活动评估和 24 小时膳食回忆。次要测量包括生物标志物和基于理论的工具。
共有 151 人(81 名青少年,70 名成年人;44 个家庭)被随机分配。在基线时,青少年每天进行中度到剧烈身体活动的平均(SD)时间为 64.7(30.2)分钟,成年人则为 43.1(35.4)分钟。两个年龄组的饮食质量都适中。生物计量测量结果显示,45.7%的青少年和 80.0%的成年人超重或肥胖。身体活动和营养方面的自我效能感和社会支持报告处于中等水平。
该计划的过程和成果与其他旨在减少移民和难民心血管风险和不良健康行为的社区相关。
该试验在 Clinicaltrials.gov 注册(NCT01952808)。