Understanding the Role of the Food Environment on Diet and Health in Rural American Indian Communities: the Strong Heart Food Environment Study

了解食物环境对美国农村印第安人社区饮食和健康的作用：强心食物环境研究

• 批准号: 10560211
• 负责人: Amanda Mae Fretts
• 金额: $ 57.87万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10560211
• 关键词: Address; American Heart Association; American Indians; Ancillary Study; Behavioral; Biological; Biological Markers; Blood Pressure; Body mass index; Cardiovascular Diseases; Central obesity; Cohort Studies; Communities; Consumption; Data; Diabetes Mellitus; Diet; Dietary Assessment; Dietary Fiber; Eating; Economic Factors; Economics; Enrollment; Environment; Family; Family Study; Feasibility Studies; Fishes; Food; Food Preferences; Foundations; Future; Genetic; Goals; Health; Health Food; Healthy Eating; Heart; High Density Lipoprotein Cholesterol; Household; Hypertension; Indian reservation; Individual; Intake; Intervention; Interview; Knowledge; Measures; Methods; Morbidity - disease rate; Neighborhoods; Nutrition Assessment; Obesity; Outcome; Participant; Persons; Physical environment; Pilot Projects; Policies; Psychosocial Factor; Reporting; Research; Research Activity; Reservations; Resources; Risk Factors; Role; Rural; Rural Community; Sampling; Smoking; Sodium; Tribes; Triglycerides; Unhealthy Diet; Urban Community; Work; built environment; cardiovascular health; cardiovascular risk factor; cohort; combat; contextual factors; cost; design; fasting glucose; food environment; food insecurity; food security; fruits and vegetables; good diet; hypercholesterolemia; improved; informant; insight; member; mortality; nutrition; programs; rural Americans; social culture; social factors; sugar; sweetened beverage; tribal Nation; tribal community; Address; American Heart Association; American Indians; Ancillary Study; Behavioral; Biological; Biological Markers; Blood Pressure; Body mass index; Cardiovascular Diseases; Central obesity; Cohort Studies; Communities; Consumption; Data; Diabetes Mellitus; Diet; Dietary Assessment; Dietary Fiber; Eating; Economic Factors; Economics; Enrollment; Environment; Family; Family Study; Feasibility Studies; Fishes; Food; Food Preferences; Foundations; Future; Genetic; Goals; Health; Health Food; Healthy Eating; Heart; High Density Lipoprotein Cholesterol; Household; Hypertension; Indian reservation; Individual; Intake; Intervention; Interview; Knowledge; Measures; Methods; Morbidity - disease rate; Neighborhoods; Nutrition Assessment; Obesity; Outcome; Participant; Persons; Physical environment; Pilot Projects; Policies; Psychosocial Factor; Reporting; Research; Research Activity; Reservations; Resources; Risk Factors; Role; Rural; Rural Community; Sampling; Smoking; Sodium; Tribes; Triglycerides; Unhealthy Diet; Urban Community; Work; built environment; cardiovascular health; cardiovascular risk factor; cohort; combat; contextual factors; cost; design; fasting glucose; food environment; food insecurity; food security; fruits and vegetables; good diet; hypercholesterolemia; improved; informant; insight; member; mortality; nutrition; programs; rural Americans; social culture; social factors; sugar; sweetened beverage; tribal Nation; tribal community

