Delivery of Turtle Island Tales to Promote Family Wellness

传播海龟岛故事以促进家庭健康

• 批准号: 10661441
• 负责人: Emily J Tomayko
• 金额: $ 43.87万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-03 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10661441
• 关键词: Address; Adopted; Adoption; Adult; American Indians; Area; Behavioral; Cancer Control; Cancer Prevention Intervention; Child; Child Health; Childhood; Chronic Disease; Communities; Complex; County; Data; Data Collection; Development; Diet; Disparity; Dissemination and Implementation; Economics; Education; Educational Personnel; Equity; Evaluation; Evidence based intervention; Family; Focus Groups; Food Safety; Goals; Grant; Health; Health Food; Health behavior; Health behavior change; Healthy Eating; Home; Individual; Inequity; Intake; Intervention; Interview; Island; Longevity; Maintenance; Malignant Neoplasms; Methods; Modeling; Montana; Names; North America; Obesity; Obesity associated cancer; Oregon; Outcome; Parents; Physical activity; Population; Poverty; Poverty Areas; Prevention strategy; Production; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Project Grants; Resources; Risk; Rural; Services; South Dakota; Special Supplemental Nutrition Program for Women, Infants, and Children; Specific qualifier value; Surveys; System; Trauma; Turtles; Universities; Wisconsin; budget impact; cancer prevention; cancer risk; collaborative approach; community based participatory research; community engagement; community-level factor; cost effectiveness; design; disorder prevention; disorder risk; dissemination science; early childhood; effectiveness evaluation; evidence base; experience; food insecurity; food resource; frontier; fruits and vegetables; health equity; health inequalities; implementation science; implementation strategy; improved; innovation; intervention delivery; novel; nutrition; obesity in children; obesity prevention; obesity risk; preventive intervention; programs; randomized, clinical trials; repository; satisfaction; social; Address; Adopted; Adoption; Adult; American Indians; Area; Behavioral; Cancer Control; Cancer Prevention Intervention; Child; Child Health; Childhood; Chronic Disease; Communities; Complex; County; Data; Data Collection; Development; Diet; Disparity; Dissemination and Implementation; Economics; Education; Educational Personnel; Equity; Evaluation; Evidence based intervention; Family; Focus Groups; Food Safety; Goals; Grant; Health; Health Food; Health behavior; Health behavior change; Healthy Eating; Home; Individual; Inequity; Intake; Intervention; Interview; Island; Longevity; Maintenance; Malignant Neoplasms; Methods; Modeling; Montana; Names; North America; Obesity; Obesity associated cancer; Oregon; Outcome; Parents; Physical activity; Population; Poverty; Poverty Areas; Prevention strategy; Production; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Project Grants; Resources; Risk; Rural; Services; South Dakota; Special Supplemental Nutrition Program for Women, Infants, and Children; Specific qualifier value; Surveys; System; Trauma; Turtles; Universities; Wisconsin; budget impact; cancer prevention; cancer risk; collaborative approach; community based participatory research; community engagement; community-level factor; cost effectiveness; design; disorder prevention; disorder risk; dissemination science; early childhood; effectiveness evaluation; evidence base; experience; food insecurity; food resource; frontier; fruits and vegetables; health equity; health inequalities; implementation science; implementation strategy; improved; innovation; intervention delivery; novel; nutrition; obesity in children; obesity prevention; obesity risk; preventive intervention; programs; randomized, clinical trials; repository; satisfaction; social

