Exploring Food Insecurity and Pilot Testing a Diabetes Nutrition Education Program and Healthy Food Access Service for American Indian and Alaska Native Adults with Type 2 Diabetes

探索粮食不安全并为患有 2 型糖尿病的美洲印第安人和阿拉斯加原住民成年人试点测试糖尿病营养教育计划和健康食品获取服务

• 批准号: 10183754
• 负责人: Sarah A Stotz
• 金额: $ 14.83万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10183754
• 关键词: Address; Adult; Alaska Native; American Indians; Area; Behavior; Beverages; Biometry; Blood Glucose; Blood Pressure; Body Weight; Body mass index; Caring; Cities; Clinic; Clinical; Clinical Trials; Colorado; Communities; Data; Data Analyses; Data Collection; Data Set; Development; Diabetes Mellitus; Diabetic Diet; Dietary Intervention; Eating; Educational Curriculum; Educational workshop; Effectiveness; Environment; Environmental Pollution; Evidence based intervention; Farming environment; Food; Food Access; Foundations; Funding; Gardenal; Glycosylated hemoglobin A; Goals; Habits; Health; Health Food; Healthcare; Healthy Eating; Household; Intake; International; Intervention; Intervention Studies; Knowledge; Life; Measures; Medical; Mentored Research Scientist Development Award; Mentors; Methodology; Methods; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Oklahoma; Outcome; Participant; Pilot Projects; Population; Positioning Attribute; Poverty; Problem Solving; Process; Public Health; Randomized; Research; Research Design; Research Methodology; Research Personnel; Research Support; Rural Community; Science; Secure; Self Efficacy; Services; Site; Sodium; Strategic Planning; Surveys; Testing; Time; Training; Transportation; Universities; Waiting Lists; Water; Work; career; career development; design; diabetes education; diabetes management; diabetes self-management; effective intervention; effectiveness trial; experience; farmer; fast food; food insecurity; food security; good diet; health disparity; improved; intervention participants; learning strategy; novel; nutrition; nutrition education; portion control; pragmatic trial; programs; saturated fat; secondary analysis; skills; social health determinants; symposium; therapy design; urban Native American; urban area

PROJECT SUMMARY / ABSTRACT Healthy nutrition habits are key to managing type 2 diabetes (T2D). However, American Indian and Alaska Natives (AI/ANs) often lack access to healthy food and disproportionately experience food insecurity. Food insecurity, defined as lack of consistent access to enough food for an active, healthy life, negatively impacts one’s ability to manage blood sugar and body weight. I am pursuing a K01 Mentored Research Scientist Development Award to fill critical training gaps in the areas of quantitative data analysis of intervention studies and effectiveness and pragmatic study design. In order to effectively bridge my prior training and research experience to obtain my first R01, I have carefully developed a mentored training plan that strategically supports my research aims for this K01 award. I am currently Co-Investigator on a study team that developed a culturally responsive diabetes nutrition education curriculum for AI/AN adults with T2D, entitled “What Can I Eat? Healthy Choices for AI/ANs with T2D” (WCIE). WCIE includes interactive, hands-on nutrition education learning activities, including portion control, decreasing sugary beverages and saturated fat, and problem solving for barriers to healthful eating. In January 2020 we launched a tribally-supported, 6-site, waitlist control design test of WCIE. In June 2021, we will complete data collection with 150 AI/AN adults who have T2D. Data will include 3 timepoints for immediate intervention and 5 for waitlist intervention participants over 6 months with surveys (nutrition knowledge, behavior, self-efficacy) and clinical outcomes (BMI, blood pressure, and HbA1c). Though WCIE does not include a specific food insecurity intervention, we included a household food insecurity measure at all data collection timepoints. In Aim #1 of this proposed K01 I will examine the relationship between food insecurity and clinical WCIE outcomes in the existing dataset through secondary analysis to utilize my new intervention quantitative data analysis skills and advance understanding of the moderating effect of food insecurity on diabetes nutrition education and T2D outcomes among AI/ANs. In Aim #2 I will design/pilot test WCIE with added service to improve healthy food access and evaluate its feasibility/impact on T2D outcomes at an urban AI/AN- serving clinic in Oklahoma City, OK. We will work with the Oklahoma City clinic to identify their need for a healthy food access service in the following domains: transportation, availability of healthy food, or affordability of healthy food. Aim #2 will provide me the opportunity to utilize my new training in effectiveness and pragmatic trials study design and quantitative data analysis of intervention studies. My detailed training plan includes formal coursework at the University of Colorado Anschutz Medical Campus, seminars, workshops/conferences on AI/AN health research, and support from my mentors who are experts and leaders in the area of AI/AN diabetes health, AI/AN health interventions, T2D and food insecurity interventions, and quantitative/study design methodology. The proposed training plan and aims will provide me with a set of skills and expertise needed to successfully obtain R01 funding and become a leader in diabetes health disparities intervention science.

项目摘要 /摘要 健康的营养习惯是管理2型糖尿病的关键（T2D）。 当地人（AI/ANS）通常缺乏获得健康食品的机会，并且会遭受粮食不安全。 不安全感，被定义为无法持续获得足够的食物来实现活跃，健康的生活，负面影响 一个人管理血糖和体重的能力。 填补国际研究定量数据分析领域的关键培训差距的发展奖 有效且务实的研究设计。 获得第一个R01的经验，我仔细地制定了一个指导的培训计划 我的研究旨在获得K01奖。 AI/一个具有T2D的成年人的反应型糖尿病的糖尿病课程，标题为“我可以吃什么？健康健康健康的健康。 使用T2D的AI/ANS的选择”（WCIE）。WCIE包括互动性的，动手的教育活动， 包含部分控制，减少含糖饮料和饱和脂肪以及障碍的问题解决方案 健康的饮食。2020年1月，我们推出了一个由部落支持的6个站点的候补控制设计测试。 在2021年6月，我们将与150个具有T2D的成年人一起完成数据收集。 立即干预，5个候补干预参与者在6个月内进行调查（营养 知识，行为，自我效能）和临床结果（BMI，血压和HBA1C） 不包括特定的食品研究所干预措施，我们在所有数据上都包括家庭食品食品不安全 收集时间点。 通过二级分析，封装数据集中的临床WCIE结果利用我的新国际 定量数据分析技能并提高对主持的Ofect Ofod不安全感的理解 AI/ANS中的糖尿病和结果。 服务以改善健康食品的获取并评估其对城市AI/AN-的T2D结果的可行性/影响 在俄克拉荷马城服务诊所，我们将在俄克拉荷马州诊所工作 以下领域的食品访问服务：运输，健康食品的可用性或健康的可负担性 食物2。 我的详细培训计划的设计和定量数据分析 科罗拉多大学安索斯大学医学校园的课程工作，研讨会，讲习班/会议 AI/A/A Health研究，以及我的导师的支持，他们是AI/A AN糖尿病领域的专家和领导者 健康，人工智能/健康干预措施，T2D和粮食不安全以及定量/研究设计 方法论。 成功获得R01资金，并vecome是糖尿病健康领域的领导者。