Community Translation of the South Asian Healthy Lifestyle Intervention (SAHELI)

南亚健康生活方式干预（SAHELI）的社区翻译

• 批准号: 10221765
• 负责人: NAMRATHA R KANDULA
• 金额: $ 66.79万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10221765
• 关键词: Address; Adoption; Age; Asians; Atherosclerosis; Bangladesh; Behavior Therapy; Behavioral; Belief; Bhutan; Blood Pressure; Cardiovascular Diseases; Cardiovascular Models; Cholesterol; Clinical; Clinical effectiveness; Communities; Control Groups; Counseling; Diastolic blood pressure; Diet; Education; Effectiveness; Effectiveness of Interventions; Ethnic group; Evaluation; Family; Foundations; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Goals; Guidelines; Heart Diseases; Heterogeneity; Hispanics; Hour; Hybrids; India; Individual; Informal Social Control; Intervention; Life Style; Maldives; Mediating; Mediator of activation protein; Methods; Modeling; Monitor; Motivation; Myocardial Ischemia; Nepal; Not Hispanic or Latino; Outcome; Pakistan; Patients; Pattern; Persons; Physical activity; Pilot Projects; Population; Positioning Attribute; Process; Public Health; Randomized Controlled Trials; Recording of previous events; Research; Risk; Risk Factors; Self Efficacy; Social support; South Asian; Sri Lanka; Subgroup; Techniques; Testing; Translations; Trust; Unhealthy Diet; United States; Use Effectiveness; Weight; Work; acceptability and feasibility; atherosclerosis risk; base; behavior change; cardiovascular disorder risk; cardiovascular health; clinical implementation; clinical risk; community based participatory research; comparison group; cost; design; diet and exercise; disease disparity; effectiveness evaluation; efficacy testing; ethnic minority population; evidence base; family support; healthy lifestyle; high risk; hybrid type 1 trial; illness perceptions; implementation evaluation; information gathering; intervention effect; intervention participants; lifestyle intervention; mortality; mortality statistics; motivational enhancement therapy; perceived stress; physical inactivity; prevent; preventive intervention; primary outcome; psychosocial; racial and ethnic; response; retention rate; sex; skills; social; social culture; stress management; treatment effect

Project Summary South Asians, the second fastest growing ethnic group in the Unites States (U.S.), have an elevated risk of early and aggressive cardiovascular disease (CVD) compared to non-Hispanic Whites and other Asian subgroups. Recent mortality statistics show that South Asians have a higher heart disease mortality rate than these other racial/ethnic groups, suggesting an urgent need for targeted public health efforts. Although intensive diet and physical activity counseling interventions are recommended for individuals with CVD risk factors, our prior research identified that existing lifestyle interventions are not reaching South Asians because these interventions did not address the social and cultural determinants of cardiovascular health. Using community-based participatory research, we developed and pilot-tested the South Asian Healthy Lifestyle Intervention (SAHELI), a theoretically-driven lifestyle intervention that integrates evidence-based behavior change techniques with the community's sociocultural context, needs, and beliefs. The intervention includes weekly group classes, experiential activities, and motivational interviewing to increase the components of self- regulation that have been shown to be most effective for eliciting diet and physical activity changes. The pilot study (n=63) established feasibility and acceptability of the SAHELI intervention, had a 100% retention rate at 6 months, and showed significant improvements in weight and hemoglobin A1c among intervention participants compared to a control group. The goal of the proposed study is to conduct a randomized controlled trial to test the efficacy of the SAHELI intervention in a larger, more generalizable at-risk South Asian population and to collect information on the intervention's potential for implementation in real-world settings. Our Primary Aims are to: 1) Determine whether participation in the SAHELI intervention is associated with significantly greater improvements in clinical risk factors associated with CVD (primary outcomes of systolic and diastolic blood pressure, cholesterol, glycated hemoglobin, and weight) relative to a comparison group that receives print education materials on healthy lifestyle; and 2) Conduct a multi-stakeholder implementation evaluation to evaluate the SAHELI intervention and community-based participatory research process. We hypothesize that the SAHELI intervention will result in significantly greater improvements in clinical risk factors than print education materials at 12 months. In Secondary Aims, we will determine SAHELI's effect on behavioral and psychosocial outcomes, and examine mediators of intervention effect. The proposed study expands on our prior research by using an effectiveness and preliminary implementation (type 1 hybrid) design, which tests the effects of a clinical intervention on relevant outcomes while observing and gathering information on initial implementation. Given the lack of evidence on effective lifestyle interventions for South Asians at-risk for CVD, the proposed research is of scientific and public health import.

项目摘要 南亚人是Unites州（美国）中第二快的种族，其风险较高 与非西班牙裔白人和其他亚洲人相比，早期和侵略性心血管疾病（CVD） 亚组。最近的死亡率统计数据表明，南亚人的心脏病死亡率高于 这些其他种族/族裔群体，表明迫切需要有针对性的公共卫生努力。虽然 对于患有CVD风险的人，建议采取强化饮食和身体活动咨询干预措施 因素，我们先前的研究表明，现有的生活方式干预措施没有到达南亚人，因为 这些干预措施并未针对心血管健康的社会和文化决定因素。使用 基于社区的参与性研究，我们开发并进行了试点测试的南亚健康生活方式 干预措施（Saheli），一种理论上驱动的生活方式干预措施，整合基于证据的行为 通过社区的社会文化背景，需求和信念来改变技术。干预包括 每周小组课程，体验活动和动机访谈，以增加自我的组成部分 被证明对引起饮食和体育锻炼变化最有效的调节。飞行员 研究（n = 63）确定了萨赫利干预的可行性和可接受性，其保留率为100％ 6个月，并且在干预中显示体重和血红蛋白A1C的显着改善 参与者与对照组相比。拟议的研究的目的是进行随机 对照试验测试Saheli干预措施在更大，更普遍的南亚的功效 人口并收集有关干预措施在现实环境中实施潜力的信息。 我们的主要目的是：1）确定参与Saheli干预是否与 与CVD相关的临床危险因素的改善（收缩期的主要结果）明显更大 相对于比较组 接受有关健康生活方式的印刷教育材料； 2）进行多利益相关者实施 评估以评估Saheli干预和基于社区的参与研究过程。我们 假设Saheli干预将导致临床风险因素的改善明显改善 比12个月的印刷教育材料。在次要目标中，我们将确定Saheli对 行为和社会心理结局，并检查干预效果的介体。拟议的研究 通过使用有效性和初步实施（1型混合动力）来扩展我们先前的研究 设计，测试临床干预对相关结果的影响，同时观察和收集 有关初始实施的信息。鉴于缺乏有关南方有效生活方式干预措施的证据 ASIAS在CVD处于危险中，拟议的研究是科学和公共卫生的进口。