Heart Matters: Collaborate and Leverage Evidence in an African American Rural Network to Implement Risk Reduction Strategies for CVD (Heart Matters: Co-Learn to Reduce CVD)
心脏问题:在非裔美国人农村网络中合作并利用证据来实施 CVD 风险降低策略(心脏问题:共同学习减少 CVD)
基本信息
- 批准号:10463643
- 负责人:
- 金额:$ 61.08万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-08-15 至 2026-07-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAdoptionAdultAffectAfrican AmericanAfrican American populationBehaviorBiological MarkersBlood PressureCardiovascular DiseasesCholesterolClinicClinicalCollaborationsCommunitiesConsolidated Framework for Implementation ResearchCountyDisease OutcomeEffectivenessEnrollmentEvidence based programFeedbackFundingGoalsHeartHybridsIndividualKnowledgeLearningMapsMethodsMorbidity - disease rateNorth CarolinaOutcomeParticipantPatient Self-ReportPenetrationPhysical activityProtocols documentationRandomizedRandomized Controlled TrialsReadinessResearchRisk ReductionRuralRural CommunityScienceSiteSocial supportSystemTestingTrainingTraining SupportTranslationsUnited Statesbasebehavioral outcomeburden of illnesscardiometabolismcardiovascular disorder riskconcept mappingcost effectivecost effectivenessdietarydisease disparityeffectiveness evaluationeffectiveness implementation designefficacy testingfeasibility testingfeasibility trialhigh riskimplementation barriersimplementation determinantsimplementation evaluationimplementation outcomesimplementation strategyimprovedinnovationmodel buildingmortalityorganizational readinessrecruitrural African Americanrural countiesrural settingstakeholder perspectivessuccesstreatment armtrial designuptake
项目摘要
ABSTRACT
Cardiovascular disease (CVD) exacts a disproportionate toll on rural African American communities in the
Southeast. Implementing and scaling a proven-effective, evidence-based program (EBP) is essential to
mitigate growing disparities in CVD risk among rural communities. We previously adapted PREMIER, an EBP,
into Heart Matters and conducted a randomized controlled feasibility trial at seven host sites in two rural
counties in eastern North Carolina (NC), largely populated with African Americans with high CVD burden. As
with PREMIER, systolic blood pressure and self-reported physical activity and dietary behaviors significantly
improved in the intervention arm compared to controls after 6 months. Heart Matters’ success, however, was
dampened by critical implementation barriers at the organizational level, including limited readiness, partial
collaboration between stakeholders, and low organizational efficacy to implement an EBP, which reduced
fidelity and penetration of Heart Matters. To address implementation barriers, our research team will
investigate the implementation and effectiveness of the Heart Matters EBP by scaling to five rural counties in
Eastern NC. Guided by the Consolidated Framework for Implementation Research, our overall objective is to
partner with organizations to scale and test Heart Matters implementation to other rural African American
communities, and support translation of evidence to practice in eastern NC. In year 1, we will collaborate with
our longstanding community-academic coalition to identify and recruit eligible organizations from our study
setting (Edgecombe, Franklin, Nash, Vance, and Warren Counties). We will engage organizations (n=60) in
formative research using concept mapping to identify and map contextual implementation factors affecting EBP
implementation in rural African American communities. We will use these findings to refine existing training
protocols and develop an organizational collaborative called “Collaborate and Leverage Evidence in an African
American Rural Network” or Co-LEARN. In year 2, we will identify Co-LEARN sites (n=18) and employ
participatory systems science methods to develop an implementation blueprint through: 1) shared learning
aimed at training and capacity building and 2) shared action planning aimed at continuous quality improvement
of implementation strategy at the site-level. The objective of Co-LEARN is to increase organizational
readiness, strengthen network collaborations, and enhance organizational efficacy to implement a CVD EBP.
In years 3-4, we will employ a hybrid type II implementation effectiveness design to conduct a cluster
randomized controlled trial (n=486). We will evaluate outcomes of implementation (e.g., acceptability, adoption,
penetration), CVD biomarkers (e.g., blood pressure, cholesterol, physical activity) and cost effectiveness of
Heart Matters. Our long-term goal is to increase acceptability, adoption, and penetration of CVD EBPs in rural
United States by building organizational readiness and capacities to implement sustainable and cost-effective
EBPs to mitigate CVD disparities.
