The Health for Hearts United Collaborative

项目主任/首席调查员(最后、第一、中间)：Ralston，Penny A。 心与心健康联合协作 项目摘要 心血管疾病(CVD)是美国人的主要死亡原因，对 与以下人群相比，非裔美国人(AA)的心血管疾病相关发病率和死亡率最高 其他民族/种族群体。这些高心血管疾病发生率的风险因素与各种因素有关，包括 生活方式。基于教会的干预已被证明在改善儿童的身体健康结果方面是有效的 美国医学会。然而，推进以教会为基础的健康科学的一个关键障碍是 有效的战略和循证卫生计划的实施程度以及 由教会自己维持的心脏健康联合协作(HHUC)，一个社区- 由45个教堂组成的学术伙伴关系，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，该研究旨在降低北部两县地区腹主动脉的心血管风险 佛罗里达州，使用基于社区的参与性研究方法。我们现在寻求利用这一协作 环境，以调查教会本身实施这种干预的情况，因为我们扩大了 HHUC。因此，拟议的项目将决定HHUC实施战略的有效性 在生态学理论的指导下，关于腹主动脉的处理结果和降低心血管疾病风险， 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、 和基本的支持。基于在选定的HHUC教会中观察到的成功，我们建议增加第四个 包括两种可能的实施战略之一的组件：1)内部领先者(IC)驱动 包括两个特点的战略(领导力发展、文化定制规划方法)或2) 没有这些功能的外部变革推动者(外部专业人员[EP])驱动的战略。在第一阶段，我们将 使用来自四个教会的卫生领导，试行和完善由IC和EP驱动的实施战略 通过确定两县片区的可行性和可接受性。在第二阶段，我们将使用一种有效性- 实施混合类型3设计，以评估IC和EP实施策略 过程成果(覆盖、采用、实施和维护)；以及个人健康行为(食品 选择、饮食质量、体力活动)和临床结果(体重指数、腰围、收缩压和舒张压 血压)，使用会众(&gt；18，n=225)，在两县地区的九个教堂：三个IC治疗， 三个EP处理，三个与延迟可比活动比较。这项研究的发现将 告知HHUC的扩大和AAA中心血管疾病风险的降低，对其他社区有影响 和美国的地区。 OMB编号0925-0001/0002(批准的第03/2020版至2023年2月28日)续页格式页

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