A multilevel community engaged intervention to build a sustainable and equitable food economy with food is medicine offerings in the Mississippi Delta to improve minority health and reduce disparities

多层次社区参与干预，在密西西比三角洲建立可持续和公平的食品经济，提供食品即药品，以改善少数族裔的健康并减少差距

• 批准号: 10597864
• 负责人: CHRISTINA D ECONOMOS
• 金额: $ 137.41万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10597864
• 关键词: Address; Adult; African American; Agriculture; Area; Behavioral; Biological; Black race; Blood Pressure; Body mass index; Chronic Disease; Clinic; Communities; Consumption; County; Development; Diabetes Mellitus; Disadvantaged; Disease; Economics; Environment; Farm; Food; Food Policy; Generations; Glycosylated hemoglobin A; Goals; Growth; Health; Health Expenditures; Healthcare Systems; Individual; Institutes; Intervention; Link; Measures; Medicare/Medicaid; Medicine; Minority Groups; Mississippi; Modeling; National Institute on Minority Health and Health Disparities; Obesity; Outcome; Outcome Measure; Participant; Physical environment; Poverty; Process; Production; Randomized; Randomized Controlled Trials; Recording of previous events; Reduce health disparities; Research; Risk Factors; Rural Minority; S-nitro-N-acetylpenicillamine; Social Justice; Soil; Sunflowers; Testing; Universities; Vertebral column; Washington; Woman; Work; base; cardiometabolic risk; college; community center; community engaged research; community engagement; design; diabetes risk; disparity reduction; experience; farmer; food desert; food insecurity; fruits and vegetables; health care service utilization; health disparity; health disparity populations; improve minority health; improved; improved outcome; innovation; member; men; minority health disparity; novel; nutrition; policy recommendation; programs; response; safety net; social; social culture

PROJECT SUMMARY/ABSTRACT The goal of this project is to test whether a multi-level, community-engaged intervention to build a sustainable food economy with food-is-medicine programs in the Mississippi Delta can improve minority health and reduce health disparities. Our central hypothesis is that an intervention developed with active community engagement to increase local production and distribution of fruits and vegetables (FV), will increase FV consumption and decrease body mass index (BMI), hemoglobin A1c (HbA1c) and health disparities among participating adults compared to control participants over a 12-month study period. Aim 1: To design a novel intervention that bolsters the local food economy and delivers food-is-medicine programming to a minority population within communities with persistent disadvantage. Using the principles and processes of community-engaged research, we will unite community partners and members of Bolivar, Washington, and Sunflower Counties in a local multi-sector Delta Food Policy Council (FPC). The FPC will design and implement a multi-level intervention to provide appropriate nutrition, focusing on locally grown FV, to build a sustainable food economy and improve health outcomes. Aim 2: To test whether the novel intervention reduces health disparities by improving outcomes related to obesity and diabetes among a rural minority population. We will work collaboratively with the FPC to implement and evaluate a multi-level, community-engaged, randomized controlled intervention targeting 300 adults (>25 y) with food insecurity, BMI >25, and HbA1c)>5.7-8.5%. Outcome measures are (*primary): Individual-level: increase F+V consumption*; decrease obesity (BMI)*, diabetes risk (HbA1c)*, and systolic blood pressure Community-level: increase production and distribution of FV; institute access to produce and decrease food insecurity; and decrease health care utilization Aim 3: Generate a replicable and scalable food economy model to reduce obesity and improve diabetes. The model will focus on adults living in areas with disadvantage and make sustainable food-is-medicine policy recommendations related to SNAP, Medicare/Medicaid and the Farm Bill to state and federal legislatures. Expected impact: Community-centered efforts that build vital local food economies to support food-is-medicine programming represent a major innovation that integrates nutrition into the healthcare system and social safety net to ameliorate disease, mitigate disparities, and save billions of dollars in health care expenditures annually.

项目概要/摘要 该项目的目标是测试是否可以通过多层次、社区参与的干预措施来建立可持续的 密西西比三角洲“食品即药品”计划的粮食经济可以改善少数族裔的健康并减少 健康差异。我们的中心假设是，通过积极的社区参与制定干预措施 增加当地水果和蔬菜 (FV) 的生产和分配，将增加 FV 的消费和 降低参与成年人之间的体重指数 (BMI)、糖化血红蛋白 (HbA1c) 和健康差异 在 12 个月的研究期间与对照组参与者进行比较。 目标 1：设计一种新颖的干预措施，促进当地粮食经济并提供“食物就是药物” 为社区内长期处于不利地位的少数群体制定计划。使用 社区参与研究的原则和流程，我们将联合社区合作伙伴和成员 玻利瓦尔县、华盛顿县和向日葵县属于当地多部门三角洲食品政策委员会 (FPC)。柔性电路板 将设计和实施多层次干预措施，以提供适当的营养，重点关注当地种植的 FV，建立可持续的粮食经济并改善健康状况。 目标 2：测试新型干预措施是否通过改善相关结果来减少健康差异 农村少数民族人口的肥胖和糖尿病。我们将与 FPC 合作， 实施并评估针对 300 人的多层次、社区参与、随机对照干预措施 粮食不安全、BMI >25 和 HbA1c)>5.7-8.5% 的成年人（>25 岁）。结果衡量标准是（*主要）： 个人层面：增加F+V消耗*；降低肥胖 (BMI)*、糖尿病风险 (HbA1c)* 和收缩压 血压 社区层面：增加FV的生产和分配；建立生产和减少粮食的机会 不安全感；并减少医疗保健利用率 目标 3：建立可复制且可扩展的食品经济模型，以减少肥胖并改善糖尿病。 该模型将重点关注生活在贫困地区的成年人，并制定可持续的“食物就是药物”政策 向州和联邦立法机构提出与 SNAP、医疗保险/医疗补助和农业法案相关的建议。 预期影响：以社区为中心的努力，建设重要的当地粮食经济，支持“食物就是药物” 规划代表了一项重大创新，将营养融入医疗保健系统和社会安全 净改善疾病，缩小差距，并每年节省数十亿美元的医疗保健支出。