Native American Youth Cardiovascular Disease Prevention: Implementation of Culturally-Tailored Evidence-Based After School and Home Visitation Programs for Healthy Eating and Physical Activity

美国原住民青少年心血管疾病预防：实施基于文化的循证课后和家访计划，以促进健康饮食和体育活动

• 批准号: 10437213
• 负责人: SIMONE A. FRENCH
• 金额: $ 72.12万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10437213
• 关键词: Address; Adoption; American Indians; Behavior; Behavioral; Cardiovascular Diseases; Chronic Disease; Cities; Communities; Conscious; Consensus; Diabetes Mellitus; Diet; Dose; Education; Educational Curriculum; Effectiveness; Environment; Evaluation; Evidence based intervention; Evidence based program; Family; Food; Future; Goals; Health Personnel; Health Priorities; Healthy Eating; Home visitation; Hypertension; Individual; Intervention; Leadership; Level of Evidence; Low income; Maintenance; Measurement; Mentors; Minnesota; Modeling; Native Americans; Obesity; Outcome; Physical activity; Primary Health Care; Process; Program Sustainability; Public Health; Race; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Design; Research Personnel; Resources; Risk Factors; Schools; Scientist; Self Determination; Site; Social Work; Structural Racism; Structure; System; Training; Training Support; Twin Multiple Birth; Universities; Work; Youth; after-school program; base; cardiometabolic risk; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; care systems; community based participatory research; community burden; community clinic; effectiveness evaluation; ethnic minority population; evidence base; experience; implementation fidelity; implementation intervention; implementation outcomes; implementation process; implementation science; implementation strategy; implementation trial; innovation; personalized approach; poor communities; prevent; programs; racial and ethnic; racism; school district; service providers; social; social exclusion; social health determinants; socioeconomics; tool; uptake; urban Native American; youth sports

PROJECT SUMMARY – Project 3 Urban Native American communities experience significant and persistent disparities in cardiovascular diseases, obesity and diabetes, and their preventable behavioral precursors, diet and physical activity. This study implements two multi-level evidence-based interventions (EBIs) Minnesota NET-Works and Stanford GOALS in partnership with six American Indian after school programs and community-serving organizations in the Minneapolis, St Paul and Duluth Minnesota. Adoption and maintenance of these programs can be enhanced and effectiveness strengthened through a structured, evidence-based participatory approach that tailors the interventions to meet the cultural, organizational contextual, and broader socioeconomic context and incorporates local innovations. This proposal is poised to achieve these goals through a community-based participatory research (CBPR).Coalition including the healthcare provider Minneapolis Native American Community Clinic (NACC, primary care system), Minneapolis and St Paul and Duluth Minnesota School Districts' Indian Education after school programs (school system), the social service provider Division of Indian Work's Family Spirit Home Visitation program (social service provider system), departments of public health and University of Minnesota researchers. The Coalition will use the evidence-based 10-step Getting to Outcomes (GTO) tailoring and implementation approach to enhance implementation fidelity, reach and acceptance, and sustainability among the after school programs and community-serving organizations. Native American organization leadership and program delivery staff will receive mentoring and training in the tailored EBI curricula and in effective implementation strategies. Implementation strategy effectiveness will be assessed using a stepped wedge study design. The study uses the Social Ecological Model as its multilevel intervention framework, and RE-AIM as its implementation process evaluation measurement framework. Implementation outcomes include organizational leadership support, staff implementation capacity, and intervention fidelity (program reach, intervention content, delivery, receipt and dose). An important innovative aspect of the proposed research is its use of evidence-based implementation strategies to strengthen the capacity of the programs and staff to implement the interventions with broad reach, high participation, and strong fidelity by aligning with local culture and context. The proposed project will use proven effective implementation strategies to build program organizational leadership and program delivery staff implementation capacity to successfully engage urban Native American families in strengths-based, culturally- grounded programs to promote youth physical activity and healthy eating. Sustained program engagement among urban Native American families will promote healthy eating and physical activity behaviors that will reduce future cardiovascular disease risk in this highly burdened community.

项目摘要 - 项目3 美洲原住民社区在心血管中经历了巨大和持续的差异 疾病，肥胖和糖尿病及其可预防的行为前体，饮食和身体活动。这 研究实施了两种多层循证干预措施（EBIS）明尼苏达州网络和斯坦福大学 与六个美洲印第安人课后计划和社区服务组织合作的目标 明尼阿波利斯，圣保罗和德卢斯明尼苏达州。这些程序的采用和维护可能是 通过一种结构化的，基于证据的参与方法增强和有效性 调整干预措施，以满足文化，组织环境和更广泛的社会经济背景和 合并本地创新。该建议被毒死以通过社区以社区为目标 参与研究（CBPR）。包括医疗保健提供者明尼阿波利斯美洲原住民 社区诊所（NACC，初级保健系统），明尼阿波利斯和St Paul和Duluth Minnesota学校 地区的印度教育课后课程（学校系统），印度社会服务提供商部门 工作的家庭精神家庭探视计划（社会服务提供商系统），公共卫生部门 明尼苏达大学的研究人员。联盟将使用基于证据的10步到 结果（GTO）裁缝和实施方法，以增强实施忠诚度，覆盖范围和 接受和可持续性的课程课程和社区服务组织之间的可持续性。本国的 美国组织的领导力和计划交付人员将在量身定制的 EBI课程和有效的实施策略。实施策略有效性将是 使用阶梯楔形研究设计进行评估。该研究使用社会生态模型作为其多层次 干预框架，并将其作为其实施过程评估测量框架。 实施成果包括组织领导力支持，员工实施能力以及 干预保真度（计划范围，干预内容，交付，收据和剂量）。重要的创新 拟议研究的方面是使用基于证据的实施策略来加强 计划和工作人员的能力以广泛的影响，高参与和 通过与当地文化和环境保持一致，坚定不移。拟议的项目将有效地使用 实施策略以建立计划组织领导和计划交付人员 实施能力成功地使城市原住民家庭参与基于优势的，文化 - 扎根于促进青年体育锻炼和健康饮食的计划。持续的计划参与 在美国原住民家庭中，将促进健康的饮食和体育锻炼行为 在这个高度燃烧的社区中，减少未来的心血管疾病风险。