Enhancing capacity in faith-based organizations to implement and sustain multilevel innovations to improve physical activity

增强信仰组织实施和维持多层次创新以改善身体活动的能力

• 批准号: 10392298
• 负责人: Elva M Arredondo
• 金额: $ 75.56万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10392298
• 关键词: Address; Adoption; Adult; Advocate; Behavior; Body mass index; Cancer Control; Cardiovascular Diseases; Cessation of life; Chronic Disease; Church; Collaborations; Communities; Community Health Aides; Control Groups; Data; Effectiveness; Evidence based intervention; Gender Role; Guidelines; Health; Health Promotion; Hybrids; Individual; Intervention; Latina Population; Latino; Latino Population; Life Style; Maintenance; Malignant Neoplasms; Methods; National Cancer Institute; Obesity; Organizational Change; Outcome; Pathway interactions; Personal Satisfaction; Physical activity; Physical activity scale; Population; Practical Robust Implementation and Sustainability Model; Randomized; Reach Effectiveness Adoption Implementation and Maintenance; Research; Risk Factors; Role; Testing; Training; attentional control; base; behavior change; cardiovascular risk factor; community setting; contextual factors; design; effectiveness implementation trial; empowered; ethnic minority; evidence base; exercise intervention; expectation; experience; experimental study; follow-up; implementation framework; implementation strategy; improved; innovation; member; moderate-to-vigorous physical activity; organizational climate; physical inactivity; prevent; program dissemination; programs; racial and ethnic; scale up; social culture; sustainability framework; tailored messaging; underserved community; uptake

PROJECT SUMMARY Despite the benefits of physical activity (PA) to prevent cardiovascular disease (CVD) and other chronic diseases, few adult Latinas meet PA guidelines. Given the central role of faith-based organizations (FBOs) within the Latino community and their commitment to the well-being of their members, FBOs are ideal settings for health promotion. Evidence-based approaches for increasing PA and reducing obesity such as Faith in Action exist, but few PA interventions go to scale. Implementation strategies that enhance the capacity of FBO leaders and community health workers (promotoras) to implement EBIs can facilitate their uptake. We propose to enhance Faith in Action with three organization-level strategies designed to increase program fit and effectiveness: 1) training FBO leaders in health promotion 2) tailoring messaging to enhance fit between Faith in Action and each unique FBO context, and 3) empowering promotoras to advocate for organizational change. Given the need to improve strategies to sustain health programs in community settings, we propose to test the influence of two additional sustainment strategies: 1) strengthening community collaborations and 2) providing technical support. We will conduct a hybrid type II effectiveness-implementation trial using a clustered RCT design to test the impact of the proposed implementation strategies on organization-level change and individual behavior in diverse FBOs for a 12-month intervention and 6-month follow-up. Thirty-two FBOs will be randomly assigned to a Standard EBI condition (Faith in Action as originally implemented), an Enhanced condition (Standard condition + organizational-level implementation strategies), or Enhanced + Sustainment condition (Enhanced implementation condition + sustainment strategies). We will collect quantitative and qualitative data at baseline, 6 months, 12 months, and 18 months post baseline. The proposed study aims to: 1) Test the short and long-term impacts of organization-level implementation strategies in 2 Enhanced conditions on organizational outcomes compared to the Standard EBI condition, 2) Examine individual reach and effectiveness among Latinas (n=812) in FBOs in the 2 Enhanced conditions compared to the Standard EBI condition. Secondary aims examine theoretical mechanisms of action (e.g., organizational climate) and the additional impact of two sustainment strategies. Informed by the Practical Robust Implementation and Sustainability Model (PRISM) and Reach Effectiveness-Adoption Implementation and Maintenance (RE-AIM) frameworks, the current study will use mixed methods to adapt Faith in Action to diverse FBOs. This research is innovative because it experimentally tests organization-level implementation strategies and their associated mechanism of action in Latino FBOs' from diverse denominations. Our findings will impact the field by providing rigorously derived evidence for the scale-up of innovative EBIs in FBOs. If successful, findings from the current study will provide evidence of organizational-level strategies for uptake, sustainment, and generalizable implementation strategies for scale-up of PA interventions to increase PA and reduce chronic disease in FBOs across the US.

项目摘要 尽管有体育锻炼的好处（PA）可以预防心血管疾病（CVD）和其他慢性 疾病，很少有成年拉丁裔符合PA指南。鉴于基于信仰的组织（FBO）的核心作用 在拉丁裔社区及其对成员福祉的承诺，FBO是理想的环境 促进健康。基于证据的方法来增加PA和减少肥胖症，例如信仰 存在动作，但是很少有PA干预进行扩展。增强FBO能力的实施策略 领导者和社区卫生工作者（Propitionras）实施EBIS可以促进他们的吸收。我们建议 通过三种旨在提高计划拟合和的组织级策略来增强行动信仰 有效性：1）培训健康促进的FBO领导者2）调整消息传递以增强信仰之间的适合 在行动和每个独特的FBO环境中，以及3）授权促销活动倡导组织变革。 鉴于需要改善在社区环境中维持健康计划的策略，我们建议 另外两种维持策略的影响：1）加强社区合作； 2）提供 技术支援。我们将使用聚集的RCT进行一项II型混合有效性实施试验 设计旨在测试拟议的实施策略对组织级别变化的影响 12个月干预和6个月的随访中的不同FBO中的个人行为。 32个FBO将会 随机分配到标准的EBI条件（最初实施的行动信仰），增强 条件（标准条件 +组织级实施策略）或增强 +维持 条件（增强的实施条件 +维持策略）。我们将收集定量和 基线后的定性数据，基线后6个月，12个月和18个月。拟议的研究旨在： 1）测试2个增强的组织级实施策略的短期和长期影响 与标准EBI条件相比，组织结果的条件，2）检查个人覆盖范围 与标准相比 EBI条件。次要目的检查了理论机制（例如，组织氛围）和 两种维持策略的其他影响。由实践强大的实施和 可持续性模型（PRISM）并达到有效性实施和维护（RE-AIM） 框架，当前的研究将使用混合方法将信仰适应不同的FBO。这项研究 之所以创新，是因为它通过实验测试组织级实施策略及其相关的 拉丁裔FBO中的作用机理来自不同的教派。我们的发现将通过 为FBO中创新的EBIS扩大规模提供了严格的衍生证据。如果成功，从 当前的研究将提供组织级策略的证据，以实现吸收，维持和 可推广的实施策略，以扩大PA干预措施以增加PA并减少慢性 美国FBO的疾病。