Wellness Program Implementation: School & Student Toolkits

健康计划实施：学校

• 批准号: 8909129
• 负责人: JUDITH WYLIE-ROSETT
• 金额: $ 5.62万
• 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 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8909129
• 关键词: Achievement; Action Research; Address; Adolescence; Adolescent; Adoption; Behavior; Behavioral; Beverages; Body mass index; Chronic Disease; Cluster randomized trial; 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; High School Student; Home environment; Hour; Individual; Institutes; Intake; Intervention; Life Style; Maintenance; Methods; 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; healthy lifestyle; high school; improved; member; models and simulation; nutrition; obesity prevention; prevent; programs; response; sedentary; simulation; social; trial design

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)：本申请将响应PAR 10-038，评估一种实施模式，该模式让健康理事会的高中生参与计划，以实现与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卫生队协调员的协助和支持下进行协作规划。为了促进实现2010年膳食指南，我们将实施一个进程，使学校能够从循证课程中选择工具包战略和要素(例如，青少年健康体力活动(PATH)，其中包括使用低成本资源的实施战略)。2010年饮食指南针对青少年肥胖的行为建议包括：减少含糖饮料的摄入量；增加早餐的频率；增加蔬菜和水果的摄入量，使其达到每天2.5杯，并传达“用水果和蔬菜填满你的盘子”的教育信息；减少快餐的频率；进行体育锻炼(目标是每天1小时)；减少久坐的行为时间(每天2小时)。社会生态框架为解决学校(微环境层面)和学生(个人层面)面临的障碍的两层综合方法奠定了基础。在学校层面，实施障碍将是 由学校健康理事会确定(或被带到)学校健康委员会(例如，拥挤的体育馆、缺乏设备、食品服务问题)，使用仿照更健康一代学校工具包联盟的工具包方法。在学生层面，工具包将重点放在改变生活方式的实施障碍上。学生工具包的选项包括通过社交媒体(如Facebook、短信或电子邮件)为学生量身定做的支持，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。采用阶梯式楔形整群随机试验设计，对参与式实施模式进行测试，每年从纽约市医疗队高中中随机抽取。这一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在不同、复杂的学校环境中解决健康障碍，我们将使用系统动力学建模(SDM)。这种方法将把定量和定性的评估结果综合到模拟输出中，以显示健康规划在干预期间被适应和维持的过程。我们假设，参与式实施学校的学生将比等待名单上的卫生服务团对照学校的学生获得更好的饮食和体育活动健康习惯。第二个假设是，与等待名单上的HealthCorps对照学校的学生相比，他们所在的NYC HealthCorps学校被随机分配到参与式实施后，学生将获得关键的健康行为；第三个假设：使用系统动力学模型来评估实施将有助于更稳健的传播。模拟分析将应用RE-AIM框架：(REACH(参与率)、有效性(结果)、采用(可接受性)、实施(干预保真度)和维护(学生和学校改变生活方式的可持续性))。