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.

项目总结/摘要 资源不足的社区受到结构性障碍和有害条件的影响， 心理和身体健康方面的差距。生活在这些社区的人也可能面临财务和 在社区中参与有意义和有益活动的后勤障碍，这与风险有关 抑郁症和心血管代谢疾病的风险。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疾病，这支持了干预这些疾病的价值。 危险因素同时发生。结构化的干预措施，增加参与奖励 活动对治疗抑郁症是有效的，但这种方法还没有被广泛推广 在资源不足的人群中，他们在获得医疗保健系统方面面临挑战， 心脏代谢危险因素。 该项目将完善和测试一种新的方法，以减轻抑郁症和心脏代谢的负担。 疾病在资源不足的社区。健康社区的活动与休闲（二） 干预的目的是通过适应行为，促进参与奖励活动， 激活治疗抑郁症，并直接提供资源，从事有益的娱乐和 社会活动，无论是独立的，并通过我们的合作伙伴社区为基础的组织。拱 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， 消除获得治疗的障碍。目标1是让社区利益相关者参与共同 设计可持续发展战略，以最大限度地提高可行性、可接受性和可接受性。目标2是对以下方面进行初步评价： 对来自资源不足社区的成年抑郁症患者进行了精细的干预。变化 抑郁症状，肥胖，和身体活动超过四个月将比较这些之间 随机分配到一个社区卫生服务中心和一个传统的健康推广比较中心。除了临床结果， 计划的实施、成本和可行性的关键指标将被量化，并假设机制 将探索潜在的治疗效果（目标3）。该项目还包括可持续性规划活动 专注于保护这个项目，作为我们社区的持久资源。调查结果将告知 设计一个明确的实施试验，并确定纳入行为的潜在价值 在针对得不到充分服务的人群的其他外联干预措施中发挥积极作用。