Reducing Cardiovascular Disease Risk Factors in Rural Communities in NC

减少北卡罗来纳州农村社区的心血管疾病危险因素

• 批准号: 9566458
• 负责人: Giselle Corbie
• 金额: $ 12万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-03-15 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9566458
• 关键词: Address; Advocate; African American; Behavior Therapy; Cardiovascular Diseases; Cause of Death; Communities; Community Surveys; Controlled Study; Data; Environmental Risk Factor; Evaluation; Evidence based intervention; Focus Groups; Foundations; Geography; Goals; Group Interviews; Health Services Research; Healthcare; Heart Diseases; Heart Rate; High Prevalence; Individual; Intervention; Literature; Methods; Modeling; Morbidity - disease rate; Online Systems; Outcome; Outcomes Research; Perception; Phase; Physical environment; Prevention; Prevention Research; Prevention program; Prevention strategy; Process; Race; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Research; Research Infrastructure; Resources; Risk Behaviors; Risk Factors; Risk Reduction; Role; Rural; Rural Community; Science; Social Environment; Social Work; Source; Stroke; Technology; Testing; Translations; base; behavior change; burden of illness; cardiovascular disorder prevention; cardiovascular disorder risk; community based participatory research; design; empowerment; family influence; health care quality; heart disease prevention; implementation research; innovation; interest; member; minority communities; mobile computing; new technology; outreach; prevent; research study; rural African American; rural area; rural setting; social; socioeconomics; theories

DESCRIPTION (provided by applicant): Project Summary/Abstract Cardiovascular disease (CVD) is the leading cause of death in the US, however African American residents of rural areas in the south and southeast regions have the highest prevalence of CVD of any group. African Americans carry a significant burden of CVD risk factors that often co-occur; this burden is amplified in rural communities. CVD disparities at the intersection of race and geography are driven by individual risk behaviors and complicated by factors such as limited access to quality healthcare, socio-economic inequities, limited healthcare infrastructure and environmental barriers to behavior change. Interventions to ameliorate CVD burden in rural African American communities will require placing the individual in the context of the larger community and taking advantage of new technologies to support behavior change. However, how best to integrate mobile technology into existing evidenced based interventions (EBIs) is still an emerging field and social and physical environmental factors important in rural communities are rarely considered in existing EBIs. The proposed study will address this gap in the literature by determining the feasibility and efficacy of adapting EBIs to consider the social and physical environment in important in rural African American communities and determining the acceptability of mobile technology in these communities to support behavior change. The proposed study is built on the strong foundation of Project GRACE's 8-year history of designing and testing interventions using a community-based participatory research (CBPR) approach, and individual and collaborative expertise in community-based CVD outreach, service and research. We have developed a phased CBPR study with a long-term goal to reduce rates of CVD in Eastern NC. The overall objective of this proposal is to assess feasibility of implementing an EBI, adapted to the needs and interests of a rural community in order to plan a large scale study. To that end our specific aims are to 1) expand and sustain a Project GRACE CVD coalition of community and academic stakeholders to develop successful CVD risk prevention strategies in rural communities; 2) conduct a mixed-method community needs and assets assessment based on: a) assemble, review and assess existing sources of CVD data; b) identification of community strengths and resources using a web-based survey of community, faith based, social service and healthcare organizations; c) determine the acceptability of components of CVD risk reduction EBIs and community members' perceptions of possible targets for intervention using focus group interviews; d) determine specific family influences (barriers and facilitators) on acceptability of EBI acceptability; 3) adapt PREMIER, a multi-component EBI using intervention mapping; and 4) conduct a small-scale randomized control trial to assess a) efficacy; and, b) feasibility and adaption of implementing adapted PREMIER in rural settings.

描述（由申请人提供）：项目摘要/摘要心血管疾病（CVD）是美国的主要死亡原因，但是南部和东南地区农村地区的非裔美国人居民的CVD率最高。非洲裔美国人承担着CVD危险因素的重大负担，这些风险因素经常同时发生；这种负担在农村社区中得到了扩大。种族和地理交集的CVD差异是由个人风险行为驱动的，并且由于有限的质量医疗保健，社会经济不平等，有限的医疗保健基础设施以及行为改变的环境障碍等因素而变得复杂。减轻非裔美国人社区中CVD负担的干预措施将需要将个人放在更大的社区的背景下，并利用新技术来支持行为改变。但是，如何最好地将移动技术整合到现有的基于证据的干预措施（EBIS）仍然是一个新兴领域，而在现有的EBI中很少考虑在农村社区中重要的社会和身体环境因素。拟议的研究将通过确定适应EBI的可行性和功效来解决文献中的这一差距，以考虑在非裔美国人社区中重要的社会和物理环境，并确定移动技术在这些社区中支持行为改变的可接受性。拟议的研究建立在Project Grace使用基于社区的参与性研究（CBPR）方法以及基于社区的CVD外展，服务和研究中的个人和协作专业知识的设计和测试干预措施的8年历史上的强大基础。我们已经开发了一项分阶段的CBPR研究，其长期目标旨在降低NC东部的CVD率。该提案的总体目的是评估实施EBI的可行性，该可行性适应农村社区的需求和利益，以计划进行大规模研究。为此，我们的具体目标是1）扩大和维持一个社区和学术利益相关者的Grace CVD联盟，以制定农村社区的成功预防CVD风险预防策略； 2）基于以下方式进行混合方法社区的需求和资产评估：a）组装，审查和评估现有的CVD数据来源； b）使用基于网络的社区，基于信仰，社会服务和医疗组织的基于网络的调查来识别社区优势和资源； c）确定CVD风险降低EBI的组件的可接受性和社区成员对使用焦点小组访谈的干预目标的看法； d）确定特定的家庭影响（障碍和促进者）对EBI可接受性的可接受性； 3）适应Premier，这是一种使用干预映射的多组分EBI； 4）进行一项小规模的随机对照试验，以评估a）功效； b）在农村环境中实施改编的总理的可行性和适应性。