PROJECT 2: PROJECT SUMMARY American Indian (AI) communities experience profound health and economic inequities across the lifespan, including increased risk for obesity, cancer, food insecurity (FI), and poverty. Overwhelming evidence indicates obesity prevention evidence-based interventions (EBIs) reduce cancer risk, but the degree to which EBIs have been developed in culturally relevant ways or to reach large numbers of AI families is extremely limited. Community engaged dissemination and implementation (CEDI) strategies are needed across multiple social ecological levels to increase EBI adoption, implementation, and maintenance in AI communities. Our objective is to increase the reach of EBIs for cancer and obesity prevention among AI families who live in persistent poverty areas (PPAs). The proposed project, Reach through Equitable Implementation of Turtle Island Tales in AI Communities (REI-Turtle Island), is a participatory action research project designed to improve local capacity for sustained EBI impact. Turtle Island Tales is a family-focused, home-based EBI for childhood obesity prevention named to acknowledge Turtle Island as the term for North America used by many AI communities. REI-Turtle Island will be conducted across four state Cooperative Extension Systems serving as Supplemental Nutrition Assistance Program Education (SNAP-Ed) agencies in AI communities with ~4,000 children and their families in PPAs in rural and frontier areas. REI-Turtle Island engages system, community, and organizational partners to identify, refine, and develop CEDI strategies to address both disease prevention FI. A Project Steering Committee and Local Community Advisory Boards will conduct iterative planning and evaluation using outcomes specified in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. For Aim 1, we will facilitate and evaluate the reach of T-Tales in PPAs within AI communities in Montana, Oregon, South Dakota, and Wisconsin when delivered by Extension/SNAP-Ed; determine the effectiveness of T-Tales for health behavior change, and evaluate the reduction in FI among participating families by facilitating connections with community and system-level resources (e.g., SNAP, WIC). For Aim 2, we will evaluate the state-level adoption, implementation, and organizational maintenance capacity of Extension/SNAP and AI communities for T-Tales and determine budget impacts of implementing T-Tales into sustained Extension/SNAP-Ed delivery. We expect to generate a novel CEDI Strategies Toolkit to move obesity and cancer prevention EBIs into sustained community implementation and account for the unique social and cultural contexts in AI communities in PPAs. Findings will advance the field of CEDI science through the co-production of strategies to influence EBI adoption, implementation, and maintenance using an innovative conceptual framework that leverages social ecological, dissemination and implementation, behavioral, and health equity frameworks to prevent obesity and cancer in AI families in PPAs.

项目2：项目摘要 美洲印第安人（AI）社区在整个生命周期中经历了深远的健康和经济不平等， 包括增加肥胖，癌症，粮食不安全（FI）和贫困风险。压倒性的证据表明 肥胖预防基于证据的干预措施（EBIS）降低了癌症的风险，但EBIS的程度 以文化相关的方式开发或达到大量AI家庭是极为有限的。 在多种社会中需要社区参与的传播和实施（CEDI）策略 生态水平增加了AI社区的EBI采用，实施和维护。我们的目标 是在持续存在 贫困地区（PPA）。拟议的项目是通过公平地实施乌龟岛的故事 AI社区（Rei-Turtle Island）是一个参与式行动研究项目，旨在改善本地 持续EBI影响的能力。 Turtle Island Tales是一个以家庭为中心的家庭EBI童年的EBI 预防肥胖预防将乌龟岛视为许多AI使用的北美术语 社区。 Rei-Turtle岛将在四个州合作扩展系统中进行 AI社区的补充营养援助计划教育（SNAP-ED）机构约4,000个 儿童及其家人在农村和边境地区的PPA中。 Rei-Turtle Island互动系统，社区， 以及组织合作伙伴，以识别，完善和制定CEDI策略来解决这两种疾病的预防 fi。项目指导委员会和当地社区咨询委员会将进行迭代计划，并 使用在覆盖范围，有效性，采用，实施和维护中指定的结果进行评估 （RE-AIM）框架。对于AIM 1，我们将促进和评估AI中PPA中T-Tales的覆盖率 蒙大拿州，俄勒冈州，南达科他州和威斯康星州的社区通过扩展/快照交付时； 确定T-Tales对健康行为改变的有效性，并评估FI的减少 通过促进与社区和系统级资源的联系来参与家庭（例如，Snap， WIC）。对于AIM 2，我们将评估州级的采用，实施和组织维护 扩展/快照和AI社区的T-Tales的能力，并确定实施预算的影响 T-Tales持续扩展/快照交付。我们希望生成一种新颖的CEDI策略工具包 将肥胖和预防癌症EBIS转移到持续的社区实施中，并解释 PPA中AI社区的独特社会和文化背景。调查结果将推进CEDI科学领域 通过共同制定了影响EBI采用，实施和维护的策略 利用社会生态，传播和实施的创新概念框架， 行为和健康公平框架可预防PPA中的AI家族的肥胖和癌症。