Development Project 1

这一试点项目是与新墨西哥州纳瓦霍民族成员正在进行的伙伴关系的一部分。在缺乏服务的社区中，这项与癌症相关的公共卫生干预提案的长期目标是改善纳瓦霍民族人民的蔬菜和水果消费以及总体健康。美国西南部的印第安人对蔬菜和水果的摄入量很低，尤其是纳瓦霍人，他们的肥胖率也很高。纳瓦霍民族的土地是一片食物沙漠，因为它缺乏负担得起的健康食品，但纳瓦霍人接受提议的健康干预措施。种植自己的农产品的花园和小农场曾经是纳瓦霍人健康生活方式的一部分。 传统上，种植被视为一种更新活动，每个生长季都是自我更新的机会。 与纳瓦霍民族的研究合作需要在几年的时间里定期进行几个小时的对话和会议，以赢得信任。过去五年，我们与纳瓦霍民族成员密切合作，建立了成功的合作关系。许多社区领导人现在正在联系NMSU和其他合作推广机构，寻求帮助，将花园带回纳瓦霍民族的社区。我们计划在目前这些合作的基础上进一步发展，并共同建设我们的合作伙伴的能力，以开发和评估可持续的园艺健康干预计划，以改善纳瓦霍人及其邻居的健康和福祉。 具体地说，我们的目标是：1)开发一种多组成部分的干预措施，将社区花园、教育讲习班和纳瓦霍社区的社区外展部分整合在一起；2)评估综合干预措施对采用园艺做法、蔬菜和水果摄入量的影响；以及3)评估综合干预措施对与园艺和蔬菜水果消费相关的自我监控、自我效能、行为能力和社会规范的影响。 在社会认知理论的指导下，我们计划共同开发社区花园，并提供一个文化上合适的综合行为改变计划，并提供技术园艺支持，通过在纳瓦霍社区的分阶段合作干预来扩大这些花园项目。纳瓦霍文化和传统习俗的各个方面将纳入干预活动。纳瓦霍技术学院、Dine学院和NMSU合作推广机构是确保可持续性的干预措施的重要组成部分。该项目将为R01型建议奠定基础，包括干预措施和结果测量的规范，以小组随机设计正式评估干预措施的有效性。在试点中，使用准实验设计，我们将获得效应大小和变异性的估计，用于确定R01的样本大小。这项提议直接回应了NMSU/FHCRC伙伴关系的总体目标：它将增加NMSU在竞争环境中进行癌症研究的能力，并在FHCRC关注与癌症相关的健康差异研究。

This pilot project is part of an ongoing partnership with members of the Navajo Nation in New Mexico. The long range goal of this cancer-related public health intervention proposal in underserved communities is to improve vegetable and fruit consumption and general health among people ofthe Navajo Nation. The Southwest American Indian population has low intake of vegetables and fruit, especially among the Navajo, who also have high rates of obesity. The Navajo Nation land is a food desert because of its lack of access to affordable healthy foods, but the Navajo people are receptive to the wellness intervention proposed. Gardens and small farms that involved growing your own produce were once part of a healthy lifestyle for Navajo people. Traditionally, planting is viewed as a renewing activity, and each growing season is an opportunity for self renewal. Research collaborations with the Navajo Nation require dedication of hours in conversations and meetings at regular intervals over several years to gain trust. We have worked closely with members of the Navajo Nation over the past five years and have built a successful collaborative relationship. Many community leaders are now reaching out to NMSU and other cooperative extension agents for assistance with bringing gardens back to the communities on the Navajo Nation. We plan to build further on these current collaborations and together build the Capacity of our partners to develop and evaluate a sustainable garden-based health intervention program to improve health and wellness of the Navajo people and their neighbors. Specifically, we aim to: 1) Develop a multi-component intervention that integrates community gardens, educational workshops and community outreach components in Navajo communities; 2) Estimate the effects of an integrated intervention on adoption of gardening practices, vegetable and fruit intake; and 3) Estimate the effects of an integrated intervention on self-monitoring, self-efficacy, behavioral capability, and social norms related to gardening and vegetable and fruit consumption. Guided by an adaptation of social cognitive theory, we plan jointly to develop community gardens and to provide a culturally appropriate integrated behavioral change program with technical horticultural support to augment these garden projects through a phased collaborative intervention in Navajo communities. Aspects of Navajo culture and traditional practices will be integrated into the intervention activities. Navajo Technical College, Dine College and NMSU cooperative extension agents are an essential part ofthe intervention to ensure sustainability. This project will lay the groundwork, including specification ofthe intervention and ofthe outcome measures, for an R01 type proposal to formally evaluate the effectiveness ofthe intervention with a group randomized design. In the pilot, using a quasi-experimental design, we will obtain estimates of effect size and variability for use in determining the sample size for the R01. This proposal is directly responsive to the overall goal ofthe NMSU/FHCRC partnership: it will increase the capacity of NMSU to conduct cancer research in a competitive environment and attention at FHCRC to cancer-related health disparities research.