Healthy Immigrant Community: Mobilizing the Power of Social Networks

项目摘要/摘要--项目1 在许多衡量标准中，移民人口抵达美国时比一般人更健康，但 他们在美国居住的时间越长，他们的心血管风险就会上升得越多，部分原因是系统性因素 促进不良行为的养成。考虑到影响这些人的复杂的社会文化力量 要解决这些问题，需要一种基于社区的参与性研究(CBPR)方法。罗切斯特 健康社区伙伴关系(RHCP)是一种CBPR伙伴关系，在集体部署方面经验丰富 对移民群体的干预。RHCP测试了12个面对面的模块以促进健康 移民群体中的行为。在12个月时，初选儿童的情况有显著改善 饮食质量与对照组相比的结果，表明该计划可以满足儿童的独特需求 移民社区。然而，干预的强度限制了它的传播潜力，而干预 没有明确解决健康减肥问题，也没有针对超重或肥胖的参与者。随后，一个 对1301名西班牙裔和索马里成年人的社交网络(SN)分析发现，肥胖和行为由 可确定的社交网络。RHCP合作伙伴随后重新设计了现有的超重和肥胖干预材料 来自移民社区的成年人将由他们的社会网络中的同行干预者提供。这个 对4个群体(2名索马里人，2名西班牙人；总共39人)进行了社交网络干预的试点测试；参与者 显示出体重、血压和胆固醇的显著降低，以及 3个月时饮食质量和体力活动(保留率100%)。在此基础上，我们的总体目标是 促进明尼苏达州东南部移民社区的可持续健康促进。这个项目的目的是 1)评估社交网络信息CBPR衍生的健康促进干预对肥胖的有效性 和两个移民社区心血管风险的其他衡量标准；以及，2)评估对 将干预措施嵌入区域健康促进资源的可持续性和接受结果 集线器。使用阶梯式楔形群组随机设计，46个成人社交网络亚组(23个西班牙裔，23个 索马里)约322名参与者(每组7名)将被随机分配接受干预 要么立即，要么推迟一年。这项干预将包括12项基于社区的指导 和教育课程，随后由训练有素的索马里人和西班牙裔人主持12次维护课程 干预者以面对面或虚拟的形式向其小组成员提供干预。通过24小时衡量的结果 来自美国心脏协会的《生活的简单7》：BMI和腰围， 血压、空腹血糖、总胆固醇、体力活动水平和饮食质量。本节目 将调动SNS的力量，为困难人群中肥胖相关行为提供可扩展和可持续的解决方案 才能接触到人群。CBPR通过针对以下社会文化决定因素来加强该计划的相关性 这些行为。

PROJECT SUMMARY/ABSTRACT - Project 1 Across many measures, immigrant populations arrive to the US healthier than the general population, but the longer they reside in the US, the more their cardiovascular risk rises, mediated in part by systemic factors that promote the adoption of unhealthy behaviors. Given the complex sociocultural forces that influence these behaviors, a community-based participatory research (CBPR) approach is needed to address them. Rochester Healthy Community Partnership (RHCP) is a CBPR partnership experienced at collectively deploying interventions with immigrant groups. RHCP tested an intervention of 12 face-to-face modules to promote healthy behaviors within immigrant populations. At 12 months, there were significant improvements in the primary outcome of dietary quality compared with controls, suggesting this program could meet the unique needs of immigrant communities. However, the intervention intensity limits its dissemination potential, and the intervention did not explicitly address healthful weight loss, nor target overweight or obese participants. Subsequently, a social network (SN) analysis of 1,301 Hispanic and Somali adults found that obesity and behaviors clustered by ascertainable SNs. RHCP partners then re-designed existing intervention materials for overweight and obese adults from immigrant communities to be delivered by peer interventionists within their social networks. The resultant social network intervention was pilot tested with 4 groups (2 Somali, 2 Hispanic; total N=39); participants demonstrated significant reduction in weight, blood pressure, and cholesterol as well as improvements in their dietary quality and physical activity at 3 months (100% retention rate). Building on this, our overall objective is to foster sustainable health promotion for Southeast Minnesota immigrant communities. The aims of this program are to 1) assess the efficacy of a social network-informed CBPR-derived health promotion intervention on obesity and other measures of cardiovascular risk in two immigrant communities; and, 2) assess the impact on sustainability and uptake outcomes of embedding the intervention within a regional health promotion resource hub. Using a stepped wedge cluster randomized design, 46 social network sub-groups of adults (23 Hispanic, 23 Somali) with approximately 322 participants (7 per group) will be randomly assigned to receive the intervention either immediately or after a delay of one year. The intervention will consist of 12 community-based mentoring and education sessions, followed by 12 maintenance sessions delivered by trained Somali and Hispanic interventionists to members of their groups in a face-to-face or virtual format. Outcomes measured through 24 months, will be derived from the American Heart Association’s “Life’s Simple 7”: BMI and waist circumference, blood pressure, fasting blood glucose, total cholesterol, physical activity level, and dietary quality. This program will mobilize the power of SNs for scalable and sustainable solutions to obesity-related behaviors among difficult to reach populations. CBPR enhances the relevance of this program by targeting sociocultural determinants of these behaviors.