Project Diabetes: Weight Gain Prevention in Hispanic Girls (GEMAS Study)
Condition: Obesity; Diet; Exercise; Behavioral Research
MeSH terms: Weight Gain
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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).
    

Intervention name(s): Active intervention; Alternative Intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 12-week family-based weight gain intervention program focused on dietary intake and physical activity for 8-10 year old Hispanic girls and their parents (N=30 girl-parent dyads).; 12-week alternative intervention addressing self-esteem, for 8-10 year old Hispanic girls and their parents (N=30 girl-parent dyads).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention