Tribal Health and Resilience in Vulnerable Environment (Thrive) Study

脆弱环境中的部落健康和复原力（繁荣）研究

• 批准号: 9265918
• 负责人: Valarie Blue Bird Jernigan
• 金额: $ 60.42万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-15 至 2019-03-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9265918
• 关键词: Address; Adult; Behavioral Risk Factor Surveillance System; Beverages; California; Choctaw Nation of Oklahoma; Chronic Disease; Clinic; Clinical; Communities; Computerized Medical Record; Cross-Sectional Studies; Data; Development; Diabetes Mellitus; Diet and Nutrition; Dietary intake; Educational Materials; Electronic Health Record; Environment; Ethnic group; Evaluation; Food; Health; Health Food; Health behavior; Height; Household; Hypertension; Individual; Intake; Intervention; Knowledge; Link; Malignant Neoplasms; Manuals; Measures; Methods; Montana; Multimedia; Native Americans; Obesity; Oklahoma; Online Systems; Outcome; Patient Self-Report; Perception; Pilot Projects; Policy Maker; Population; Price; Process; Randomized; Recommendation; Records; Registries; Research Methodology; Research Personnel; Reservations; Resources; Rural; Sales; Sampling; Subgroup; Surveys; Telephone; Time; Tribes; Update; Voice; Weight; aged; base; community planning; density; design; evidence base; fast food; food environment; food security; fruits and vegetables; improved; innovation; non-Native; nutrition; obesity risk; open source; public health relevance; racial and ethnic; resilience; success; tribal Nation; tribal community; tribal health; tribal member; web site

DESCRIPTION (provided by applicant): Background: Food insecurity increases one's risk for obesity, diabetes, hypertension, and cancer (via its links to poor diet and nutrition), conditions highly prevalent among Native Americans in Oklahoma (obesity 42%, diabetes 15%, and hypertension 38%).1 Our pilot study shows that 3 times as many Natives in Oklahoma are food insecure as Whites (21.3% vs. 7.3% respectively).2 Yet few or no studies have assessed individual- and environmental-level correlates of food insecurity among Natives and none have developed interventions or broad-based educational materials within Oklahoma tribal nations.3,4 Aims and Methods: This study, led by a Native American Choctaw Investigator will, Aim #1: Assess correlates (sociodemographics, health behaviors, perceived food environment) and outcomes (dietary intake including vegetables and fruits, BMI, diabetes, and hypertension) of food insecurity in the Chickasaw and Choctaw nations in Oklahoma. A telephone survey will be administered to 500 Native American adults (18+) randomly sampled from tribal registries. Clinical measures will be validated for 200 of those surveyed using tribal clinic electronic health records. Perceptions of food environments will be compared to objective store measures using GIS data. Aim #2: Design, implement, and evaluate a convenience store intervention to increase the availability and intake of vegetables and fruits among tribal members. Using a cluster-randomized design with 20 matched tribally owned convenience stores (5 cases and 5 controls in each tribe), we will implement evidence-based strategies (increased availability and variety, point of purchase information, reduced prices/coupons) to increase the sales and intake of vegetables and fruits among tribal members. Store-level changes will be measured by pre/post sales records and the Nutrition Environment Measures Survey; individual-level changes by two cross-sectional surveys, administered to 300 convenience store shoppers before and 300 shoppers after the intervention. Tribal members will use video voice,3 an action-oriented participatory media research method to collect qualitative and environmental data (e.g. types of foods/beverages sold and promoted in the convenience stores) to facilitate community planning and channel recommendations to policy makers. Aim #3: Create a multimedia manual, co-developed with tribal members, guiding tribes in food environment changes, and disseminated over a free and open source Website allowing for tribal user- created content. Innovation: Each of the 3 aims builds on our preliminary data and/or best practices, and leverages tribal resources and partnerships to enhance survey participation rates and convenience store "healthy makeovers." Significance and Impact: The knowledge from surveys on food insecurity correlates and health outcomes will inform the design of the convenience store intervention to increase availability of vegetables and fruits. The resulting multimedia manual will guide food environment changes among tribes nationally to address the critically high rates of obesity, diabetes, and hypertension within this population.

描述（由申请人提供）：背景：粮食不安全增加肥胖，糖尿病，高血压和癌症的风险（通过其与饮食不良和营养的联系），俄克拉荷马州原住民中美洲原住民的状况高度普遍（肥胖42％，糖尿病42％，糖尿病，糖尿病，15％和高血压38％。 (21.3% vs. 7.3% respectively).2 Yet few or no studies have assessed individual- and environmental-level correlates of food insecurity among Natives and none have developed interventions or broad-based educational materials within Oklahoma tribal nations.3,4 Aims and Methods: This study, led by a Native American Choctaw Investigator will, Aim #1: Assess correlates (sociodemographics, health behaviors, perceived food environment) and奇卡索和俄克拉荷马州choctaw国家的饮食不安全感的结果（包括蔬菜和水果，BMI，糖尿病和高血压）的结果（饮食摄入量）。将对从部落注册机构随机取样的500名美国原住民成年人（18岁以上）进行电话调查。使用部落诊所电子健康调查的人中有200名临床指标将得到验证 记录。使用GIS数据将对食物环境的看法与目标存储措施进行比较。目标＃2：设计，实施和评估便利店的干预措施，以增加部落成员中蔬菜和水果的供应和摄入。我们将使用20家匹配的部落拥有的便利店（每个部落中的5个案例和5个控件）的群集设计设计，我们将实施基于证据的策略（增加的可用性和多样性，购买信息，降低价格/优惠券），以增加部落成员中蔬菜和水果的销售和摄入量。商店级别的变化将通过销售前/后销售记录和营养环境测量调查来衡量；单个级别的横截面调查更改，在干预后对300家便利店购物者和300个购物者进行了更改。部落成员将使用视频语音，3一种面向动作的参与媒体研究方法来收集定性和环境数据（例如，在便利店中出售和促销的食品/饮料类型）来促进社区规划，并向政策制定者提供建议。 AIM＃3：创建一个多媒体手册，与部落成员共同开发，指导部落在食品环境中发生变化，并在免费的开源网站上传播，以允许部落用户创建的内容。创新：三个目标中的每一个都以我们的初步数据和/或最佳实践为基础，并利用部落资源和伙伴关系来提高调查参与率和便利店“健康改头换面”。意义和影响：调查对粮食不安全相关和健康成果的知识将为便利店干预的设计提供信息，以增加蔬菜和水果的可用性。由此产生的多媒体手册将指导全国部落之间的食品环境变化，以解决该人群中肥胖，糖尿病和高血压的严重率。