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Improving Health Habits in Impoverished Populations

改善贫困人口的健康习惯

基本信息

批准号：
7469479
负责人：
Lillian Gelberg
金额：
$ 15.4万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-01 至 2010-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7469479
关键词：
Address Adherence Behavior Behavioral Biological Markers Blood Glucose Cardiovascular Diseases Caring Characteristics Chronic Chronic Care Chronic Disease Clinic Clinic Visits Clinical Engineering Clinical Research Communities Community Health Condition Counseling County Data Development Diabetes Mellitus Diet Diet Habits Disease Eating Exercise Exposure to Family Fasting Glycosylated hemoglobin A Habits Health Health Educators Health Priorities Health Promotion Health Status Health education Healthcare Systems Heart Diseases Hemoglobin Hispanics Hypotension Individual Intervention Interview Latino Life Life Style Link Lipids Literature Los Angeles Low income Measures Mediating Mexican Americans Minority Mission Motivation Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Obesity Outcome Assessment Outcome Measure Overweight Patient Education Patient Preferences Patient Self-Report Patients Persons Physical activity Physicians Plant Roots Population Population Heterogeneity Prevalence Prevention program Process Process Measure Program Development Protocols documentation Provider Public Health Randomized Reading Research Research Personnel Resources Risk Risk Factors Self Care Self Efficacy Series Services Smoking Behavior Social support Standards of Weights and Measures System Time Uninsured United States National Institutes of Health Visit base behavior change clinical application compliance behavior demographics design desire diet and exercise disorder prevention early /brief intervention /therapy fitness follow-up improved innovation intervention program nutrition preference prescription document prescription procedure prevent programs promoter sedentary self help social theories therapy design tool trend

项目摘要

DESCRIPTION (provided by applicant): Poor diet, physical inactivity, and sedentary behaviors among low-income, minority populations have been linked to greater risk of chronic health conditions such as overweight/obesity, cardiovascular disease, and type 2 diabetes. Low-income clinics that serve these populations often represent an untapped opportunity for health promotion in impoverished individuals. Few studies have examined the feasibility of using brief physician advice and multi-level, clinic-based interventions to change poor dietary habits, physical inactivity, and sedentary lifestyle behaviors among these culturally diverse populations that comprise the clinic population. This exploratory project proposes to address this scientific gap by introducing and piloting a Self- Care Stimulating Disease Prevention Program (SCSDPP) to address poor dietary habits, physical inactivity, and sedentary lifestyle behaviors among low income, uninsured patient populations (primarily Latinos) served by the community clinics of the Venice Family Clinic (VFC) health center in Los Angeles County. The program will include the development of 1) a simple-to-use patient Health Priority Assessment (HPA) tool designed to assess patient preferences for behavior change; 2) a standard protocol for physicians to provide brief health advice using motivation interviewing (< 2 minutes per visit); 3) a protocol for distributing self-help aids for patient use (e.g., pedometer, exercise videos); and 4) a series of monthly follow-up counseling sessions by lay health educators (e.g., promoters) to help patients address their lifestyle change priorities overtime. We will conduct a randomized controlled pilot of the SCSDPP in approximately 100 patient cases at two community health clinics within the VFC health center system. The pilot will utilize precise outcome measures, including commonly-accepted biomarkers (e.g., HbA1c, fasting blood glucose) and psychometrically-validated measures of process and health status, to accurately assess the magnitude of changes in diet and physical activity among patients over a 12-month observation period. The feasibility of integrating the SCSDPP into the community health clinic setting will be evaluated, and is the primary aim of this project. The results will inform efforts to plan a larger, successor study. Relevance to Public Health: this study evaluates a clinic-based brief intervention protocol for preventing overweight/obesity, a public health problem that has been linked to greater risk of chronic health conditions such as heart disease and diabetes.

描述（由申请人提供）：低收入少数群体中的不良饮食、缺乏身体活动和久坐行为与超重/肥胖、心血管疾病和 2 型糖尿病等慢性健康状况的风险增加有关。为这些人群提供服务的低收入诊所通常为贫困人口的健康促进提供了一个尚未开发的机会。很少有研究探讨使用简短的医生建议和基于临床的多层次干预措施来改变构成诊所人群的这些文化多样化人群中不良饮食习惯、缺乏身体活动和久坐的生活方式行为的可行性。该探索性项目旨在通过引入和试点自我保健刺激疾病预防计划 (SCSDPP) 来解决这一科学差距，以解决洛杉矶县威尼斯家庭诊所 (VFC) 健康中心社区诊所服务的低收入、无保险患者群体（主要是拉丁美洲人）中不良饮食习惯、缺乏身体活动和久坐的生活方式行为。该计划将包括开发 1) 一种易于使用的患者健康优先评估 (HPA) 工具，旨在评估患者对行为改变的偏好； 2) 医生使用动机访谈（每次就诊 < 2 分钟）提供简短健康建议的标准方案； 3) 分发供患者使用的自助辅助工具的协议（例如计步器、锻炼视频）； 4) 由非专业健康教育者（例如推广者）每月举办一系列后续咨询课程，以帮助患者解决生活方式改变的优先事项。我们将在 VFC 卫生中心系统内的两个社区卫生诊所对大约 100 例患者进行 SCSDPP 随机对照试点。该试点项目将利用精确的结果测量，包括普遍接受的生物标志物（例如 HbA1c、空腹血糖）以及经心理测量验证的过程和健康状况测量，以准确评估患者在 12 个月观察期内饮食和身体活动变化的程度。将评估 SCSDPP 融入社区卫生诊所环境的可行性，这是该项目的主要目标。结果将为计划更大规模的后续研究提供信息。与公共卫生的相关性：本研究评估了一种基于临床的简短干预方案，用于预防超重/肥胖，这是一个与心脏病和糖尿病等慢性健康状况的更大风险相关的公共卫生问题。