Exploring Food Insecurity and Pilot Testing a Diabetes Nutrition Education Program and Healthy Food Access Service for American Indian and Alaska Native Adults with Type 2 Diabetes

探索粮食不安全并为患有 2 型糖尿病的美洲印第安人和阿拉斯加原住民成年人试点测试糖尿病营养教育计划和健康食品获取服务

• 批准号: 10671503
• 负责人: Sarah A Stotz
• 金额: $ 15.05万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671503
• 关键词: Address; Adult; Alaska Native; American Indians; Area; Behavior; Beverages; Biometry; Blood Glucose; Blood Pressure; Body Weight; Body mass index; Caring; Cities; Clinic; Clinical; Clinical Trials; Colorado; Communities; Data; Data Analyses; Data Collection; Data Set; Development; Diabetes Mellitus; Diabetic Diet; Dietary Intervention; Disparity; Eating; Educational Activities; Educational Curriculum; Educational workshop; Environment; Environmental Pollution; Evidence based intervention; Farm; Food; Food Access; Foundations; Funding; Glycosylated hemoglobin A; Goals; Habits; Health; Health Food; Healthcare; Healthy Eating; Household; Intake; International; Intervention; Intervention Studies; Knowledge; Life; Marketing; Measures; Medical; Mentored Research Scientist Development Award; Mentors; Methodology; Methods; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Oklahoma; Outcome; Participant; Pilot Projects; Population; Positioning Attribute; Poverty; Problem Solving; Process; Public Health; Randomized; Research; Research Design; Research Methodology; Research Personnel; Rural Community; Science; Secure; Self Efficacy; Services; Site; Sodium; Strategic Planning; Surveys; Testing; Training; Transportation; Tribes; Universities; Waiting Lists; Water; Work; career; career development; design; diabetes education; diabetes management; diabetes self-management; effective intervention; effectiveness study; effectiveness trial; experience; farmer; fast food; food insecurity; food security; good diet; health disparity; improved; intervention participants; learning strategy; novel; nutrition; nutrition education; pilot test; portion control; pragmatic study; pragmatic trial; programs; saturated fat; secondary analysis; skills; social health determinants; symposium; therapy design; urban Native American; urban area

PROJECT SUMMARY / ABSTRACT Healthy nutrition habits are key to managing type 2 diabetes (T2D). However, American Indian and Alaska Natives (AI/ANs) often lack access to healthy food and disproportionately experience food insecurity. Food insecurity, defined as lack of consistent access to enough food for an active, healthy life, negatively impacts one’s ability to manage blood sugar and body weight. I am pursuing a K01 Mentored Research Scientist Development Award to fill critical training gaps in the areas of quantitative data analysis of intervention studies and effectiveness and pragmatic study design. In order to effectively bridge my prior training and research experience to obtain my first R01, I have carefully developed a mentored training plan that strategically supports my research aims for this K01 award. I am currently Co-Investigator on a study team that developed a culturally responsive diabetes nutrition education curriculum for AI/AN adults with T2D, entitled “What Can I Eat? Healthy Choices for AI/ANs with T2D” (WCIE). WCIE includes interactive, hands-on nutrition education learning activities, including portion control, decreasing sugary beverages and saturated fat, and problem solving for barriers to healthful eating. In January 2020 we launched a tribally-supported, 6-site, waitlist control design test of WCIE. In June 2021, we will complete data collection with 150 AI/AN adults who have T2D. Data will include 3 timepoints for immediate intervention and 5 for waitlist intervention participants over 6 months with surveys (nutrition knowledge, behavior, self-efficacy) and clinical outcomes (BMI, blood pressure, and HbA1c). Though WCIE does not include a specific food insecurity intervention, we included a household food insecurity measure at all data collection timepoints. In Aim #1 of this proposed K01 I will examine the relationship between food insecurity and clinical WCIE outcomes in the existing dataset through secondary analysis to utilize my new intervention quantitative data analysis skills and advance understanding of the moderating effect of food insecurity on diabetes nutrition education and T2D outcomes among AI/ANs. In Aim #2 I will design/pilot test WCIE with added service to improve healthy food access and evaluate its feasibility/impact on T2D outcomes at an urban AI/AN- serving clinic in Oklahoma City, OK. We will work with the Oklahoma City clinic to identify their need for a healthy food access service in the following domains: transportation, availability of healthy food, or affordability of healthy food. Aim #2 will provide me the opportunity to utilize my new training in effectiveness and pragmatic trials study design and quantitative data analysis of intervention studies. My detailed training plan includes formal coursework at the University of Colorado Anschutz Medical Campus, seminars, workshops/conferences on AI/AN health research, and support from my mentors who are experts and leaders in the area of AI/AN diabetes health, AI/AN health interventions, T2D and food insecurity interventions, and quantitative/study design methodology. The proposed training plan and aims will provide me with a set of skills and expertise needed to successfully obtain R01 funding and become a leader in diabetes health disparities intervention science.

