Native American Youth Cardiovascular Disease Prevention: Implementation of Culturally-Tailored Evidence-Based After School and Home Visitation Programs for Healthy Eating and Physical Activity

美国原住民青少年心血管疾病预防：实施基于文化的循证课后和家访计划，以促进健康饮食和体育活动

• 批准号: 10494238
• 负责人: SIMONE A. FRENCH
• 金额: $ 69.11万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494238
• 关键词: Address; Adoption; American Indians; Behavior; Behavioral; Cardiovascular Diseases; Chronic Disease; Cities; Communities; Conscious; Consensus; Diabetes Mellitus; Diet; Dose; Education; Educational Curriculum; Effectiveness; Environment; Evaluation; Evidence based intervention; Evidence based program; Family; Food; Future; Goals; Health Personnel; Health Priorities; Healthy Eating; Home visitation; Hypertension; Individual; Intervention; Leadership; Level of Evidence; Low income; Maintenance; Measurement; Mentors; Minnesota; Modeling; Native Americans; Obesity; Outcome; Physical activity; Primary Health Care; Process; Program Sustainability; Public Health; Race; Randomized; Reach Effectiveness Adoption Implementation and Maintenance; Research; Research Design; Research Personnel; Resource-limited setting; Resources; Risk Factors; Schools; Scientist; Self Determination; Site; Social Work; Structural Racism; Structure; System; Training; Training Support; Twin Multiple Birth; Universities; Work; Youth; after-school program; base; cardiometabolic risk; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; care systems; community based participatory research; community burden; community clinic; effectiveness evaluation; evidence base; experience; implementation fidelity; implementation intervention; implementation outcomes; implementation process; implementation science; implementation strategy; implementation trial; innovation; minority children; personalized approach; prevent; process evaluation; programs; racial and ethnic; racism; school district; service providers; social; social exclusion; social health determinants; socioeconomics; tool; uptake; urban Native American; youth sports

PROJECT SUMMARY – Project 3 Urban Native American communities experience significant and persistent disparities in cardiovascular diseases, obesity and diabetes, and their preventable behavioral precursors, diet and physical activity. This study implements two multi-level evidence-based interventions (EBIs) Minnesota NET-Works and Stanford GOALS in partnership with six American Indian after school programs and community-serving organizations in the Minneapolis, St Paul and Duluth Minnesota. Adoption and maintenance of these programs can be enhanced and effectiveness strengthened through a structured, evidence-based participatory approach that tailors the interventions to meet the cultural, organizational contextual, and broader socioeconomic context and incorporates local innovations. This proposal is poised to achieve these goals through a community-based participatory research (CBPR).Coalition including the healthcare provider Minneapolis Native American Community Clinic (NACC, primary care system), Minneapolis and St Paul and Duluth Minnesota School Districts' Indian Education after school programs (school system), the social service provider Division of Indian Work's Family Spirit Home Visitation program (social service provider system), departments of public health and University of Minnesota researchers. The Coalition will use the evidence-based 10-step Getting to Outcomes (GTO) tailoring and implementation approach to enhance implementation fidelity, reach and acceptance, and sustainability among the after school programs and community-serving organizations. Native American organization leadership and program delivery staff will receive mentoring and training in the tailored EBI curricula and in effective implementation strategies. Implementation strategy effectiveness will be assessed using a stepped wedge study design. The study uses the Social Ecological Model as its multilevel intervention framework, and RE-AIM as its implementation process evaluation measurement framework. Implementation outcomes include organizational leadership support, staff implementation capacity, and intervention fidelity (program reach, intervention content, delivery, receipt and dose). An important innovative aspect of the proposed research is its use of evidence-based implementation strategies to strengthen the capacity of the programs and staff to implement the interventions with broad reach, high participation, and strong fidelity by aligning with local culture and context. The proposed project will use proven effective implementation strategies to build program organizational leadership and program delivery staff implementation capacity to successfully engage urban Native American families in strengths-based, culturally- grounded programs to promote youth physical activity and healthy eating. Sustained program engagement among urban Native American families will promote healthy eating and physical activity behaviors that will reduce future cardiovascular disease risk in this highly burdened community.

项目总结-项目3