Using implementation mapping to maximize equity of school-based policies for obesity prevention

利用实施规划最大限度地提高基于学校的肥胖预防政策的公平性

基本信息

批准号：
10572736
负责人：
Gabriella Mcloughlin
金额：
$ 17.15万
依托单位：
TEMPLE UNIV OF THE COMMONWEALTH
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-02-15 至 2028-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10572736
关键词：
Academic achievement Address Adolescent Adopted Adoption Adult Behavior Child Child Nutrition Childhood Clinical Research Clinical Trials Collaborations Communities Complex Consolidated Framework for Implementation Research Consumption Cost Analysis Data Development Development Plans Diet Disease Disparity Doctor of Philosophy Eating Effectiveness Energy Intake Enrollment Ensure Equity Focus Groups Food Services Foundations Goals Group Interviews Growth and Development function Health Inequity Intervention Interview K-12 Education K-Series Research Career Programs Link Low Income Population Low income Maps Measures Mentored Research Scientist Development Award Mentorship Methods Modeling National Heart, Lung, and Blood Institute Needs Assessment Nutrient Obesity Outcome Overweight Parents Penetration Performance Philadelphia Policies Predisposition Prevention Price Procedures Public Health Randomized Randomized, Controlled Trials Reduce health disparities Reporting Research Research Personnel Research Project Grants Risk Sampling Schools Students Surveys System Target Populations Testing Time Training Universities Vulnerable Populations Weight Work Youth cardiovascular disorder prevention cardiovascular disorder risk career career development cost design dietary effectiveness/implementation trial environmental intervention ethnic minority experience food environment food insecurity health determinants health equity health inequalities high school implementation barriers implementation determinants implementation efforts implementation evaluation implementation outcomes implementation protocol implementation research implementation science implementation strategy improved innovation junior high school marginalization minority children neglect nutrition obesity in children obesity prevention obesity risk pilot test pilot trial pragmatic randomized trial programs racial minority school district social health determinants student participation teacher

项目摘要

PROJECT SUMMARY The overall goal of this K01 award is to provide Gabriella McLoughlin, PhD, MS, with the training and mentorship to establish an independent program of research focused on improving implementation of Policy, Systems, and Environmental (PSE) interventions for childhood obesity and cardiovascular disease prevention. Childhood obesity disparities have been exacerbated in recent years, such that children from racial/ethnic minority and low-income backgrounds are most at risk. Multiple factors, such as increased food insecurity resulting in a low-quality diet, contribute to this increased threat. Childhood obesity tracks into adulthood, increasing the risk of cardiovascular disease, and warranting sustainable interventions for youth to address social determinants of health. Since children and adolescents consume over half of their energy intake at school, providing free nutrient-rich breakfast and lunch to low-income youth through Universal School Meals (USM) is a key PSE approach to addressing obesity disparities. Adoption of USM is linked with reductions in obesity risk for low-income students, improved diet quality, reduced food insecurity, and enhanced academic achievement outcomes. Unfortunately, schools adopting USM report consistent challenges to its implementation such as low student participation and financial difficulty in adhering to Federal nutrition requirements. Programs and policies designed to mitigate health disparities for obesity cannot make the most impact if they are not reaching their target population. Because the federal reimbursement rate for schools is tied to the number of students receiving school meals, maintaining participation is critical to making USM financially feasible. The purpose of this K01 award is to conduct an implementation mapping procedure with the School District of Philadelphia (SDP), resulting in the development and testing of an equity-focused implementation strategy for USM. This will be achieved through three aims: 1) Investigate determinants of USM implementation through a health equity lens; 2) Develop and tailor a USM implementation strategy through a community-engaged approach; and 3) Evaluate the implementation and student health outcomes of the implementation strategy. To accomplish these aims and prepare for a larger implementation effectiveness trial, the applicant will receive rigorous formal training in 1) assessing implementation determinants grounded in health equity 2) community-engaged implementation mapping, 3) randomized controlled trials, and 4) cost analysis of implementation under the mentorship of Drs. Jennifer Fisher, Omar Martinez, Resa Jones, Ross Brownson, Alex Dopp, and Shiriki Kumanyika. Temple University is the ideal setting for this work given a longstanding relationship with the local community, facilitating Dr. McLoughlin's collaboration with SDP and completion of the study aims through a community-engaged approach. This K01 award holds significant potential for public health impact and will enable Dr. McLoughlin to establish a rigorous program of research to improve PSE implementation and reduce obesity and cardiovascular disease risk in vulnerable populations.

项目摘要该K01奖的总体目标是向Gabriella McLoughlin博士提供培训和培训指导建立独立研究计划，重点是改善政策的实施，针对儿童肥胖和预防心血管疾病的系统和环境（PSE）干预措施。近年来，儿童肥胖差异已加剧，以使种族/族裔的孩子少数民族和低收入背景最有风险。多种因素，例如增加粮食不安全性导致低质量的饮食，导致这种威胁增加。童年肥胖痕迹到成年，增加心血管疾病的风险，并为青年人提供可持续的干预措施来解决健康的社会决定因素。由于儿童和青少年消耗超过一半的能量摄入量学校，通过通用学校用餐为低收入青年提供免费营养丰富的早餐和午餐（USM）是解决肥胖差异的关键PSE方法。 USM的采用与减少有关低收入学生的肥胖风险，提高饮食质量，饮食不安全和学术增强成就结果。不幸的是，采用USM的学校报告了一致的挑战实施诸如学生参与度较低和坚持联邦营养方面的财务困难要求。旨在减轻肥胖健康差异的计划和政策不能使最大如果他们没有达到目标人群的影响。因为学校的联邦报销率是与接受学校用餐的学生人数有关，维持参与对于使USM至关重要在财务上可行。该K01奖的目的是与费城学区（SDP），导致以股票为中心的开发和测试 USM的实施策略。这将通过三个目的来实现：1）调查的决定因素 USM通过健康权益镜头实施； 2）制定和量身定制USM实施策略通过社区参与的方法； 3）评估的实施和学生健康成果实施策略。实现这些目标并为更大的实施有效性做准备审判，申请人将在1）评估实施决定因素扎根的情况下接受严格的正规培训在卫生公平2）社区参与的实施映射，3）随机对照试验，4）成本在DRS的指导下对实施的分析。詹妮弗·费舍尔（Jennifer Fisher），奥马尔·马丁内斯（Omar Martinez），雷萨·琼斯（Resa Jones），罗斯（Ross）布朗森，亚历克斯·多普（Alex Dopp）和西里基·库曼尼卡（Shiriki Kumanyika）。坦普尔大学是这项工作的理想环境与当地社区的长期关系，促进了麦克劳林博士与SDP和该研究的完成是通过社区参与的方法旨在的。该K01奖具有重要的公共卫生影响的潜力，并将使麦克劳林博士建立严格的研究计划改善PSE实施，并减少弱势群体中的肥胖和心血管疾病风险。