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.

项目概要该 K01 奖项的总体目标是为 Gabriella McLoughlin 博士、硕士提供培训和指导建立一个独立的研究计划，重点是改进政策的实施，针对儿童肥胖和心血管疾病预防的系统和环境（PSE）干预措施。近年来，儿童肥胖差异不断加剧，来自种族/族裔的儿童少数族裔和低收入背景面临的风险最大。多种因素，例如粮食不安全加剧导致低质量的饮食，导致这种威胁增加。童年时期的肥胖会一直延续到成年，增加心血管疾病的风险，并需要对青少年采取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了一半以上的能量摄入学校，通过全民校餐向低收入青少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 的采用与减少低收入学生的肥胖风险、改善饮食质量、减少粮食不安全并提高学业水平成就成果。不幸的是，采用 USM 的学校报告称其持续面临挑战实施情况，例如学生参与度低和遵守联邦营养的经济困难要求。旨在减少肥胖造成的健康差异的计划和政策无法发挥最大作用如果他们没有达到目标人群，就会产生影响。因为学校的联邦报销率是与接受学校膳食的学生人数相关，保持参与对于 USM 的发展至关重要经济上可行。该 K01 奖项的目的是进行实施映射程序费城学区 (SDP)，从而开发和测试了以公平为重点的 USM 的实施策略。这将通过三个目标来实现：1）调查通过健康公平视角实施 USM； 2) 制定并定制USM实施策略通过社区参与的方法； 3) 评估实施情况和学生健康成果实施策略。为实现这些目标，为取得更大的实施成效做好准备试验期间，申请人将接受严格的正式培训，内容包括 1) 评估实施决定因素健康公平 2) 社区参与的实施规划，3) 随机对照试验，以及 4) 成本在Drs的指导下进行实施分析詹妮弗·费舍尔、奥马尔·马丁内斯、瑞莎·琼斯、罗斯布朗森、亚历克斯·多普和 Shiriki Kumanyika。天普大学是这项工作的理想环境与当地社区的长期关系，促进 McLoughlin 博士与 SDP 的合作，通过社区参与的方式完成研究的目标。此次K01奖项意义重大潜在的公共卫生影响，将使麦克劳林博士能够建立严格的研究计划改善 PSE 实施并降低弱势群体的肥胖和心血管疾病风险。