Center to Improve Chronic disease Outcomes through Multi-level and Multi-generational approaches Unifying Novel Interventions and Training for health EquitY (The COMMUNITY Center)

通过多层次、多代人方法统一新型干预措施和培训以促进健康公平改善慢性病结果的中心（社区中心）

• 批准号: 10892512
• 负责人: Elizabeth Gross Cohn
• 金额: $ 97.17万
• 依托单位: COLUMBIA UNIVERSITY 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: 2021-09-22 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10892512
• 关键词: Address; Adoption; Adult; Affect; American Heart Association; Behavior; Behavior Therapy; Behavioral; Black Populations; Black race; Cardiometabolic Disease; Cardiovascular Diseases; Chronic Disease; Cluster randomized trial; Communities; Community Health; Cost of Illness; Data Collection; Diabetes Mellitus; Diet; Dimensions; Disease Outcome; Disparity; Effectiveness; Enrollment; Ensure; Environment; Equity; Ethnic Origin; Evaluation; Faith-based organization; Future; Goals; Health; Health Educators; Health Policy; Health Technology; Health behavior; Health education; Heat Waves; High Prevalence; Hispanic Populations; Home; Hypertension; Immigrant community; Individual; Indoor Air Pollution; Inflammatory; Intervention; Life; Life Style; Light; Longterm Follow-up; Malignant Neoplasms; Measures; Methods; Misinformation; Modeling; Monitor; Morbidity - disease rate; Motivation; National Institute on Minority Health and Health Disparities; Neighborhoods; New York City; Noise; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Participant; Pathway interactions; Physical activity; Physical environment; Public Health; Race; Randomized; Recommendation; Research; Role; Sampling; Shapes; Site; Sleep; Strategic Planning; Support System; System; Underserved Population; United States National Institutes of Health; Update; Woman; Work; aged; allostatic load; behavior change; blood pressure reduction; burden of illness; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; community center; community engagement; community involvement; community organizations; community setting; disease disparity; economic disparity; economic impact; effectiveness/implementation design; effectiveness/implementation study; empowerment; evidence based guidelines; fitbit; glycemic control; good diet; health disparity; health equity; health inequalities; health knowledge; health training; healthy lifestyle; hispanic community; implementation determinants; implementation framework; implementation intervention; implementation outcomes; improved; improvement on sleep; innovation; intervention effect; lifestyle factors; lifestyle intervention; men; mortality; multiple chronic conditions; neighborhood disadvantage; novel; peer; poor sleep; preservation; primary endpoint; primary outcome; programs; risk prediction; secondary outcome; sleep health; treatment as usual; urban setting

PROJECT SUMMARY/ABSTRACT: Improving multiple domains of cardiometabolic health (CMH) through contextual behavioral interventions has the potential to substantially reduce persistent chronic disease disparities. Sleep is critical for preserving CMH and is amenable to intervention in real-world settings. Although sleep health, in conjunction with other lifestyle behaviors, can improve CMH through complementary or synergistic pathways, most existing lifestyle change programs focus solely on diet and physical activity. We will conduct a community-based cluster randomized trial to evaluate the impact of incorporating a multidimensional sleep health intervention into the BWELL4LIFE program, an ongoing 4-week program for promoting CMH through healthy diet and physical activity, delivered by peer health educators at faith-based organizations and community centers in underserved NYC neighborhoods (Aim 1). The enhanced 6-week intervention, SLEEP2BWELL, will include the following additional components: 1) two sleep health education and group coaching sessions, 2) self-monitoring and motivational enhancement using a Fitbit, and 3) addressing prevalent environmental barriers to healthy sleep in urban settings such as noise, light, heatwaves, with a novel and timely extension to address indoor air pollution based on input from our community partners. We will randomize 14 community sites into the intervention (SLEEP2BWELL) or usual care (BWELL4LIFE) group, enrolling an average of 15 participants per site for an expected sample of 210. We will collect objective measures of sleep and physical activity throughout the study, and assess diet and CMH outcomes at baseline, 10 weeks (primary endpoint), and 24 weeks (long-term follow-up to assess sustainability of the intervention’s effect). We hypothesize that SLEEP2BWELL will enhance the effectiveness of BWELL4LIFE leading to greater improvements in CMH, including reduced blood pressure (primary outcome) improved health behaviors (sleep, diet, physical activity) and adiposity markers (secondary outcomes), as well as better glycemic control and inflammatory and allostatic load indicators (exploratory outcomes). To ensure the successful completion and future expansion of this work, we will use mixed methods to understand implementation determinants and outcomes, guided by implementation science frameworks (Aim 2). This first-of-its-kind effectiveness-implementation study, addressing individual level behaviors and factors and upstream influences and leveraging key behavior change and community engagement strategies, will investigate the integration of sleep health into a multi-behavior lifestyle change intervention aimed at addressing CMH disparities in community settings. Our innovative multilevel intervention will inform scalable sustainable community health approaches and public health policy, consistent with NIH’s priorities to improve sleep health and CMH disparities through advancement in novel multilevel bundled behavioral interventions.

