Chicago Chronic Condition Equity Network (C3EN)

芝加哥慢性病股票网络 (C3EN)

• 批准号: 10892358
• 负责人: ELBERT S. HUANG
• 金额: $ 70万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10892358
• 关键词: Academic Medical Centers; Address; Adherence; Adult; Affect; Behavior; Behavioral; Cardiometabolic Disease; Chicago; Chronic; Clinical; Communities; Community Health; Data; Disparity; Effectiveness; Equity; Evaluation; Evidence based treatment; Exhibits; Exposure to; Face; Grant; Health; Health Promotion; Health Services Accessibility; Health behavior; Healthcare Systems; Home; Household; Hyperphagia; Individual; Inequity; Intervention; Learning; Link; Measures; Mental Depression; Mental Health; Methodology; Modeling; Monitor; Obesity; Outcome; Participant; Pathology; Pathway interactions; Persons; Phase; Physical activity; Pilot Projects; Population; Premature Mortality; Process; Provider; Randomized; Recreation; Resources; Rewards; Risk; Risk Factors; Safety; Series; Structure; Testing; Training; Transportation; Underserved Population; Weight maintenance regimen; cardiometabolic risk; community engagement; community organizations; community partnership; cost; cost effectiveness; depressive symptoms; design; exercise intervention; experience; future implementation; health care availability; implementation cost; implementation trial; improved; novel strategies; outreach; physical conditioning; physical inactivity; preservation; programs; reinforcer; screening; social; social health determinants; symptom management; symptomatology; treatment effect; underserved community; uptake

PROJECT SUMMARY/ABSTRACT Underresourced communities are affected by structural barriers and detrimental conditions that contribute to disparities in mental and physical health. People living in these communities may also face financial and logistical barriers to engaging in meaningful and rewarding activities in their community, which is linked to risk for depression and cardiometabolic disease in emerging health behavior models. There is also evidence that depression, physical inactivity, and reward-driven overeating exhibit reciprocal causal relationships that promote cardiometabolic disease through multiple pathways, which supports the value of intervening on these co-occurring risk factors simultaneously. Structured interventions that increase engagement in rewarding activities are effective for treating depression, but this approach has not been adapted for broad dissemination in underresourced populations that face challenges accessing the health care system, and have a high burden of cardiometabolic risk factors. This project will refine and test a novel approach for reducing the burden of depression and cardiometabolic disease in underresourced communities. The Activity and Recreation in Communities for Health (ARCH) intervention is designed to promote engagement in rewarding activities through an adaptation of Behavioral Activation Treatment for Depression, and direct provision of resources to engage in rewarding recreational and social activities both independently and through our partnering community-based organizations. ARCH is designed to be delivered in participants’ homes and community venues by a health outreach workforce, which addresses barriers to accessing treatment. Aim 1 is to engage community stakeholders in the process of co- designing ARCH to maximize feasibility, acceptability, and uptake. Aim 2 is to conduct an initial evaluation of the refined ARCH intervention among adults from underresourced communities with depression. Changes in depressive symptoms, adiposity, and physical activity over four months will be compared between those randomly assigned to ARCH versus a traditional health outreach comparator. In addition to clinical outcomes, key metrics of program uptake, cost, and feasibility will be quantified, and hypothesized mechanisms underlying treatment effects will be explored (Aim 3). The project also includes sustainability planning activities focused on preserving this program as an enduring resource to our communities. Findings will inform the design of a definitive implementation trial, and determine the potential value of incorporating behavioral activation in other outreach interventions for underserved populations.

项目摘要/摘要 资源不足的社区受到结构性障碍和不利条件的影响，这些障碍和不利条件导致 心理和身体健康方面的差距。生活在这些社区的人还可能面临经济和 在社区中从事有意义和有回报的活动的后勤障碍，这与风险有关 针对抑郁症和心脏代谢性疾病的新兴健康行为模式。也有证据表明 抑郁、缺乏运动和奖励驱动的暴饮暴食表现出相互的因果关系 通过多种途径促进心脏代谢性疾病，这支持了干预这些途径的价值 风险因素同时并存。增加奖励参与度的结构化干预措施 活动对治疗抑郁症是有效的，但这种方法还没有被广泛传播。 在资源不足的人群中，他们面临获得医疗保健系统的挑战，并且负担很重 心脏新陈代谢危险因素。 该项目将提炼和测试一种减轻抑郁和心脏代谢负担的新方法 在资源匮乏的社区中的疾病。健康社区中的活动和娱乐(ARCH) 干预旨在通过适应行为来促进对奖励活动的参与 抑郁症的激活治疗，并直接提供资源，从事有回报的娱乐和 独立或通过我们以社区为基础的合作组织的社会活动。拱门是 旨在由健康外展工作人员在参与者的家中和社区场所提供服务，这 解决获得治疗的障碍。目标1是让社区利益攸关方参与共同 设计ARCH以最大限度地提高可行性、可接受性和可接受性。目标2是对 对患有抑郁症的资源匮乏社区的成年人进行精细化的ARCH干预。中的更改 抑郁症状、肥胖和超过四个月的体力活动将在这些人之间进行比较。 随机分配到ARCH与传统健康外展比较器。除了临床结果， 项目采用率、成本和可行性的关键指标将被量化，并假设机制 将探讨潜在的治疗效果(目标3)。该项目还包括可持续性规划活动。 专注于将这一计划作为我们社区的一种持久资源来保存。调查结果将告知 设计最终的实施试验，并确定合并行为的潜在价值 启动针对服务不足人群的其他外展干预措施。