Multilevel program and policies to reduce chronic disease for American Indians

减少美洲印第安人慢性病的多层次计划和政策

• 批准号: 9297331
• 负责人: Joel Gittelsohn
• 金额: $ 66.66万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-14 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9297331
• 关键词: Address; Adult; American; American Indians; Area; Behavior Therapy; Body Weight; Body fat; Body mass index; Child; Chronic Disease; Communities; Complement; Consumption; Coupled; Development; Diabetes Mellitus; Diet; Effectiveness of Interventions; Environment; Fatty acid glycerol esters; Food; Fostering; Goals; Health; Health Food; Household; Institution; Intake; Intervention; Intervention Trial; Lead; Literature; Malignant Neoplasms; Names; New Mexico; Nutrient; Obesity; Physical activity; Policies; Policy Developments; Policy Maker; Population; Prevention Research; Prevention program; Prevention strategy; Prevention trial; Program Sustainability; Psychosocial Factor; Randomized; Randomized Controlled Trials; Research; Risk Behaviors; Running; Schools; Testing; Time; United States National Institutes of Health; Waist-Hip Ratio; Wisconsin; Work; Workplace; base; disorder prevention; environmental intervention; evidence base; experience; food environment; fruits and vegetables; improved; innovation; instrument; interest; obesity prevention; obesity risk; prevention evaluation; programs; public health relevance; sedentary activity; successful intervention; theories; tribal health; tribal leader

 DESCRIPTION (provided by applicant): American Indian (AI) populations experience disproportionately high rates of obesity and related chronic diseases (CD). Intervention trials aimed at modifying the food environment in AI communities have shown positive results, such as increasing the purchase and consumption of healthy foods. The current challenge is to facilitate the development of evidence-based policies in order to improve the sustainability of environmental interventions. The primary goal of the proposed research is to improve the food and physical activity (PA) environments in AI communities at multiple levels (worksites, schools, food stores) by working in partnership with tribal leaders to enact policies and programs that aim to reduce CDs. We will achieve this goal by developing, implementing, and evaluating a randomized controlled community-based trial which is supported or implemented by tribal leaders through policy. The study will take place in six AI communities located in Wisconsin and New Mexico. This project builds directly on our previous successful work in five AI communities where we conducted a multilevel obesity prevention trial (OPREVENT) targeting food stores, worksites and schools. This proposed trial (OPREVENT2) complements and expands upon the previous one, by fostering the development of relevant policies among tribal leaders which is key for sustainability. The specific aims of OPREVENT2 are: 1) To conduct formative research to describe tribal policy development and enactment in participating AI communities, in order to support tribal health policy makers to identify effective policies to sustain obesity and chronic disease prevention/reduction programs, by building capacity and collaborative partnerships; 2) To develop a community-based CD prevention program for AI communities informed by our earlier trials, formative research from Aim 1 and best-practices from the scientific literature; an 3) To evaluate the impact of the CD related policies and programs on adiposity, psychosocial factors and obesity risk behaviors, including dietary quality (e.g., fruit and vegetable servings), nutrient intake, and PA in a community- randomized controlled trial. The proposed study directly addresses NIH PAR-11-346 priorities by developing and testing an innovative multilevel obesity prevention strategy in AI communities that combines supportive policy with a culturally appropriate multilevel intervention. The proposed study is also locally generated and, therefore, more likely to be self-sustaining. We expect to impact the following areas of interest to the PAR: engagement of tribal leaders in developing and implementing CD policy, development of culturally appropriate community-based CD prevention programs, and increased availability of healthy foods, improvements in diet and PA, and reductions in adiposity.

 描述（由适用提供）：美洲印第安人（AI）人群经历肥胖和相关慢性疾病（CD）的比例高。旨在修改AI社区食品环境的干预试验显示了积极的结果，例如增加了健康食品的购买和消费。当前的挑战是支持基于证据的政策的制定，以提高环境干预的可持续性。拟议的研究的主要目标是通过与部落领导人合作制定旨在减少CD的政策和计划，改善多个级别的AI社区（工作人员，学校，食品商店）的粮食和体育锻炼（PA）环境。我们将通过制定，实施和评估一个随机对照社区的审判来实现这一目标，该试验由部落领导者通过政策支持或实施。该研究将在威斯康星州和新墨西哥州的六个AI社区进行。该项目直接建立在我们以前在五个AI社区的成功工作，在该社区中，我们针对食品商店，工作场所和学校进行了多级肥胖试验（Oprevent）。该拟议的试验（Oprevent2）通过促进部落领导人之间相关政策的制定来完成并扩展了前一个试验，这是可持续性的关键。 Oprevent2的具体目的是：1）进行形成性研究以描述部落政策的发展和参与人工智能社区的参与，以支持部落卫生政策制定者通过建立能力和协作伙伴关系来确定维持肥胖和慢性疾病预防/减少疾病的有效政策； 2）为我们较早的试验，AIM 1的形成性研究以及科学文献的最佳实践的形成性研究开发基于社区的CD预防计划； A 3）评估CD相关政策和计划对肥胖，心理因素和肥胖风险行为的影响，包括饮食质量（例如，水果和蔬菜）， 在社区随机对照试验中，营养摄入量和PA。拟议的研究直接通过在AI社区中开发和测试创新的多层次肥胖策略来直接解决NIH PAR-11-346的优先事项，该策略将支持性政策与文化上适当的多层次干预相结合。拟议的研究也是本地产生的，因此更有可能是自我维持的。我们期望影响以下感兴趣的领域：部落领导者参与制定和实施CD政策，发展基于文化的社区CD预防计划，增加健康食品的可用性，饮食和PA的改善以及肥胖的减少。