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.

项目摘要/摘要 该项目的目的是测试多层，社区参与的干预措施，以建立可持续性 在密西西比三角洲的食品IS中心计划的食品经济可以改善少数民族健康并减少 健康差异。我们的核心假设是，通过积极的社区参与开发的干预措施 为了增加水果和蔬菜（FV）的本地生产和分配，将增加FV的消费量和 减少体重指数（BMI），血红蛋白A1C（HBA1C）和参与成年人的健康差异 与在12个月的研究期间对照参与者相比。 目的1：设计一种新颖的干预措施，以巩固当地的食品经济并提供食品IS-医学 向持续不利的社区中的少数族裔人口编程。使用 社区参与研究的原则和过程，我们将团结社区合作伙伴和成员 玻利瓦尔，华盛顿和向日葵县在当地的多部队三角洲食品政策委员会（FPC）中。 FPC 将设计和实施多层次干预措施以提供适当的营养，重点是本地生长 FV，建立可持续的粮食经济并改善健康成果。 目标2：测试新颖的干预是否通过改善相关结果来降低健康差异 农村少数民族人口中的肥胖和糖尿病。我们将与FPC合作 针对目标300 成人（> 25 y），粮食不安全，BMI> 25和HBA1C）> 5.7-8.5％。结果指标是（*主要）： 个人级别：增加F+V消耗*；减少肥胖（BMI）*，糖尿病风险（HBA1C）*和收缩期 血压 社区级别：增加FV的生产和分配；研究所获取生产和减少食物 不安全感；并减少医疗保健利用 目标3：生成可复制且可扩展的食品经济模型，以减少肥胖症并改善糖尿病。 该模型将着重于生活在有利的地区的成年人，并制定可持续的食品IS医学政策 与SNAP，Medicare/Medicaid以及州和联邦立法机关有关的建议。 预期影响：以社区为中心的努力，建立了重要的当地粮食经济体以支持食品IS中等 编程代表了一项重大创新，将营养纳入医疗保健系统和社会安全 净减轻疾病，减轻差异，并每年节省数十亿美元的医疗支出。