Obesity Clinical Trial
Official title:
Project Diabetes: Weight Gain Prevention in Hispanic Girls (GEMAS Study)
Over the past 30 years obesity has reached epidemic proportions in the United States (Ogden
et al, 2006). While this epidemic affects all socioeconomic levels, certain racial/ethnic
groups such as Hispanics, are disproportionately affected by obesity and diabetes. The age
of onset of excess obesity in Hispanic females, formerly young adulthood, is now younger.
Childhood obesity poses intermediate and long-term health risks, including: type 2 diabetes,
hyperlipidemia, elevated blood pressure, and metabolic syndrome. Although biological factors
may influence a child's risk for becoming overweight, the home environment has been shown to
be a predisposing and reinforcing contextual factor for unhealthy eating and exercise
behaviors. Since parents are the primary transmitters of Hispanic cultural practices and
significantly influence their children's diet and physical activity behaviors from preschool
through high school, family-based weight-gain prevention interventions are likely to be
effective.
The goal of this implementation study is to contribute to the reduction of racial/ethnic
disparities in obesity and risk of type 2 diabetes by tailoring a recently successful
childhood obesity prevention program originally developed for African American girls to
implement and evaluate with preadolescent Hispanic girls.
Over the past 30 years obesity has reached epidemic proportions in the United States (Ogden
et al, 2006). While this epidemic affects all socioeconomic levels, certain racial/ethnic
groups such as Hispanics, are disproportionately affected by obesity and diabetes. The age
of onset of excess obesity in Hispanic females, formerly young adulthood, is now younger.
Childhood obesity poses intermediate and long-term health risks, including: type 2 diabetes,
hyperlipidemia, elevated blood pressure, and metabolic syndrome (Goran et al 2003; Hale and
Rupert, 2006). Although biological factors may influence a child's risk for becoming
overweight, the home environment has been shown to be a predisposing and reinforcing
contextual factor for unhealthy eating and exercise behaviors (Arredondo et al, 2006).
Two recent empirical reviews of childhood obesity interventions demonstrated the increased
effectiveness of family-based approaches (Kitzmann and Beech, 2006; Summerbell et al, 2007).
Since parents are the primary transmitters of Hispanic cultural practices and significantly
influence their children's diet and physical activity behaviors from preschool through high
school (Snethen et al, 2007), family-based weight-gain prevention interventions are likely
to be effective. The sociocultural context of Hispanic girls involves a much higher degree
of interdependence among family members in Hispanic compared to White families (Schwartz,
2007). In addition to family-based approaches to pediatric obesity prevention,
culturally-relevant and community-based participatory approaches have been strongly
recommended by the Institute of Medicine (IOM) and the Strategic Plan for NIH Obesity
Research (NIH, 2004:25).
The goal of this implementation study is to contribute to the reduction of racial/ethnic
disparities in obesity and risk of type 2 diabetes by tailoring a recently successful
childhood obesity prevention program originally developed for African American girls to
implement and evaluate with preadolescence Hispanic girls. This project will be a
collaborative, participatory community-academic partnership between Vanderbilt University
Medical Center (VUMC), Tennessee State University (TSU) Center for Health Research, Meharry
Medical College, Progreso Community Center (PCC) and the Nashville Latino Health Coalition
(NLHC). Specifically, the childhood obesity prevention program called Girl's health
Enrichment Multi-site Studies (GEMS) will be tailored to be culturally-appropriate and
piloted in the Hispanic/Latino community in Nashville/Davidson County, Tennessee. Dr.
Bettina Beech led the development of the original GEMS intervention, which was developed and
pilot-tested in Memphis, Tennessee (Beech et al, 2003). We have assembled a
multi-disciplinary team with expertise in pediatric obesity (Drs. Beech, Barkin, and Cook),
type 2 diabetes (Dr. Tom Elasy), community-based participatory research (Drs. Beech, Barkin,
Hull), Hispanic culture (Drs. Hull and Zoorob, PCC), and community engagement (NLHC, PCC,
and Drs. Beech and Hull).
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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