Developing a multi-component intervention to address cardiometabolic disease (CMD) risk in Samoan children

制定多成分干预措施来解决萨摩亚儿童的心脏代谢疾病 (CMD) 风险

• 批准号: 10740178
• 负责人: Courtney Cheu Lin Choy
• 金额: $ 11.85万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740178
• 关键词: 11 year old; 13 year old; 4 year old; 8 year old; Active Learning; Address; Affect; Age; Americas; Area; Award; Behavioral; Belief; Blood Pressure; Body fat; Body mass index; Cardiometabolic Disease; Child; Child Health; Clinical Trials; Cohort Studies; Communities; Country; Data; Development; Disease Marker; Early Intervention; Effectiveness; Enrollment; Ensure; Environment; Environmental Risk Factor; Epidemiology; Evaluation; Faculty; Focus Groups; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Goals; Growth; Health; High Prevalence; Human Biology; Income; Infrastructure; Intervention; Interview; Life; Life Style; Longitudinal Studies; Mentors; Mentorship; Methods; Modeling; Obesity; Outcome; Overweight; Pacific Islander; Pacific Islands; Personal Satisfaction; Phase; Polynesian; Population; Populations at Risk; Positioning Attribute; Prediabetes syndrome; Prevalence; Prevention; Probability; Public Health; Qualitative Methods; Qualitative Research; Reduce health disparities; Research; Research Training; Resource-limited setting; Risk; Risk Factors; Samoa; Samoan; Scientist; Southeastern Asia; Testing; Training; Underserved Population; United States; Work; beneficiary; blood pressure elevation; boys; cardiometabolic risk; career development; cohort; combat; cost; diabetic; disorder risk; efficacious intervention; ethnic minority population; evidence base; experience; girls; health assessment; high risk; implementation framework; implementation science; indexing; innovation; leadership development; learning strategy; member; modifiable risk; multi-component intervention; multidisciplinary; pilot test; primary caregiver; programs; racial minority population; scale up; skills; tenure track; therapy development; usability

PROPOSAL SUMMARY The goal of the proposed K99/R00 award is to support Dr. Courtney Choy’s development into an independent community-engaged implementation scientist, with a focus on epidemiology and leveraging quantitative and qualitative data to address noncommunicable, cardiometabolic disease (CMD) risk in Pacific Islander children. Although they are among the most at risk of CMD, few efficacious interventions or innovations to address CMDs have reached Pacific Islander communities. The objective of this proposal is to develop and implement a context- specific, multi-component intervention to address CMD risk in Samoan children. Samoa, a middle-income Polynesian country with a large global diaspora, experiences among the highest CMD prevalence in the world. Existing data from the Ola Tuputupua’e (‘Growing Up’) cohort study, which this proposal will leverage, suggests that risk emerges early in life. Half of the enrolled children were affected by either obesity, elevated blood pressure, and/or high glycated hemoglobin (HbA1c) by the age of 9. During the K99 training phase, Dr. Choy will (1) extend her epidemiological training and use growth mixture modeling to inform intervention targets and timing and (2) gain new skills in qualitative methods, and implementation science to select and contextually adapt an intervention for use in Samoa. The Active Implementation Frameworks and evidence-based best practices in Pacific Islander communities will guide intervention development and implementation, which will take place in the R00 phase. The result will be a multi-component intervention for Samoan children that targets the age period in which markers of CMD risk (body mass index, blood pressure, and HbA1c) are most sensitive to modifiable behavioral and environmental risk factors. Further, the multi-component intervention will incorporate at least two evidence-based lifestyle/behavioral change strategies to address CMD risk factors, utilize existing infrastructure and local capacity (with an implementation team) and align with community-identified priorities. Preliminary evidence of the feasibility, acceptability, and effectiveness of the developed intervention among children in Samoa will produce a scalable program with the potential for replication in other Pacific Islander populations and comparable low-resource settings. To achieve career development goals and ensure a successful transition to independence, Dr. Choy has established an exceptional training environment, developed experiential learning activities to apply newly gained skills from didactic coursework, and assembled a multidisciplinary mentorship team with expertise in public health, implementation science, clinical trials, human biology, epidemiology, and Pacific Islander health. The mentorship, research training, leadership and career development activities proposed will ensure that at the conclusion of this award, Dr. Choy will be well-positioned to extend the methods developed to Pacific Islanders in the US, who are among the fastest-growing racial and ethnic minority groups and –because of their high CMD risk– are the ideal beneficiaries of early intervention to reduce health disparities.

提案摘要 拟议的 K99/R00 奖项的目标是支持 Courtney Choy 博士发展成为独立的 社区参与的实施科学家，重点关注流行病学并利用定量和 用于解决太平洋岛民儿童非传染性心脏代谢疾病 (CMD) 风险的定性数据。 尽管他们是 CMD 风险最高的人群之一，但解决 CMD 的有效干预措施或创新很少 已经到达太平洋岛民社区。该提案的目标是制定和实施一个背景- 旨在解决萨摩亚中等收入国家儿童 CMD 风险的具体、多方面干预措施。 波利尼西亚国家拥有大量全球侨民，是世界上 CMD 患病率最高的国家之一。 本提案将利用 Ola Tuputupua’e（“成长”）队列研究的现有数据表明 这种风险在生命早期就出现了，一半的登记儿童受到肥胖、血压升高的影响。 9 岁时压力和/或高糖化血红蛋白 (HbA1c)。在 K99 训练阶段，Choy 博士 将 (1) 扩展她的流行病学培训并使用生长混合模型来告知干预目标和 时机和（2）获得定性方法和实施科学方面的新技能，以进行选择和根据具体情况进行调整 萨摩亚使用的干预措施 积极实施框架和基于证据的最佳实践 太平洋岛民社区将指导干预措施的制定和实施，这将在 R00 阶段的结果将是针对萨摩亚儿童的年龄段的多方面干预。 其中 CMD 风险标志物（体重指数、血压和 HbA1c）对可改变的药物最敏感 此外，多成分干预将至少包含两个因素。 基于证据的生活方式/行为改变策略，以解决 CMD 风险因素，利用现有基础设施 和当地能力（与实施团队）并与社区确定的优先事项保持一致。 证明所制定的儿童干预措施的可行性、可接受性和有效性 萨摩亚将制定一个可扩展的计划，有可能在其他太平洋岛民群体中复制， 实现职业发展目标并确保成功过渡到类似的低资源环境。 独立，蔡博士建立了卓越的培训环境，发展了体验式学习 应用从教学课程中新获得的技能的活动，并组建了多学科指导 团队拥有公共卫生、实施科学、临床试验、人类生物学、流行病学等方面的专业知识 太平洋岛民健康。指导、研究培训、领导力和职业发展活动。 提议将确保在该奖项结束时，蔡博士将能够很好地扩展这些方法 发展到美国的太平洋岛民，他们是增长最快的种族和少数民族群体之一 由于 CMD 风险较高，他们是减少健康差距的早期干预的理想受益者。