The research activities proposed in this application address a pressing need in American Indian (AI) communities to better understand multi-level (i.e., community- , household- , and individual- level) factors in the physical and socio-cultural environment that impact diet and cardiovascular diseases. The premise of the proposed project was informed by: (1) our previous work in the Strong Heart Study (SHS) and the Strong Heart Family Study (SHFS)—the largest multi-tribal cohort studies of risk factors for cardiovascular disease in AIs in the USA—that highlighted the exceedingly high burden of obesity and poor diet quality among AIs; and (2) findings from our Healthy Food, Healthy Families Feasibility Study—a small pilot study in a SHS/SHFS community that assessed the major barriers and facilitators to eating healthy. Although the SHS/SHFS has followed more than 4,000 AIs from 12 rural communities for the past 34 years, all data collected as part of the study has focused on individual-level biological and behavioral factors associated with cardiovascular diseases; no data has been collected on multi-level components of the physical or sociocultural food environments in this cohort. As such, we have incomplete knowledge about the influence of these domains on diet and cardiovascular health in these rural AI communities. To address these gaps, we will leverage existing data from the SHS/SHFS, and add comprehensive assessments of multi-level factors related to the physical and socio-cultural environment (factors selected based on previous pilot work) that may impact diet and cardiovascular health to the upcoming SHS/SHFS exam in 12 rural AI communities. For this project, we will assess associations of community-level (e.g., food outlet availability, food cost, norms around healthy eating), household-level (e.g., food insecurity, food outlet accessibility; food preferences), and individual-level (e.g., perceived nutrition environment) aspects of the physical and socio- cultural environment with diet (reported intake of fruits and vegetables; sugar-sweetened beverages) and cardiovascular risk factors (BMI; fasting glucose) among SHS/SHFS participants from 12 tribes. We will also assess the influence of participation in nutrition assistance programs (i.e., supplemental nutrition assistance program (SNAP) or the Food Distribution Program on Indian Reservations) on diet and cardiovascular risk factors (i.e., reported intake of fruits and vegetables; sugar-sweetened beverages; BMI; fasting glucose). Exploratory outcomes include: HDL cholesterol, triglycerides, systolic blood pressure, incident diabetes and incident cardiovascular diseases. Greater efforts are needed to understand the most salient factors that impact diet and cardiovascular health in rural Tribal communities. This ancillary study will leverage existing resources from the SHS/SHFS, while adding a comprehensive dietary assessment, measures of food security, and assessments of nutrition economic and neighborhood environments to the study.

本申请中提出的研究活动涉及美洲印第安人（AI）的紧迫需求 社区更好地了解多层次（即社区，家庭和个人层面）因素 影响饮食和心血管疾病的物理和社会文化环境。前提 提议的项目得到了以下信息：（1）我们先前在强大的心脏研究（SHS）和强壮的心脏方面的工作 家庭研究（SHF） - AIS中心血管疾病风险因素的最大多部位队列研究 美国 - 强调了AIS中肥胖的燃烧量很大，饮食质量差； （2） 我们健康食品，健康家庭可行性研究的发现 - SHS/SHFS中的小型试点研究 评估了主要障碍和促进者健康饮食的社区。虽然SHS/SHF有 在过去的34年中，追随来自12个农村社区的4,000多名AIS，所有数据均作为一部分收集 研究的重点是与心血管相关的个体生物学和行为因素 疾病；尚未收集有关物理或社会文化食品的多层组成部分的数据 该队列中的环境。因此，我们对这些领域的影响有不完整的知识 这些农村AI社区的饮食和心血管健康。为了解决这些差距，我们将利用现有的 来自SHS/SHF的数据，并添加与物理有关的多层次因素的全面评估 和社会文化环境（基于先前的试点工作选择的因素），可能会影响饮食和 在12个农村AI社区即将举行的SHS/SHFS考试的心血管健康。 对于这个项目，我们将评估社区级别的协会（例如，食品渠道可用性，食品成本， 健康饮食的规范），家庭水平（例如，食品不安全感，食品出口可及性；食物 偏好），以及身体和社会的个人级别（例如，感知的营养环境） 饮食的文化环境（报道了水果和蔬菜的摄入量；糖甜的卧室）和 来自12个部落的SHS/SHFS参与者中的心血管危险因素（BMI；空腹葡萄糖）。我们也会 评估参与营养援助计划的影响（即补充营养援助 关于饮食和心血管风险的计划（SNAP）或印度预订的食品分发计划 因素（即报道的水果和蔬菜的摄入量；糖乐卧室； BMI；空腹葡萄糖）。 探索性结果包括：HDL胆固醇，甘油三酸酯，收缩压，入射糖尿病和 事件心血管疾病。 需要更大的努力来了解影响饮食和心血管的最显着因素 粗糙的部落社区的健康。这项辅助研究将利用SHS/SHF的现有资源， 同时添加全面的饮食评估，粮食安全措施和营养评估 研究的经济和邻里环境。