Implementing Health Promotion Activities in Native Employers

描述(由申请人提供)：美国印第安人/阿拉斯加原住民(AI/AN)通常被认为是美国所有非白人种族/民族中疾病和行为健康差距最大的群体。几乎没有对实现这些目标的干预措施进行过测试。人工智能/人工智能社区的一个潜在干预点是通过工作场所，因为工作场所提供接触人工智能/人工智能人员的途径，得到通信和金融基础设施的支持。2003年，卫生与公众服务部向全国雇主发出行动呼吁，针对慢性病实施工作场所健康促进干预措施。我们为普通民众制定并试行了一套专门为工作场所实施的一揽子计划。我们的综合方案建立在两个联邦特别工作组--美国预防服务特别工作组和社区预防服务特别工作组--收集的证据的基础上。它推荐了雇主应该在工作场所实施的15种做法，这些做法属于医疗保险福利、保单、计划以及通信和跟踪系统等广泛领域。这15项实践旨在帮助员工增加以下7种具体行为：1)结肠癌筛查，2)健康饮食，3)流感免疫接种，4)乳房X光检查，5)巴氏涂片，6)体育锻炼，6)戒烟治疗。人工智能/AN人员的工作环境、需求和生活结构，加上他们遭受的健康差距，需要形成性研究来创造和测试这种干预。因此，这项提议的具体目标是创建一套在人工智能/人工智能工作场所环境中文化上合适的经证实的健康促进干预措施；测试在4种不同类型的人工智能/人工智能/人工智能工作场所实施该一揽子干预措施的可行性；并评估其可接受性和可用性。我们从试点研究中发现的雇主以及他们对我们的方法和建议的反应表明，我们正在满足一个在很大程度上没有得到满足的需求--在印度国家，这种需求甚至会更大。对于拟议研究的成功至关重要，我们还发现，试点研究中制定的干预措施可以由社区合作伙伴的项目干预者在学术合作伙伴的监督下成功提供。社区参与对于印度社区参与的研究工作的成功以及对新方法的接受和传播至关重要。该项目将在几个方面对公共卫生产生重要影响。它针对的是差异较大的人群，即美洲原住民。它利用公共卫生渠道实施行之有效的工作场所干预措施。最后，将进一步开发一种可在多种环境下使用的干预模式，用于改变慢性病的多种危险因素。

DESCRIPTION (provided by applicant): American Indian/Alaska Native (AI/AN) populations are generally considered to suffer from the most dramatic disease and behavior health disparities of any non-White racial/ethnic group in the US. Few interventions to accomplish these goals have been tested. One potential point of intervention in AI/AN communities is through the workplace because workplaces provide access to AI/AN people, supported by communications and financial infrastructures. In 2003, the Department of Health and Human Services issued a call to action to the nation's employers to implement workplace health promotion interventions aimed at chronic diseases. We have created and piloted a package for the general population that is specifically designed to be implemented in the workplace. Our comprehensive package builds on the evidence collected by 2 federal task forces, the U.S. Preventive Services Task Force and the Task Force on Community Preventive Services. It recommends 15 practices that employers should implement in the workplace that fall into the broad domains of health insurance benefits, policies, programs, and communication and tracking systems. The 15 practices are aimed at helping employees increase the following 7 specific behaviors: 1) colon cancer screening, 2) healthy eating, 3) influenza immunization, 4) mammography use, 5) Pap smear use, 6) physical activity, and 6) tobacco cessation treatment. The working environments, needs, and structures of the lives of AI/AN people, in conjunction with the health disparities they suffer from, call for formative research to create and test such an intervention. Thus, the specific aims of this proposal are to create a package of proven health promotion interventions that is culturally appropriate in AI/AN workplace settings; test the feasibility of implementing this package in 4 different types of AI/AN workplaces; and evaluate its acceptability and usability. Our findings from the pilot study employers and their responsiveness to our approach and recommendations suggested that we are serving a largely unmet need - a need that will be even greater in Indian Country. Critical to the success of the proposed study, we have also found that the intervention developed in the pilot study could be successfully delivered by project interventionists from a community partner, with oversight from the academic partners. Community participation is critical to the success of research efforts involving Indian communities and to the acceptance and dissemination of new approaches. This project will be important to public health in several ways. It targets a disparities population, Native American people. It uses a public health channel for the implementation of proven interventions, workplaces. Finally, it will further develop an intervention model that can be used in multiple settings, and used to change multiple risk factors for chronic disease.