Healthy Immigrant Community: Mobilizing the Power of Social Networks

项目总结/摘要-项目1 从许多方面来看，移民来到美国比一般人更健康，但 他们在美国居住的时间越长，他们的心血管风险就越高，部分是由系统性因素介导的， 促进不健康行为的养成。鉴于影响这些问题的复杂社会文化力量， 行为，需要一个基于社区的参与性研究（CBPR）的方法来解决这些问题。罗切斯特 健康社区伙伴关系（RHCP）是一个CBPR伙伴关系，在集体部署 对移民群体的干预。RHCP测试了12个面对面模块的干预，以促进健康 移民人口中的行为。在12个月时，主要的 与对照组相比，饮食质量的结果表明，该计划可以满足 移民社区。然而，干预强度限制了其传播潜力， 并没有明确提出健康的减肥，也没有针对超重或肥胖的参与者。随后 社交网络（SN）对1,301名西班牙裔和索马里成年人的分析发现，肥胖和行为聚集在一起， 可确定的SN。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其社交网络内的同伴干预者提供。的 由此产生的社会网络干预进行了试点测试与4组（2索马里，2西班牙裔;总N=39）;参与者 体重、血压和胆固醇显著降低， 3个月时的饮食质量和体力活动（100%留存率）。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。这一方案的目标 是1）评估社交网络知情的CBPR衍生的健康促进干预对肥胖症的有效性 以及两个移民社区的心血管风险的其他措施; 2）评估对 将干预措施纳入区域健康促进资源的可持续性和吸收成果 枢纽采用阶梯楔形随机分组设计，46个社交网络亚组的成年人（23西班牙裔，23 索马里）约322名参与者（每组7人）将被随机分配接受干预 无论是立即还是延迟一年后。干预措施将包括12次社区辅导 和教育课程，然后由训练有素的索马里和西班牙裔人提供12次维护课程， 干预者以面对面或虚拟形式与其团体成员进行交流。通过24小时测量的结果 月，将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。这个程序 将动员SN的力量，为与肥胖相关的行为提供可扩展和可持续的解决方案， to reach到达populations人口. CBPR通过针对社会文化决定因素，增强了该方案的相关性。 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.