The Health for Hearts United Collaborative

项目主任/主要研究者（最后，第一，中间）：Ralston，Penny A。 心脏健康联合会 项目摘要 心血管疾病（CVD）是美国死亡的主要原因， 非裔美国人（AAs）的CVD相关发病率和死亡率最高， 其他种族/民族。这些高CVD率的风险因素与多种因素有关，包括 生活方式基于教会的干预措施已被证明是有效的改善身体健康的结果， 原子吸收法然而，推进以教会为基础的健康科学的一个关键障碍是了解最重要的 有效的战略和循证卫生方案的实施程度， 由教会自己维护的心脏健康联合协作（HHUC），一个社区- 学术伙伴关系由45个教会组成，与更广泛的多县卫生联盟合作， 是在两项成功的干预研究后建立的，以减少北卡罗来纳州两县地区AA的CVD风险。 佛罗里达，使用基于社区的参与性研究方法。我们现在寻求利用这种合作 环境，以调查这种干预的实施，由教会本身，因为我们扩大了 HHUC。因此，拟议项目将决定HHUC实施战略的有效性 在生态学理论的指导下， 实施研究综合框架（CFIR）和RE-AIM框架，并使用两个- 阶段性方法。HHUC模式目前包括三个组成部分：治理结构，年度活动， 基本的支持。根据在选定的HHUC教会观察到的成功，我们建议增加第四个 包括两种可能的实施策略之一的组件：1）内部冠军（IC）驱动 战略，包括两个特点（领导力发展，文化量身定制的规划方法）或2） 外部变革推动者（外部专业人士[EP]）驱动的战略，而不具备这些特征。在第一阶段，我们将 试点和完善IC和EP驱动的实施战略，利用来自四个教会的卫生领导人， 通过确定可行性和可接受性来确定两县区域。在第二阶段，我们将使用有效性- 实施混合3型设计，以评估IC和EP实施策略， 过程结果（覆盖、采用、实施和维护）;以及个人健康行为（食物 选择，饮食质量，体力活动）和临床结果（BMI，围度，收缩和舒张 血压），使用两县地区9个教堂的会众（>18，n=225）：3次IC治疗， 三个EP处理，和三个延迟可比活动的比较。这项研究的结果将 告知HHUC的扩展和AA中CVD风险的降低，以及对其他社区的影响 和美国的地区。 OMB编号0925-0001/0002（修订版03/2020批准至02/28/2023）页码继续格式页码

Program Director/Principal Investigator (Last, First, Middle): Ralston, Penny A. The Health for Hearts United Collaborative Project Summary Cardiovascular disease (CVD) is the leading cause of death in the United States, and disproportionately affects African Americans (AAs) who have the highest rates for CVD-related morbidity and mortality in comparison to other ethnic/racial groups. Risk factors for these high CVD rates are related to a variety of factors, including lifestyle. Church-based interventions have been shown to be effective in improving physical health outcomes of AAs. However, a critical barrier to advancing the science of church-based health is understanding the most effective strategies and the extent to which evidence-based health programs can be implemented and maintained by churches themselves The Health for Hearts United Collaborative (HHUC), a community- academic partnership comprised of 45 churches in collaboration with a broader multi-county health coalition, was established after two successful intervention studies to reduce CVD risk in AAs in a two-county area of North Florida, using community-based participatory research approaches. We now seek to use this collaborative environment to investigate implementation of this intervention by the churches themselves as we expand the HHUC. Thus, the proposed project will determine the effectiveness of HHUC implementation strategies in relation to process outcomes and reducing CVD risk in AAs, guided by ecological theory, the Consolidated Framework for Implementation Research (CFIR), and the RE-AIM framework, and using a two- phase approach. The HHUC model currently includes three components: governance structure, annual events, and basic support. Based on observed successes in selected HHUC churches, we propose adding a fourth component that includes one of two possible implementation strategies: 1) an internal champions (IC)-driven strategy that includes two features (leadership development, culturally-tailored planning approaches) or 2) an external change agent (external professionals [EP])-driven strategy without these features. In Phase 1, we will pilot and refine the IC and EP-driven implementation strategies using health leaders from four churches in the two-county area by determining feasibility and acceptability. In Phase 2, we will use an effectiveness- implementation hybrid Type 3 design to evaluate the IC and EP implementation strategies in relation to process outcomes (reach, adoption, implementation and maintenance); and individual health behaviors (food choice, dietary quality, physical activity) and clinical outcomes (BMIs, girth circumferences, systolic and diastolic blood pressure), using congregants ((>18, n=225) in nine churches in the two-county area: three IC treatment, three EP treatment, and three comparison with delayed comparable activities. The findings from this study will inform the expansion of the HHUC and the reduction of CVD risk in AAs, with implications for other communities and regions in the U.S. OMB No. 0925-0001/0002 (Rev. 03/2020 Approved Through 02/28/2023) Page Continuation Format Page