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.

项目概要 南亚人是美国人口增长第二快的族裔群体，患此病的风险较高 与非西班牙裔白人和其他亚洲人相比，患有早期和侵袭性心血管疾病 (CVD) 亚组。最近的死亡率统计数据显示，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 建议对有心血管疾病风险的个人进行强化饮食和身体活动咨询干预 因素，我们之前的研究发现，现有的生活方式干预措施并未惠及南亚人，因为 这些干预措施没有解决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，我们开发并试点了南亚健康生活方式 干预（SAHELI），一种理论驱动的生活方式干预，整合了基于证据的行为 根据社区的社会文化背景、需求和信仰改变技术。干预措施包括 每周的小组课程、体验活动和动机访谈，以增加自我激励的成分 已被证明对于引起饮食和身体活动改变最有效的调节。飞行员 研究 (n=63) 确立了 SAHELI 干预措施的可行性和可接受性，在 100% 的保留率 6 个月后，干预期间体重和糖化血红蛋白显着改善 参与者与对照组进行比较。拟议研究的目标是进行一项随机 对照试验测试 SAHELI 干预措施在更大、更普遍的高危南亚地区的有效性 人口并收集有关干预措施在现实环境中实施的潜力的信息。 我们的主要目标是： 1) 确定参与 SAHELI 干预是否与 与 CVD 相关的临床危险因素（收缩压的主要结果）显着改善 和舒张压、胆固醇、糖化血红蛋白和体重）相对于对照组 收到有关健康生活方式的印刷版教育材料； 2) 进行多方利益相关者实施 评估 SAHELI 干预和基于社区的参与性研究过程。我们 假设 SAHELI 干预将导致临床危险因素显着改善 比 12 个月时印刷的教育材料要多。在次要目标中，我们将确定 SAHELI 对 行为和心理社会结果，并检查干预效果的中介因素。拟议的研究 通过使用有效性和初步实施（1 类混合）扩展了我们之前的研究 设计，在观察和收集的同时测试临床干预对相关结果的影响 有关初步实施的信息。鉴于缺乏关于南方地区有效生活方式干预的证据 亚洲人有患心血管疾病的风险，拟议的研究具有科学和公共卫生意义。