Applying Innovative Approaches to Design and Implement an Intervention to Improve Cardiovascular Health in Hispanic/Latin communities through Restaurants

这个应用程序的总体目标是提供候选人，梅丽莎福斯特博士，必要的培训， 转变为促进西班牙裔社区营养和心血管健康的独立研究人员 通过创新的、基于证据的环境干预措施和政策。拟议项目响应 迫切需要改善西班牙裔加勒比社区的饮食质量和心血管健康， 创新方法。虽然大多数营养干预措施针对的是个人行为， 来创造支持健康食物选择的环境。餐馆可以成为促进这一变化的一种手段， 考虑到外出消费食品的重要性日益增加。与一个跨学科和多- 部门团队的导师和合作者，博士福斯特将适用于理论为基础的框架，从实施 科学发展和测试西班牙裔加勒比餐厅行动（HCRiA）倡议，一项干预措施， 改善波多黎各和多米尼加餐馆营养环境。解决复杂和 动态性质的餐厅环境，研究补充了理论框架的方法 从系统科学和以人为本的设计。这些方法有助于餐厅的参与 利益相关者（业主，厨师和服务员），以确定和解决阻碍健康饮食行为的障碍 在餐馆里。目标1将使用来自系统科学的参与式小组讨论技术来描述 顾客和餐馆层面的因素，促进和阻碍健康的营养环境，在HC餐厅。 目标2将应用行为变化轮（实施科学理论框架）和人类- 中心设计方法，让餐厅利益相关者（业主，员工和客户）参与设计， HCRIA倡议。目标3将使用混合方法，准实验设计，以试点测试的结果 总共干预了四家餐厅。研究活动将与课程和指导交织在一起 进一步发展以下关键培训领域：（1）以人为本的设计和系统科学， (2)实施科学，（3）准实验方法，（4）大型项目和赠款 发展该K 01项目有助于改善食品环境的公共卫生方法， 饮食相关的健康差距，并应用实施科学来解决一个重要的证据- 实践差距，预防和治疗心血管疾病的循证饮食模式没有得到 在社区一级实行。拟议计划的完成将为成功实施 竞争R 01级资金，用于HCRiA倡议的全面社区试验，支持申请人的 通过在研究人员和社区中的传播活动， 营养研究者的多样性。

The overall goal of this application is to provide the candidate, Melissa Fuster, Ph.D., essential training to transition into an independent researcher promoting nutrition and cardiovascular health in Hispanic communities through innovative, evidence-based environmental interventions and policies. The proposed project responds to the critical need to improve diet quality and cardiovascular health among Hispanic Caribbean communities using innovative approaches. While most nutrition interventions target individual behaviors, there is a pressing need to create environments that support healthy food choices. Restaurants can be a vehicle to facilitate this change, given the growing importance of foods consumed away from home. Working with an interdisciplinary and multi- sectoral team of mentors and collaborators, Dr. Fuster will apply a theory-based framework from Implementation Sciences to develop and test the Hispanic Caribbean Restaurants in Action (HCRiA) initiative, an intervention to improve nutrition environments in Puerto Rican and Dominican restaurants. Addressing the complex and dynamic nature of restaurant environments, the study complements the theoretical framework with approaches from systems science and human-centered design. These approaches facilitate the engagement of restaurant stakeholders (owners, cooks, and wait-staff) to identify and solve barriers preventing healthier eating behaviors in restaurants. Aim 1 will use a participatory group discussion technique from systems science to characterize customer and restaurant-level factors that facilitate and hinder healthy nutrition environments in HC restaurants. Aim 2 will apply the Behavioral Change Wheel (Implementation Sciences theoretical framework) and human- centered design approaches to engage restaurant stakeholders (owners, staff, and customers) in the design of the HCRiA initiative. Aim 3 will use a mixed-method, quasi-experimental design to pilot test the resulting intervention in a total of four restaurants. Research activities will be intertwined with coursework and mentorship to further development in the following critical training areas: (1) Human-Centered Design and Systems Science, (2) Implementation Science, (3) Quasi-experimental methods, and (4) Large-scale project and grant development. This K01 project contributes public health approaches to improve food environments to ameliorate diet-related health disparities, and the application of implementation science to tackle an important evidence- practice gap, where evidence-based dietary patterns to prevent and treat cardiovascular disease are not being practiced at the community level. The completion of the proposed plan will provide a solid base to successfully compete for R01-level funding for a full-scale community trial of the HCRiA initiative, bolster the applicant’s publication record through dissemination activities among researchers and the community, and augment diversity among nutrition researchers.