Disseminating Effective Community-Led Programs to Elimanate Diabetes Disparities

描述(由申请人提供)：糖尿病流行对黑人和拉丁裔的影响不成比例，可以通过导致减肥的生活方式干预来遏制。不幸的是，这些计划要么不针对最脆弱的低收入少数群体，要么当他们的研究资金消失时就不复存在了。七年前，东哈莱姆区的社区和学术界领袖聚集在一起，利用基于社区的参与性研究来开发一种干预措施，以可持续地缩小健康差距，并使用严格的方法进行评估。合作伙伴开发了HEED，这是一种低成本、文化和经济上合适的、同行主导的基于社区的糖尿病预防计划，并招募了400名患有糖尿病前期的黑人和拉丁裔成年人参加一项基于社区的多点随机对照试验，以测试其对体重变化的影响。在这些以低收入、讲西班牙语、没有保险、受教育程度低的人群中，Heed导致了统计上所有显著的体重减轻、饮食改善和平均血糖水平。我们现在的目标是在居住在东哈莱姆区的34000名糖尿病高危成年人和为他们提供服务的324个社区组织中传播HEAT。为了实现这一目标，我们的伙伴关系将使用理论驱动的实施战略来：1)通过评估组织和个人的传播障碍以及传播的促进者，确定广泛传播HEED的方法；2)通过定制面对面的HEED研讨会和开发i-HEED在线研讨会，将HEED转化为日常使用；3)利用社会和组织网络、社交媒体和经济激励措施，有力地传播HEED；4)评估我们的传播努力的范围、覆盖范围和影响，比较不同方法的有效性，并确定经济上可持续的模式；5)通过持续的合作伙伴关系和结构化的学习机会，提高社区成员参与未来研究的能力，从而使社区受益。我们将利用吸取的经验教训，提出有价值的见解，帮助其他人在现实世界中传播以证据为基础的卫生干预措施，以消除健康差距。

DESCRIPTION (provided by applicant): The diabetes epidemic, which disproportionately impacts Blacks and Latinos, can be stemmed through lifestyle interventions that lead to weight loss. Unfortunately, these programs either do not target the most vulnerable, low-income minority populations, or cease to exist when their research funding disappears. Seven years ago, community and academic leaders in East Harlem came together to use community-based participatory research to develop an intervention that would sustainably reduce health disparities and evaluate it using rigorous methods. Partners developed HEED, a low-cost, culturally and economically appropriate, peer-led community-based diabetes prevention program, and recruited 400 Black and Latino adults with pre-diabetes to a community-based, multisite randomized controlled trial to test its impact on weight change. HEED led to statisticall significant weight loss, improvements in diet and a leveling of average glucose in this predominantly low-income, Spanish-speaking, uninsured, undereducated population. We now aim to disseminate HEED among the 34,000 adults living in East Harlem at heightened risk for diabetes and the 324 community organizations who serve them. To accomplish this, our partnership will use theoretically-driven implementation strategies to: 1) Identify ways to widely disseminate HEED through assessing organizational and individual barriers to, and facilitators of dissemination; 2) Translate HEED for everyday use by tailoring in-person HEED workshops and developing I-HEED online workshops; 3) Robustly disseminate HEED using social and organizational networks, social media, and economic incentives; 4) Evaluate the extent, reach, and impact of our dissemination efforts, compare effectiveness of different approaches, and identify economically sustainable models; 5) Increase the capacity of community members to engage in future research for community benefit through continued partnership and structured learning opportunities. We will use lessons learned to contribute valuable insights that will assis others in real-world dissemination of evidence-based health interventions to eliminate health disparities.