项目摘要 /摘要 健康的营养习惯是管理2型糖尿病（T2D）的关键。但是，美洲印第安人和阿拉斯加 当地人（AI/ANS）通常缺乏获得健康食品的机会，并且不成比例地经历粮食不安全。食物 不安全感，被定义为无法持续获得足够的食物来实现积极，健康的生活，对 一个人管理血糖和体重的能力。我正在追求K01指导的研究科学家 开发奖，以填补干预研究定量数据分析领域的关键培训空白 以及有效性和务实的研究设计。为了有效地弥合我先前的培训和研究 获得我的第一个R01的经验，我仔细制定了一项策略性支持的修改培训计划 我的研究目的是该K01奖。我目前是一个研究团队的共同投资者，该研究团队在文化上发展了 反应灵敏的糖尿病营养教育课程，适用于T2D的AI/一个成年人，标题为“我可以吃什么？ 与T2D的AI/ANS选择”（WCIE）。WCIE包括互动，动手营养教育学习活动， 包括部分控制，减少含糖饮料和饱和脂肪以及解决障碍的问题 健康饮食。 2020年1月，我们推出了一个由部落支持的，6个站点的候补控制设计测试WCIE。 2021年6月，我们将与拥有T2D的150名AI/A成人一起完成数据收集。数据将包括3个时间点 立即干预，5个月份的候补干预参与者在6个月内进行调查（营养） 知识，行为，自我效能感）和临床结果（BMI，血压和HBA1C）。虽然WCIE确实如此 不包括特定的粮食不安全干预措施，我们在所有数据上都包括家庭食品不安全感措施 收集时间点。在该提议的K01的目标＃1中，我将研究粮食不安全与 通过二级分析，现有数据集中的临床WCIE结果以利用我的新干预 定量数据分析技能并提高人们对粮食不安全感的调节作用的理解 AI/ANS中的糖尿病营养教育和T2D成果。在AIM＃2中，我将与添加 服务以改善健康食品的获取并评估其对城市AI/AN-的T2D结果的可行性/影响 在俄克拉荷马州俄克拉荷马州的诊所服务。我们将与俄克拉荷马城诊所合作，以确定他们对健康的需求 以下领域的食品访问服务：运输，健康食品的可用性或健康的可负担性 食物。 AIM＃2将为我提供机会利用我在有效性和务实试验研究方面的新培训 干预研究的设计和定量数据分析。我的详细培训计划包括正式 科罗拉多大学安索斯大学医学校园的课程工作，半决赛，讲习班/会议 AI/A/A健康研究，以及我的导师的支持，他们是AI/A糖尿病领域的专家和领导者 健康，人工智能/健康干预措施，T2D和粮食不安全干预以及定量/研究设计 方法论。拟议的培训计划和目标将为我提供一系列需要的技能和专业知识 成功获得了R01资金，并成为糖尿病差异干预科学的领导者。

项目成果

eHealth, family-based interventions, and multilevel approaches to pediatric weight management: a scoping review.

电子健康、基于家庭的干预措施和儿科体重管理的多层次方法：范围界定审查。

• DOI: 10.1093/nutrit/nuad160
• 发表时间: 2024
• 期刊: Nutrition reviews
• 影响因子: 6.1
• 作者: Henes,SarahT;Stotz,SarahA;Riggs,SandraE;Yang,Hsuan-Mein
• 通讯作者: Yang,Hsuan-Mein

All systems are interrelated: Multilevel interventions with indigenous communities.

所有系统都是相互关联的：与土著社区的多层次干预。

• DOI: 10.1016/j.cct.2022.107013
• 发表时间: 2023
• 期刊: Contemporary clinical trials
• 影响因子: 2.2
• 作者: Johnson-Jennings,MichelleD;Rink,Elizabeth;Stotz,SarahA;Magarati,Maya;Moore,RolandS
• 通讯作者: Moore,RolandS