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）人口通常被认为是美国任何非白人种族/民族群体中最严重的疾病和行为健康差异。实现这些目标的干预措施很少得到检验。人工智能/AN社区的一个潜在干预点是通过工作场所，因为工作场所提供了接触人工智能/AN人员的途径，并得到通信和金融基础设施的支持。2003年，卫生与公众服务部发出一项行动呼吁，要求全国的雇主实施针对慢性病的工作场所健康促进干预措施。我们已经为一般人群创建并试行了一个专门设计用于工作场所的一揽子计划。我们的综合方案建立在两个联邦工作组——美国预防服务工作组和社区预防服务工作组——收集的证据之上。它建议雇主在工作场所实施15项措施，这些措施涉及健康保险福利、政策、项目、沟通和跟踪系统等广泛领域。这15种做法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，4)使用乳房x光检查，5)使用巴氏涂片，6)体育锻炼，6)戒烟治疗。人工智能/非人工智能人群的工作环境、需求和生活结构，以及他们所遭受的健康差距，要求进行形成性研究，以创建和测试这种干预措施。因此，本建议的具体目标是制定一套行之有效的健康促进干预措施，在文化上适合人工智能/人工智能工作场所环境；测试在4种不同类型的AI/AN工作场所实施该方案的可行性；并评估其可接受性和可用性。我们从试点研究中发现，雇主和他们对我们的方法和建议的反应表明，我们正在满足一个很大程度上未被满足的需求——在印度，这个需求将会更大。对于拟议研究的成功至关重要的是，我们还发现，试点研究中开发的干预措施可以由社区合作伙伴的项目干预人员在学术合作伙伴的监督下成功交付。社区参与对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。这个项目将在几个方面对公共卫生很重要。它针对的是一个不平等的群体，即美洲原住民。它利用公共卫生渠道，在工作场所实施行之有效的干预措施。最后，将进一步开发一种可用于多种环境的干预模式，并用于改变慢性疾病的多种危险因素。

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.