Enhancing capacity in faith-based organizations to implement and sustain multilevel innovations to improve physical activity

项目概要 尽管体力活动 (PA) 对预防心血管疾病 (CVD) 和其他慢性疾病有好处 疾病，很少有成年拉丁裔符合 PA 指南。鉴于信仰组织 (FBO) 的核心作用 在拉丁裔社区及其对其成员福祉的承诺中，FBO 是理想的环境 促进健康。增加 PA 和减少肥胖的循证方法，例如 Faith in 行动是存在的，但公共事务干预很少能大规模实施。增强 FBO 能力的实施策略 实施 EBI 的领导者和社区卫生工作者 (promotoras) 可以促进其采用。我们建议 通过旨在提高计划适应性的三项组织级战略来增强行动信念 有效性：1) 对 FBO 领导人进行健康促进方面的培训 2) 定制信息以增强信仰之间的契合度 行动和每个独特的 FBO 环境，以及 3) 授权发起人倡导组织变革。 鉴于需要改进策略以维持社区环境中的健康计划，我们建议测试 两项额外维持战略的影响：1) 加强社区合作，2) 提供 技术支持。我们将使用集群随机对照试验进行混合 II 型有效性实施试验 旨在测试拟议实施策略对组织层面变革的影响 对不同 FBO 中的个人行为进行 12 个月的干预和 6 个月的随访。 32 个 FBO 将 随机分配给标准 EBI 条件（最初实施的信仰行动），增强型 条件（标准条件组织级实施策略），或增强维持 条件（增强实施条件维持策略）。我们将收集定量和 基线、基线后 6 个月、12 个月和 18 个月的定性数据。拟议的研究旨在： 1) 测试组织层面实施策略的短期和长期影响 2 增强 与标准 EBI 条件相比，组织成果的条件，2) 检查个人影响范围 与标准相比，FBO 中的拉丁裔 (n=812) 在 2 种增强条件下的有效性 EBI 状况。次要目标检验行动的理论机制（例如组织氛围）和 两项维持战略的额外影响。通过实际稳健的实施和 可持续发展模型 (PRISM) 和达到有效性-采用实施和维护 (RE-AIM) 目前的研究将使用混合方法来使信仰行动适应不同的 FBO。这项研究 之所以具有创新性，是因为它通过实验来测试组织级别的实施策略及其相关的 来自不同教派的拉丁裔 FBO 的行动机制。我们的研究结果将影响该领域 为 FBO 中创新 EBI 的扩大提供严格的证据。如果成功的话，调查结果 当前的研究将提供组织层面的吸收、维持和推广战略的证据 扩大 PA 干预措施的通用实施策略，以增加 PA 并减少慢性病 美国各地 FBO 中的疾病。

PROJECT SUMMARY Despite the benefits of physical activity (PA) to prevent cardiovascular disease (CVD) and other chronic diseases, few adult Latinas meet PA guidelines. Given the central role of faith-based organizations (FBOs) within the Latino community and their commitment to the well-being of their members, FBOs are ideal settings for health promotion. Evidence-based approaches for increasing PA and reducing obesity such as Faith in Action exist, but few PA interventions go to scale. Implementation strategies that enhance the capacity of FBO leaders and community health workers (promotoras) to implement EBIs can facilitate their uptake. We propose to enhance Faith in Action with three organization-level strategies designed to increase program fit and effectiveness: 1) training FBO leaders in health promotion 2) tailoring messaging to enhance fit between Faith in Action and each unique FBO context, and 3) empowering promotoras to advocate for organizational change. Given the need to improve strategies to sustain health programs in community settings, we propose to test the influence of two additional sustainment strategies: 1) strengthening community collaborations and 2) providing technical support. We will conduct a hybrid type II effectiveness-implementation trial using a clustered RCT design to test the impact of the proposed implementation strategies on organization-level change and individual behavior in diverse FBOs for a 12-month intervention and 6-month follow-up. Thirty-two FBOs will be randomly assigned to a Standard EBI condition (Faith in Action as originally implemented), an Enhanced condition (Standard condition + organizational-level implementation strategies), or Enhanced + Sustainment condition (Enhanced implementation condition + sustainment strategies). We will collect quantitative and qualitative data at baseline, 6 months, 12 months, and 18 months post baseline. The proposed study aims to: 1) Test the short and long-term impacts of organization-level implementation strategies in 2 Enhanced conditions on organizational outcomes compared to the Standard EBI condition, 2) Examine individual reach and effectiveness among Latinas (n=812) in FBOs in the 2 Enhanced conditions compared to the Standard EBI condition. Secondary aims examine theoretical mechanisms of action (e.g., organizational climate) and the additional impact of two sustainment strategies. Informed by the Practical Robust Implementation and Sustainability Model (PRISM) and Reach Effectiveness-Adoption Implementation and Maintenance (RE-AIM) frameworks, the current study will use mixed methods to adapt Faith in Action to diverse FBOs. This research is innovative because it experimentally tests organization-level implementation strategies and their associated mechanism of action in Latino FBOs' from diverse denominations. Our findings will impact the field by providing rigorously derived evidence for the scale-up of innovative EBIs in FBOs. If successful, findings from the current study will provide evidence of organizational-level strategies for uptake, sustainment, and generalizable implementation strategies for scale-up of PA interventions to increase PA and reduce chronic disease in FBOs across the US.