Osage Community Supported Agriculture Study (OCSA)

奥塞奇社区支持农业研究 (OCSA)

• 批准号: 10201061
• 负责人: Valarie Blue Bird Jernigan
• 金额: $ 54.4万
• 依托单位: OSU CENTER FOR HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-12 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10201061
• 关键词: Address; Adult; Agriculture; American Indians; Area; Birds; Blood Pressure; Body mass index; Cardiometabolic Disease; Centers for Disease Control and Prevention (U.S.); Child; Chronic Disease; Collaborations; Communities; Congresses; Control Groups; Costs and Benefits; Dependence; Diabetes Mellitus; Diastolic blood pressure; Diet; Disease; Disease Outcome; Education; Employee; Farming environment; Food; Food Access; Food Supply; Food production; Funding; General Population; Glycosylated hemoglobin A; Government; Health; Health Food; Health Status; High Prevalence; Household; Hypertension; Indian reservation; Indigenous; Individual; Institute of Medicine (U.S.); Intake; Intervention; Knowledge; Life; Marketing; Mediating; Methods; Mission; Morbidity - disease rate; Multimedia; Obesity; Oklahoma; Online Systems; Osage; Outcome; Overweight; Participant; Policies; Population; Prevention; Process; Public Health; Randomized; Randomized Controlled Trials; Research; Reservations; Risk Factors; Rural; Savings; Schools; Source; System; Testing; Time; Tribes; Unhealthy Diet; United States; Waiting Lists; aged; base; blood lipid; cardiometabolism; community based participatory research; cooking; cost; cost effectiveness; design; disparity elimination; economic evaluation; efficacy testing; evidence base; experience; fast food; food insecurity; fruits and vegetables; group intervention; health care service utilization; health disparity; health economics; health related quality of life; improved; mortality; nutrition; nutrition education; prevent; primary outcome; programs; recruit; research study; secondary outcome; tribal Nation; tribal community; urban Native American

PROJECT SUMMARY/ABSTRACT The food system is comprised of food production, access, and marketing. Public health efforts have been increasingly focused on food systems given that poor diet is the number one risk factor for preventable disease in the United States. American Indians (AIs) experience substantial diet-related health disparities: AI adults are 50% more likely to be obese, 30% more likely to have hypertension, and twice as likely to have diabetes compared to Whites. In 2013, the Osage Nation in Oklahoma launched Bird Creek Farm (BCF) with the mission to facilitate Indigenous food sovereignty, defined as the right and responsibility of Indigenous peoples to healthy and culturally appropriate foods produced through traditional Indigenous practices. By 2015, BCF had 12 employees and began providing food to tribal programs. In the same year, in collaboration with BCF, our team launched the NIMHD-funded FRESH farm-to-school program (R01MD011266). Preliminary findings from this tribally-driven community-based participatory research (CBPR) study show an increase in vegetable and fruit intake among children and adults and a decrease in food insecurity. Building upon our eight-year CBPR partnership, the proposed study will implement a new community supported agriculture (CSA) program in which Osage citizens will receive a weekly share of freshly grown farm produce for 6 months. CSAs have improved diet and health in non-AI populations, and are evidence-based strategies recommended by the Centers for Disease Control and Prevention and the Institute of Medicine to reduce health disparities, but no randomized controlled trial of a CSA program has been conducted in the AI population. Accordingly, we will test the efficacy of a CSA program combined with culturally-tailored nutrition and cooking education on diet and health outcomes among Osage adults, evaluate its cost-effectiveness, and develop a multimedia toolkit for disseminating findings. Our specific aims are to: 1) Conduct a randomized controlled trial to test the newly developed CSA program’s effect on diet, blood pressure, and blood lipids (primary outcomes) and on body mass index (BMI), hemoglobin A1c (HbA1c), food insecurity, and health status (secondary outcomes) among 600 AI adults (aged 18-75) with overweight/obesity; 2) Perform an economic evaluation for individual (e.g., health-related quality of life), organizational (e.g., healthcare utilization costs), and community-level (e.g., prevention of cardiometabolic diseases) outcomes; and 3) Document and disseminate study processes and findings using participatory video methods, and compile a web-based toolkit for other AI communities to use CBPR to improve tribal food systems. This study is the first to rigorously intervene across all components of the food system to address poor diet and health among AIs. Building upon Osage Nation assets and priorities, guided by a CBPR and Indigenous food sovereignty orientation, and based upon recommended strategies to eliminate disparities, study findings will inform research and policy efforts to create sustainable food access in reservations with high rates of chronic disease as well as urban AI communities where CSAs are available and could be tailored to AIs.

项目摘要/摘要 食品系统包括食品生产，获取和营销。公共卫生工作一直是 鉴于饮食不良是可预防疾病的第一风险因素，越来越重视食品系统 在美国。美洲印第安人（AIS）经历了与饮食相关的实质性健康差异：AI成年人是 肥胖的可能性高50％，患有高血压的可能性高30％，患有糖尿病的可能性高出两倍 与白人相比。 2013年，俄克拉荷马州的Osage Nation推出了Mister Creek Farm（BCF） 为了促进土著食品主权，被定义为土著人民对健康的权利和责任 以及通过传统土著实践生产的文化适当食品。到2015年，BCF有12个 员工并开始为部落计划提供食物。同年，我们的团队与BCF合作 启动了NIMHD资助的新鲜农场到学校计划（R01MD011266）。初步发现 基于部落驱动的社区参与研究（CBPR）研究表明，蔬菜和水果的增加 儿童和成人的摄入量以及粮食不安全的减少。在我们八年的CBPR上建立 合作伙伴关系，拟议的研究将实施一个新的社区支持农业（CSA）计划，其中 Osage Citizens将每周收到一份新鲜的农产品份额，持续6个月。 CSA有所改善 非AI人群中的饮食和健康是中心建议的基于证据的策略 疾病控制和预防以及医学研究所减少健康差异，但没有随机 AI人群已进行了CSA计划的对照试验。彼此之间，我们将测试效率 CSA计划，结合了有关饮食和健康成果的文化限制营养和烹饪教育 在Osage成年人中，评估其成本效益，并开发用于传播发现的多媒体工具包。 我们的具体目的是：1）进行随机对照试验以测试新开发的CSA计划的。 对饮食，血压和血脂（主要结果）和体重指数（BMI），血红蛋白的影响 A1C（HBA1C），粮食不安全和健康状况（次要结局）（在600名AI成年人中）（18-75岁）与 超重/肥胖； 2）对个人进行经济评估（例如，与健康相关的生活质量）， 组织（例如医疗保健利用成本）和社区级别（例如，预防心脏代谢 疾病）结果； 3）使用参与视频记录并传播研究过程和发现 方法，并为其他AI社区编译了基于网络的工具包，以使用CBPR改善部落食品系统。 这项研究是第一个严格干预食品系统的所有组成部分，以解决饮食不良和 AIS中的健康。在CBPR和土著食品的指导下，以Osage Nation资产和优先事项为基础 主权取向，并基于建议消除分布的策略，研究结果将 为研究和政策的努力提供信息，以创建可持续食品的可持续性，以高慢性病率 疾病以及城市AI社区，那里有CSA，可以根据AIS量身定制。