Osage Community Supported Agriculture Study (OCSA)

奥塞奇社区支持农业研究 (OCSA)

• 批准号: 10201061
• 负责人: Valarie Blue Bird Jernigan
• 金额: $ 54.4万
• 依托单位: OSU CENTER FOR HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-12 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10201061
• 关键词: Address; Adult; Agriculture; American Indians; Area; Birds; Blood Pressure; Body mass index; Cardiometabolic Disease; Centers for Disease Control and Prevention (U.S.); Child; Chronic Disease; Collaborations; Communities; Congresses; Control Groups; Costs and Benefits; Dependence; Diabetes Mellitus; Diastolic blood pressure; Diet; Disease; Disease Outcome; Education; Employee; Farming environment; Food; Food Access; Food Supply; Food production; Funding; General Population; Glycosylated hemoglobin A; Government; Health; Health Food; Health Status; High Prevalence; Household; Hypertension; Indian reservation; Indigenous; Individual; Institute of Medicine (U.S.); Intake; Intervention; Knowledge; Life; Marketing; Mediating; Methods; Mission; Morbidity - disease rate; Multimedia; Obesity; Oklahoma; Online Systems; Osage; Outcome; Overweight; Participant; Policies; Population; Prevention; Process; Public Health; Randomized; Randomized Controlled Trials; Research; Reservations; Risk Factors; Rural; Savings; Schools; Source; System; Testing; Time; Tribes; Unhealthy Diet; United States; Waiting Lists; aged; base; blood lipid; cardiometabolism; community based participatory research; cooking; cost; cost effectiveness; design; disparity elimination; economic evaluation; efficacy testing; evidence base; experience; fast food; food insecurity; fruits and vegetables; group intervention; health care service utilization; health disparity; health economics; health related quality of life; improved; mortality; nutrition; nutrition education; prevent; primary outcome; programs; recruit; research study; secondary outcome; tribal Nation; tribal community; urban Native American

PROJECT SUMMARY/ABSTRACT The food system is comprised of food production, access, and marketing. Public health efforts have been increasingly focused on food systems given that poor diet is the number one risk factor for preventable disease in the United States. American Indians (AIs) experience substantial diet-related health disparities: AI adults are 50% more likely to be obese, 30% more likely to have hypertension, and twice as likely to have diabetes compared to Whites. In 2013, the Osage Nation in Oklahoma launched Bird Creek Farm (BCF) with the mission to facilitate Indigenous food sovereignty, defined as the right and responsibility of Indigenous peoples to healthy and culturally appropriate foods produced through traditional Indigenous practices. By 2015, BCF had 12 employees and began providing food to tribal programs. In the same year, in collaboration with BCF, our team launched the NIMHD-funded FRESH farm-to-school program (R01MD011266). Preliminary findings from this tribally-driven community-based participatory research (CBPR) study show an increase in vegetable and fruit intake among children and adults and a decrease in food insecurity. Building upon our eight-year CBPR partnership, the proposed study will implement a new community supported agriculture (CSA) program in which Osage citizens will receive a weekly share of freshly grown farm produce for 6 months. CSAs have improved diet and health in non-AI populations, and are evidence-based strategies recommended by the Centers for Disease Control and Prevention and the Institute of Medicine to reduce health disparities, but no randomized controlled trial of a CSA program has been conducted in the AI population. Accordingly, we will test the efficacy of a CSA program combined with culturally-tailored nutrition and cooking education on diet and health outcomes among Osage adults, evaluate its cost-effectiveness, and develop a multimedia toolkit for disseminating findings. Our specific aims are to: 1) Conduct a randomized controlled trial to test the newly developed CSA program’s effect on diet, blood pressure, and blood lipids (primary outcomes) and on body mass index (BMI), hemoglobin A1c (HbA1c), food insecurity, and health status (secondary outcomes) among 600 AI adults (aged 18-75) with overweight/obesity; 2) Perform an economic evaluation for individual (e.g., health-related quality of life), organizational (e.g., healthcare utilization costs), and community-level (e.g., prevention of cardiometabolic diseases) outcomes; and 3) Document and disseminate study processes and findings using participatory video methods, and compile a web-based toolkit for other AI communities to use CBPR to improve tribal food systems. This study is the first to rigorously intervene across all components of the food system to address poor diet and health among AIs. Building upon Osage Nation assets and priorities, guided by a CBPR and Indigenous food sovereignty orientation, and based upon recommended strategies to eliminate disparities, study findings will inform research and policy efforts to create sustainable food access in reservations with high rates of chronic disease as well as urban AI communities where CSAs are available and could be tailored to AIs.

项目概要/摘要 粮食系统由粮食生产、获取和营销组成。公共卫生工作已 鉴于不良饮食是可预防疾病的头号风险因素，人们越来越关注粮食系统 在美国。美洲印第安人 (AI) 经历着与饮食相关的巨大健康差异：AI 成年人 肥胖的可能性增加 50%，患高血压的可能性增加 30%，患糖尿病的可能性增加两倍 与白人相比。 2013 年，俄克拉荷马州的 Osage Nation 成立了 Bird Creek Farm (BCF)，其使命是 促进土著粮食主权，定义为土著人民获得健康的权利和责任 以及通过传统原住民做法生产的符合文化的食品。到 2015 年，BCF 已拥有 12 员工并开始为部落项目提供食物。同年，我们的团队与BCF合作 启动了 NIMHD 资助的 FRESH 农场到学校计划 (R01MD011266)。由此初步发现 部落驱动的社区参与研究（CBPR）研究显示蔬菜和水果的增加 儿童和成人的摄入量以及粮食不安全状况的减少。以我们八年的 CBPR 为基础 合作伙伴关系中，拟议的研究将实施一项新的社区支持农业（CSA）计划，其中 奥塞奇公民将在 6 个月内每周获得一份新鲜种植的农产品。 CSA 有所改善 非人工智能人群的饮食和健康，是各中心推荐的基于证据的策略 疾病控制与预防和医学研究所减少健康差异，但没有随机 CSA 计划的对照试验已在人工智能人群中进行。据此，我们将测试功效 CSA 计划与针对饮食和健康结果的文化定制营养和烹饪教育相结合 在 Osage 成年人中，评估其成本效益，并开发一个多媒体工具包来传播研究结果。 我们的具体目标是： 1) 进行随机对照试验来测试新开发的 CSA 项目的有效性 对饮食、血压和血脂（主要结果）以及体重指数 (BMI)、血红蛋白的影响 600 名 AI 成年人（18-75 岁）的糖化血红蛋白 (HbA1c)、食品不安全和健康状况（次要结果） 超重/肥胖； 2) 对个人进行经济评估（例如与健康相关的生活质量）， 组织层面（例如，医疗保健利用成本）和社区层面（例如，预防心脏代谢疾病） 疾病）结果； 3) 使用参与式视频记录并传播研究过程和结果 方法，并为其他人工智能社区编写一个基于网络的工具包，以使用 CBPR 来改善部落粮食系统。 这项研究首次对食品系统的所有组成部分进行严格干预，以解决不良饮食和 人工智能之间的健康状况。以奥塞奇国家的资产和优先事项为基础，以 CBPR 和土著食品为指导 主权导向，并根据建议的消除差异战略，研究结果将 为研究和政策工作提供信息，以在慢性病发病率高的保留地创造可持续的粮食获取 疾病以及城市人工智能社区，其中 CSA 可用并且可以针对人工智能进行定制。