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: 10494238
• 负责人: SIMONE A. FRENCH
• 金额: $ 69.11万
• 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/10494238
• 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; Resource-limited setting; 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; evidence base; experience; implementation fidelity; implementation intervention; implementation outcomes; implementation process; implementation science; implementation strategy; implementation trial; innovation; minority children; personalized approach; prevent; process evaluation; 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 城市美洲原住民社区在心血管方面经历着显着且持续的差异 疾病、肥胖和糖尿病，及其可预防的行为前兆、饮食和身体活动。 研究实施了两项多层次循证干预措施 (EBI) 明尼苏达州 NET-Works 和斯坦福大学 目标与六个美国印第安人课后项目和社区服务组织合作 明尼苏达州明尼阿波利斯市、圣保罗市和德卢斯市可以采用和维持这些计划。 通过结构化、基于证据的参与性方法，提高效率并加强有效性， 调整干预措施以满足文化、组织背景和更广泛的社会经济背景， 该提案旨在通过基于社区的方式实现这些目标。 参与式研究 (CBPR)。联盟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），明尼阿波利斯和圣保罗和德卢斯明尼苏达学校 各地区的印度教育课后计划（学校系统），印度社会服务提供部门 沃克家庭精神家访计划（社会服务提供者系统）、公共卫生部门 和明尼苏达大学的研究人员将使用基于证据的 10 步方法。 成果 (GTO) 定制和实施方法，以提高实施保真度、影响范围和 课后计划和社区服务组织的接受度和可持续性。 美国组织领导和项目交付人员将接受量身定制的指导和培训 EBI 课程和有效的实施策略将是实施策略的有效性。 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，RE-AIM作为其实施过程评价衡量框架。 实施成果包括组织领导支持、员工实施能力和 干预保真度（计划范围、干预内容、实施、接收和剂量）。 拟议研究的一个方面是利用基于证据的实施战略来加强 计划和工作人员实施影响广泛、参与程度高的干预措施的能力 通过与当地文化和环境保持一致，拟议的项目将使用经过验证的有效方法。 建立计划组织领导和计划交付人员的实施战略 成功地让城市美洲原住民家庭参与基于优势、文化的实施能力 促进青少年身体活动和健康饮食的扎根计划。 在城市美国原住民家庭中将促进健康饮食和身体活动行为，这将 降低这个负担沉重的社区未来心血管疾病的风险。