DIDACTIC: Dissemination and Implementation of a Diet and Activity Community Trial

教学：饮食和活动社区试验的传播和实施

• 批准号: 9038181
• 负责人: Heather M Brandt
• 金额: $ 50.36万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9038181
• 关键词: Address; Adoption; African American; American; Awareness; Cancer Control; Chronic; Chronic Disease; Church; Collaborations; Communities; Community Health; Community Participation; Community Trial; Cost Effectiveness Analysis; Diet; Education; Effectiveness; Ensure; European; Evidence based intervention; Family; Goals; Health; Health Educators; Health Status; Healthy Eating; Inflammation; Intervention; Intervention Trial; Life; Malignant Neoplasms; Measures; Mentors; Methods; Modeling; Monitor; Monoclonal Antibody R24; Obesity; Output; Ownership; Participant; Phase; Physical activity; Process; Public Health; Recording of previous events; Recruitment Activity; Research; Research Infrastructure; Scientist; South Carolina; Stress; Testing; Training; Translations; Trust; Universities; base; cancer prevention; cancer risk; community based participatory research; community setting; cost; design; dissemination research; evidence base; health disparity; health training; high risk; high standard; implementation research; improved; inflammatory marker; leadership development; member; programs; racial health disparity; response; stem; success; theories; therapy design

DESCRIPTION (provided by applicant): South Carolina has some of the largest health disparities in the nation, and these are invariably more extreme in African Americans (AA) compared to European Americans. The chronic diseases that present the greatest public health challenges are now known to be inflammation related, and AAs tend to have greater inherent sensitivity to inflammation modulators. The proposed dissemination and implementation research is based on our efficacious intervention trial, "Diet & Activity Community Trial: High-Risk Inflammation" [R24 MD002769- 01], which focused on diet, physical activity, and stress reduction in collaboration with the AA faith community to reduce inflammation (referred to as the HEALS intervention). Extraordinary success in engaging the AA faith and greater AA community allows us to propose to disseminate and implement this intervention. We will ensure that the proposed dissemination and implementation research contributes to achieving our overall goal of reducing health disparities among AAs through the following specific aims: (1) Disseminate and implement the successful HEALS intervention in the AA faith community; (2) Evaluate and monitor the dissemination process for adoption, recruitment, retention, and fidelity to the HEALS intervention trial including testing the effect of the disseminated intervention using a variety of non-invasive measures that are relevant to overall health status, proven to be related to chronic inflammation in the intervention-phase trial, and that can (and will) be employed in a community setting; (3) Conduct a cost-effectiveness analysis of intervention dissemination and implementation to reduce health disparities in parameters associated with inflammation, from both budgetary and societal perspectives; and (4) Enhance the capacity of the target community to sustain the delivery of the evidence-based intervention and for community partners to engage in future research and programming to address health disparities through cultivation of a network of active church and community educators and leadership development activities. We will utilize a community-based participatory research approach to recruit 30 churches and 450 participants using a lay health, train-the-trainer model that decentralizes the research process and is suitable for dissemination and implementation research. We also will engage 30 "mentor" lay health educators (members of church education teams) who participated in the intervention trial phase to mentor and train newly recruited lay health educators for church education teams for the proposed dissemination and implementation research. We propose to use non-invasive approaches to measure key variables during dissemination and implementation. Cost-effectiveness analysis is an important component and will yield information on required inputs and outputs. The proposed research offers an opportunity to build upon a history of successful collaboration by disseminating and implementing evidence- based intervention with a focus on sustainability of efforts through capacity-building and leadership development to address health disparities in the AA community to address health disparities.

描述（由申请人提供）：南卡罗来纳州的健康差距是全国最大的，与欧洲裔美国人相比，非裔美国人 (AA) 的健康差距总是更加极端。目前已知，构成最大公共卫生挑战的慢性疾病与炎症相关，而 AA 往往对炎症调节剂具有更高的固有敏感性。拟议的传播和实施研究基于我们有效的干预试验“饮食和活动社区试验：高风险炎症”[R24 MD002769-01]，该试验与 AA 信仰合作，重点关注饮食、身体活动和减轻压力社区减少炎症（称为 HEALS 干预）。在吸引 AA 信仰和更大的 AA 社区方面取得的非凡成功使我们能够提议传播和实施这一干预措施。我们将确保拟议的传播和实施研究有助于实现我们通过以下具体目标减少 AA 之间健康差异的总体目标： (1) 在 AA 信仰社区中传播和实施成功的 HEALS 干预措施； (2) 评估和监测 HEALS 干预试验的采用、招募、保留和忠诚度的传播过程，包括使用各种方法测试传播干预措施的效果 与整体健康状况相关的非侵入性措施，在干预阶段试验中被证明与慢性炎症有关，并且可以（并将）在社区环境中采用； (3) 对干预措施的传播和实施进行成本效益分析，从预算和社会角度减少炎症相关参数的健康差异； (4) 增强目标社区的能力，以持续提供循证干预措施，并让社区合作伙伴参与未来的研究和规划，通过培养活跃的教会和社区教育者网络以及领导力发展来解决健康差距问题活动。我们将采用基于社区的参与式研究方法，使用非专业健康、培训师培训模型招募 30 个教会和 450 名参与者，该模型分散研究过程，适合传播和实施研究。我们还将聘请30名参与干预试验阶段的“导师”平信徒健康教育者（教会教育团队成员）来指导和培训教会教育团队新招募的平信徒健康教育者，以进行拟议的传播和实施研究。我们建议使用非侵入性方法来衡量传播和实施过程中的关键变量。成本效益分析是一个重要组成部分，将产生有关所需投入和产出的信息。拟议的研究提供了一个机会，通过传播和实施循证干预措施，重点关注通过能力建设和领导力发展来解决 AA 社区健康差异的努力的可持续性，以建立成功合作的历史。