Wellness Program Implementation: School & Student Toolkits

健康计划实施：学校

基本信息

批准号：
8909129
负责人：
JUDITH WYLIE-ROSETT
金额：
$ 5.62万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-01 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8909129
关键词：
Achievement Action Research Address Adolescence Adolescent Adoption Behavior Behavioral Beverages Body mass index Chronic Disease Cluster randomized trial Communities Complex Crowding Decision Making Development Diet Education Educational Curriculum Effectiveness Electronic Mail Elements Enrollment Ensure Environment Equipment Evaluation Exercise Food Services Foundations Frequencies Fruit Generations Goals Guidelines Habits Health Health behavior Healthy People 2020 High School Student Home environment Hour Individual Institutes Intake Intervention Life Style Maintenance Methods Modeling Motivation New York City Obesity Outcome Output Pattern Physical Education Physical activity Policies Process Randomized Recommendation Research Resources School Teachers Schools Self Efficacy Students System Testing Text Time Training Programs Underrepresented Minority Weight Gain Wellness Program Youth base cost design empowered evidence base fast food fruits and vegetables healthy lifestyle high school improved member models and simulation nutrition obesity prevention prevent programs response sedentary simulation social trial design

项目摘要

DESCRIPTION (provided by applicant): This application, in response to PAR 10-038, will evaluate of an implementation model that engages high school students in Wellness Council planning to achieve obesity-related health recommendations. The implementation planning will apply a participatory action research approach to empower students as stakeholders and to facilitate collaborative planning by school Wellness Councils, facilitated and supported by the HealthCorps coordinators. To facilitate achievement of the 2010 Dietary Guidelines, we will implement a process to enable schools to select toolkit strategies and elements from evidence-based curricula (e.g., Physical Activity for Teenage Health (PATH), which includes implementation strategies using low-cost resources). The 2010 Dietary Guidelines obesity-related behavioral recommendations for youth include: decreasing sugary beverage intake; increasing frequency of breakfast; increasing vegetable and fruit intake to 2 1/2 cups per day with "fill half your plate with fruit and veggies" educational message; decreasing frequency of fast food meals; becoming physically active (goal of 1 hour per day); and reducing sedentary behavior time (<2 hour day). The social ecological framework provides the foundation for a two-tiered integrative approach which addresses barriers faced by the school (micro-environmental level) and by the students (individual level). At the school level, implementation barriers will be identified by (or brought to) the school Wellness Councils (e.g., crowded gym, lack of equipment, food service issues) using a toolkit approach patterned after the Alliance for a Healthier Generation school toolkits. At the student level, the toolkit will focus on barriers to implementation of lifestyle changes. Options for the student toolkit include tailored student support via social media e.g., Facebook, text message or email to address common internal barriers, such as self-efficacy and motivation, and external barriers in the home, school and community environment. Using a stepped wedge cluster randomized trial design to roll out testing of the participatory implementation model, we will randomly select from among the NYC HealthCorps high schools each year. This design will allow us to assess the impact of wellness programming on students, in relation to their school environment. To evaluate how our participatory implementation model addresses wellness barriers in diverse, complex school settings, we will employ system dynamics modeling (SDM). This method will synthesize both quantitative and qualitative assessment results into simulation output that will show the process by which wellness programming is adapted and sustained over the intervention period. We hypothesize that students in the participatory implementation schools will achieve better dietary and physical activity health habits than students in waitlisted HealthCorps control schools. Secondary hypothesis, students will achieve key health behaviors after their NYC HealthCorps school is randomized to participatory implementation compared to students in the waitlisted HealthCorps control schools; Tertiary hypothesis: Using system dynamics modeling to evaluate implementation will facilitate more robust dissemination. The simulation analysis will apply the RE-AIM framework: (Reach (participation rates), effectiveness (outcomes), adoption (acceptability), implementation (intervention fidelity), and maintenance (sustainability of lifestye changes by students and programs by schools).

描述（由申请人提供）：本申请响应 PAR 10-038，将评估一个实施模型，该模型让高中生参与健康委员会规划，以实现与肥胖相关的健康建议。实施规划将采用参与性行动研究方法，使学生成为利益相关者，并在 HealthCorps 协调员的推动和支持下，促进学校健康委员会的协作规划。为了促进实现 2010 年膳食指南，我们将实施一个流程，使学校能够从循证课程中选择工具包策略和要素（例如，青少年健康体育活动 (PATH)，其中包括使用低成本资源的实施策略）。 2010 年膳食指南针对青少年肥胖相关行为的建议包括：减少含糖饮料的摄入量；增加早餐的频率；将蔬菜和水果的摄入量增加到每天 2 1/2 杯，并传达“用水果和蔬菜填满盘子的一半”的教育信息；减少吃快餐的频率；积极锻炼身体（目标是每天 1 小时）；减少久坐行为时间（每天<2 小时）。社会生态框架为解决学校（微环境层面）和学生（个人层面）面临的障碍的两层综合方法提供了基础。在学校层面，实施障碍将是由学校健康委员会使用以健康一代联盟学校工具包为模式的工具包方法来识别（或提交给）学校健康委员会（例如，拥挤的健身房、缺乏设备、食品服务问题）。在学生层面，该工具包将重点关注实施生活方式改变的障碍。学生工具包的选项包括通过社交媒体（例如 Facebook、短信或电子邮件）提供量身定制的学生支持，以解决常见的内部障碍（例如自我效能和动机）以及家庭、学校和社区环境中的外部障碍。我们将使用阶梯式楔形集群随机试验设计来推出参与式实施模型的测试，每年我们将从纽约市 HealthCorps 高中中随机选择。这种设计将使我们能够评估健康规划对学生及其学校环境的影响。为了评估我们的参与式实施模型如何解决多样化、复杂的学校环境中的健康障碍，我们将采用系统动力学建模 (SDM)。该方法将定量和定性评估结果合成为模拟输出，该输出将显示在干预期间调整和维持健康规划的过程。我们假设参与式实施学校的学生将比列入候补名单的 HealthCorps 控制学校的学生养成更好的饮食和身体活动健康习惯。第二个假设，与列入候补名单的 HealthCorps 对照学校的学生相比，在纽约市 HealthCorps 学校被随机分配为参与式实施后，学生将实现关键的健康行为；第三假设：使用系统动力学模型来评估实施将有助于更稳健的传播。模拟分析将应用 RE-AIM 框架：（覆盖率（参与率）、有效性（结果）、采用（可接受性）、实施（干预保真度）和维护（学生生活方式改变和学校项目的可持续性）。