Wellness Program Implementation: School & Student Toolkits

健康计划实施：学校

• 批准号: 8580482
• 负责人: JUDITH WYLIE-ROSETT
• 金额: $ 72.05万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8580482
• 关键词: Achievement; Action Research; Address; Adolescence; Adolescent; Adoption; Behavior; Behavioral; Beverages; Body mass index; Chronic Disease; Clinical Trials Design; Communities; Complex; Crowding; Decision Making; Development; Diet; Education; Educational Curriculum; Effectiveness; Electronic Mail; Elements; Enrollment; Ensure; Environment; Equipment; Evaluation; Exercise; Food Services; Foundations; Frequencies; Fruit; Generations; Goals; Guidelines; Habits; Health; Health behavior; Healthy People 2020; Home environment; Hour; Individual; Institutes; Intake; Intervention; Life Style; Maintenance; Methods; Metric; Modeling; Motivation; New York City; Obesity; Outcome; Output; Pattern; Physical Education; Physical activity; Policies; Process; Randomized; Recommendation; Research; Resources; School Teachers; Schools; Self Efficacy; Students; System; Testing; Text; Time; Training Programs; Underrepresented Minority; Weight Gain; Wellness Program; Youth; base; cost; design; empowered; evidence base; fast food; fruits and vegetables; high school; improved; member; models and simulation; nutrition; obesity prevention; prevent; programs; public health relevance; randomized trial; response; sedentary; simulation; social

DESCRIPTION (provided by applicant): This application, in response to PAR 10-038, will evaluate of an implementation model that engages high school students in Wellness Council planning to achieve obesity-related health recommendations. The implementation planning will apply a participatory action research approach to empower students as stakeholders and to facilitate collaborative planning by school Wellness Councils, facilitated and supported by the HealthCorps coordinators. To facilitate achievement of the 2010 Dietary Guidelines, we will implement a process to enable schools to select toolkit strategies and elements from evidence-based curricula (e.g., Physical Activity for Teenage Health (PATH), which includes implementation strategies using low-cost resources). The 2010 Dietary Guidelines obesity-related behavioral recommendations for youth include: decreasing sugary beverage intake; increasing frequency of breakfast; increasing vegetable and fruit intake to 2 1/2 cups per day with "fill half your plate with fruit and veggies" educational message; decreasing frequency of fast food meals; becoming physically active (goal of 1 hour per day); and reducing sedentary behavior time (<2 hour day). The social ecological framework provides the foundation for a two-tiered integrative approach which addresses barriers faced by the school (micro-environmental level) and by the students (individual level). At the school level, implementation barriers will be identified by (or brought to) the school Wellness Councils (e.g., crowded gym, lack of equipment, food service issues) using a toolkit approach patterned after the Alliance for a Healthier Generation school toolkits. At the student level, the toolkit will focus on barriers to implementation of lifestyle changes. Options for the student toolkit include tailored student support via social media e.g., Facebook, text message or email to address common internal barriers, such as self-efficacy and motivation, and external barriers in the home, school and community environment. Using a stepped wedge cluster randomized trial design to roll out testing of the participatory implementation model, we will randomly select from among the NYC HealthCorps high schools each year. This design will allow us to assess the impact of wellness programming on students, in relation to their school environment. To evaluate how our participatory implementation model addresses wellness barriers in diverse, complex school settings, we will employ system dynamics modeling (SDM). This method will synthesize both quantitative and qualitative assessment results into simulation output that will show the process by which wellness programming is adapted and sustained over the intervention period. We hypothesize that students in the participatory implementation schools will achieve better dietary and physical activity health habits than students in waitlisted HealthCorps control schools. Secondary hypothesis, students will achieve key health behaviors after their NYC HealthCorps school is randomized to participatory implementation compared to students in the waitlisted HealthCorps control schools; Tertiary hypothesis: Using system dynamics modeling to evaluate implementation will facilitate more robust dissemination. The simulation analysis will apply the RE-AIM framework: (Reach (participation rates), effectiveness (outcomes), adoption (acceptability), implementation (intervention fidelity), and maintenance (sustainability of lifestye changes by students and programs by schools).

描述（由申请人提供）：本申请，在响应PAR 10-038，将评估一个实施模式，从事高中学生在健康理事会规划，以实现肥胖相关的健康建议。实施规划将采用参与性行动研究方法，以增强学生作为利益攸关方的能力，并促进学校健康委员会在保健团协调员的协助和支持下进行合作规划。为了促进2010年膳食指南的实现，我们将实施一项程序，使学校能够从循证课程中选择工具包战略和要素（例如，青少年健康体育活动（PATH），其中包括使用低成本资源的实施战略）。2010年饮食指南对青少年肥胖相关行为的建议包括：减少含糖饮料的摄入;增加早餐的频率;每天增加蔬菜和水果的摄入量至2.5杯，并传达“水果和蔬菜占你盘子的一半”的教育信息;减少快餐餐的频率;进行体育锻炼。（目标是每天1小时）;减少久坐行为时间（每天<2小时）。社会生态框架提供了一个两层的综合方法，解决学校（微观环境层面）和学生（个人层面）所面临的障碍的基础。在学校一级，执行障碍将是 由学校健康委员会确定（或带到）（例如，健身房拥挤、缺乏设备、餐饮服务问题），采用仿照更健康一代联盟学校工具包的工具包方法。在学生一级，该工具包将侧重于实施生活方式改变的障碍。学生工具包的选项包括通过社交媒体提供量身定制的学生支持，Facebook、短信或电子邮件，以解决常见的内部障碍，如自我效能和动机，以及家庭、学校和社区环境中的外部障碍。使用阶梯式楔形群随机试验设计来推出参与式实施模式的测试，我们将每年从纽约市卫生队高中中随机选择。这种设计将使我们能够评估健康规划对学生的影响，与他们的学校环境有关。为了评估我们的参与式实施模式如何解决多样化，复杂的学校环境中的健康障碍，我们将采用系统动力学建模（SDM）。这种方法将把定量和定性评估结果综合成模拟输出，显示在干预期间调整和维持健康规划的过程。我们假设，学生在参与式实施学校将实现更好的饮食和体育活动的健康习惯比学生在候补健康队控制学校。第二假设，学生将实现关键的健康行为后，他们的纽约市健康队学校被随机参与实施相比，学生在等待健康队控制学校;第三假设：使用系统动力学模型来评估实施将促进更强大的传播。模拟分析将应用RE-AIM框架：（达到（参与率），有效性（结果），采用（可接受性），实施（干预保真度）和维护（学生和学校方案的生活方式变化的可持续性）。