项目总结/摘要： 通过相关行为干预改善心脏代谢健康（CMH）的多个领域， 大幅度减少持续性慢性病差距的潜力。睡眠对保持CMH至关重要 并且在现实世界中易于干预。虽然睡眠健康，结合其他生活方式 行为，可以通过互补或协同途径改善CMH，大多数现有的生活方式改变， 这些项目只关注饮食和体育活动。我们将进行一项基于社区的随机分组试验 评估将多维睡眠健康干预纳入BWELL 4LIFE的影响 计划，一个持续4周的计划，促进CMH通过健康的饮食和体育活动，交付 由信仰组织和社区中心的同伴健康教育工作者在服务不足的纽约市 社区（目标1）。强化的6周干预，SLEEP 2BWELL，将包括以下额外的 组成部分：1）两个睡眠健康教育和小组辅导课程，2）自我监测和激励 使用Fitbit增强，以及3）解决城市环境中健康睡眠的普遍环境障碍 例如噪音、光、热浪，并根据输入进行新颖而及时的扩展，以解决室内空气污染问题 我们的社区合作伙伴。我们将随机选择14个社区站点进行干预（SLEEP 2BWELL）或 常规护理（BWELL 4LIFE）组，每个研究中心平均招募15名参与者，预期样本量为210。 我们将在整个研究过程中收集睡眠和体力活动的客观指标，并评估饮食和CMH 基线、10周（主要终点）和24周（长期随访以评估可持续性）时的结局 干预的效果）。我们假设SLEEP 2BWELL将增强BWELL 4LIFE的有效性 导致CMH的更大改善，包括降低血压（主要结局）改善健康 行为（睡眠，饮食，体力活动）和肥胖标志物（次要结局），以及更好的血糖 对照和炎症及非稳态负荷指标（探索性结局）。确保成功 完成和未来扩展这项工作，我们将使用混合方法来了解实施情况 决定因素和成果，以实施科学框架为指导（目标2）。这是第一次 有效性----执行研究，解决个人层面的行为和因素以及上游影响 并利用关键的行为改变和社区参与战略，将调查整合 睡眠健康纳入多行为生活方式改变干预，旨在解决CMH差异， 社区设置。我们创新的多层次干预将为可扩展的可持续社区健康提供信息 方法和公共卫生政策，与NIH改善睡眠健康和CMH差异的优先事项一致 通过新的多层次捆绑行为干预的进步。

项目成果

Multidimensional Sleep Health Is Associated with Cardiovascular Disease Prevalence and Cardiometabolic Health in US Adults.

• DOI: 10.3390/ijerph191710749
• 发表时间: 2022-08-29
• 期刊: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• 作者: Makarem, Nour;Alcantara, Carmela;Musick, Sydney;Quesada, Odayme;Sears, Dorothy D.;Chen, Ziyu;Tehranifar, Parisa
• 通讯作者: Tehranifar, Parisa

Association of extreme heat events with sleep and cardiovascular health: A scoping review.

极端炎热事件与睡眠和心血管健康的关联：范围审查。

• DOI: 10.21203/rs.3.rs-3678410/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: Ashe,Nathan;Wozniak,Sarah;Conner,Malcom;Ahmed,Rayan;Demetres,MichelleR;Makarem,Nour;Tehranifar,Parissa;Nandakumar,Rajalakshmi;Ghosh,Arnab
• 通讯作者: Ghosh,Arnab