Wellness Program Implementation: School & Student Toolkits

健康计划实施：学校

• 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
• 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

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）：该申请响应于第10-038杆套餐，将评估一种实施模型，该模型与高中生的健康委员会计划一起计划，以实现与肥胖相关的健康建议。实施计划将采用参与式行动研究方法，以使学生成为利益相关者的能力，并促进学校健康委员会的合作计划，并在HealthCorps协调员的支持和支持下。为了促进2010年饮食指南的实现，我们将实施一个过程，使学校能够从基于证据的课程中选择工具包策略和要素（例如，青少年健康（PATH）的体育活动（PATH），其中包括使用低成本资源实施策略）。 2010年饮食指南与肥胖相关的青年行为建议包括：减少含糖饮料的摄入量；早餐的频率增加；每天将蔬菜和水果摄入量增加到2 1/2杯，并用“用水果和蔬菜填充一半的盘子”教育信息；快餐量的频率降低；变得活跃（每天1小时的目标）；并减少久坐行为时间（<2小时的一天）。社会生态框架为两层综合方法奠定了基础，该方法解决了学校面临的障碍（微环境层面）和学生（个人层面）。在学校一级，实施障碍将是 由（或带到）学校健康委员会（例如拥挤的健身房，缺乏设备，餐饮服务问题）确定，使用工具包的方法在联盟联盟之后为更健康的学校工具包制定。在学生一级，工具包将集中于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量身定制的学生支持，例如Facebook，短信或电子邮件，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。使用阶梯楔形群集随机试验设计来推出参与式实施模型的测试，我们将每年从NYC Healthcorps高中中随机选择。这种设计将使我们能够评估健康计划对他们的学校环境的影响。为了评估我们的参与实施模型如何解决各种复杂的学校环境中的健康障碍，我们将采用系统动态建模（SDM）。该方法将将定量和定性评估结果综合为模拟输出，这将显示在干预期间对健康编程进行调整和维持的过程。我们假设参与式实施学校的学生将获得比候补名单中的医疗服务学校的学生更好的饮食和体育锻炼习惯。次要假设，与候补名单的Healthcorps控制学校相比，学生将其NYC HealthCorps学校随机实现参与式实施后，将实现关键的健康行为；三级假设：使用系统动力学建模来评估实施将有助于更强大的传播。模拟分析将应用RE-AIM框架：（接触率（参与率），有效性（结果），采用（可接受性），实施（干预保真度）和维护（学生和学校计划的生活方式变化的可持续性）。