抽象的
心血管疾病 (CVD) 对美国农村非裔美国人社区造成了不成比例的损失
东南。实施和扩展经证明有效、循证的计划 (EBP) 对于
缩小农村社区之间日益扩大的心血管疾病风险差异。我们之前改编了 PREMIER,一个 EBP,
进入 Heart Matters 并在两个农村地区的七个主办地点进行了随机对照可行性试验
北卡罗来纳州 (NC) 东部的县主要由非裔美国人组成,CVD 负担较高。作为
与 PREMIER 相比,收缩压和自我报告的体力活动和饮食行为显着
6 个月后,与对照组相比,干预组有所改善。然而,Heart Matters 的成功在于
由于组织层面的关键实施障碍而受到抑制,包括准备有限、部分
利益相关者之间的协作以及实施 EBP 的组织效率低,这降低了
心事的保真度和穿透力。为了解决实施障碍,我们的研究团队将
通过扩展到 5 个农村县来调查 Heart Matters EBP 的实施情况和有效性
北卡罗来纳州东部。在实施研究综合框架的指导下,我们的总体目标是
与组织合作,扩大和测试“心脏问题”在其他农村非裔美国人中的实施情况
社区,并支持将证据转化为北卡罗来纳州东部的实践。在第一年,我们将与
我们长期的社区学术联盟从我们的研究中识别和招募合格的组织
县(埃奇科姆县、富兰克林县、纳什县、万斯县和沃伦县)。我们将让组织 (n=60) 参与
使用概念图来识别和绘制影响 EBP 的上下文实施因素的形成性研究
在非洲裔美国农村社区实施。我们将利用这些发现来完善现有的培训
协议并开发一个名为“非洲合作和利用证据”的组织合作
美国农村网络”或 Co-LEARN。在第 2 年,我们将确定 Co-LEARN 站点(n=18)并雇用
参与式系统科学方法通过以下方式制定实施蓝图:1)共享学习
旨在培训和能力建设,2) 旨在持续提高质量的共同行动计划
站点层面的实施策略。 Co-LEARN 的目标是增强组织能力
准备、加强网络协作并提高实施 CVD EBP 的组织效率。
在第 3-4 年,我们将采用混合型 II 实施有效性设计来进行集群
随机对照试验(n=486)。我们将评估实施结果(例如可接受性、采用率、
渗透率)、CVD 生物标志物(例如血压、胆固醇、体力活动)和成本效益
心脏很重要。我们的长期目标是提高农村地区 CVD EBP 的接受度、采用率和渗透率
美国通过建立组织准备和能力来实施可持续和具有成本效益的
EBP 旨在减少 CVD 差异。
项目成果
期刊论文数量(0)
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会议论文数量(0)
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Giselle Corbie其他文献
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{{ truncateString('Giselle Corbie', 18)}}的其他基金
Heart Matters: Collaborate and Leverage Evidence in an African American Rural Network to Implement Risk Reduction Strategies for CVD (Heart Matters: Co-Learn to Reduce CVD)
心脏问题:在非裔美国人农村网络中合作并利用证据来实施 CVD 风险降低策略(心脏问题:共同学习减少 CVD)
- 批准号:
10662283 - 财政年份:2021
- 资助金额:
$ 61.08万 - 项目类别:
Heart Matters: Collaborate and Leverage Evidence in an African American Rural Network to Implement Risk Reduction Strategies for CVD (Heart Matters: Co-Learn to Reduce CVD)
心脏问题:在非裔美国人农村网络中合作并利用证据来实施 CVD 风险降低策略(心脏问题:共同学习减少 CVD)
- 批准号:
10182576 - 财政年份:2021
- 资助金额:
$ 61.08万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
10320421 - 财政年份:2020
- 资助金额:
$ 61.08万 - 项目类别:
Diversity Supplement: Implementation of EMR-Integrated Referrals
多样性补充:实施 EMR 集成转诊
- 批准号:
10543572 - 财政年份:2020
- 资助金额:
$ 61.08万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
10542812 - 财政年份:2020
- 资助金额:
$ 61.08万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
9886378 - 财政年份:2020
- 资助金额:
$ 61.08万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
10078633 - 财政年份:2020
- 资助金额:
$ 61.08万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
10756399 - 财政年份:2020
- 资助金额:
$ 61.08万 - 项目类别:
Reducing Cardiovascular Disease Risk Factors in Rural Communities in NC
减少北卡罗来纳州农村社区的心血管疾病危险因素
- 批准号:
8604189 - 财政年份:2014
- 资助金额:
$ 61.08万 - 项目类别:
Reducing Cardiovascular Disease Risk Factors in Rural Communities in NC
减少北卡罗来纳州农村社区的心血管疾病危险因素
- 批准号:
9566458 - 财政年份:2014
- 资助金额:
$ 61.08万 - 项目类别:
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