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

项目摘要 尽管身体活动（PA）可以预防心血管疾病（CVD）和其他慢性疾病， 疾病，很少有成年拉丁美洲人符合PA指南。鉴于信仰组织的核心作用， 在拉丁裔社区内，以及他们对成员福祉的承诺，FBO是理想的环境 促进健康。增加PA和减少肥胖的循证方法，如信念， 行动是存在的，但巴勒斯坦权力机构的干预措施很少达到规模。加强联邦组织能力的实施战略 领导人和社区卫生工作者（promotoras）实施EBI可以促进他们的吸收。我们提出 通过三个组织级战略增强行动信念，旨在提高计划的适应性， 有效性：1）在健康促进方面培训FBO领导人2）定制信息，以增强信仰之间的契合 在行动和每个独特的FBO背景下，和3）授权promotoras倡导组织变革。 鉴于需要改进战略，以维持社区环境中的健康计划，我们建议测试 另外两项维持战略的影响：1）加强社区合作; 2）提供 技术支持.我们将使用聚类RCT进行混合II型有效性-实施试验 设计测试拟议执行战略对组织一级变革的影响， 不同FBO的个体行为，为期12个月的干预和6个月的随访。32个FBO将在 随机分配到标准EBI条件（最初实施的行动信念），增强 条件（标准条件+组织级实施战略），或增强+维持 条件（加强执行条件+维持战略）。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)测试组织一级执行战略的短期和长期影响 与标准EBI条件相比，组织成果的条件，2）检查个人达到 与标准相比，在2种增强条件下，FBO中拉丁裔（n = 812）的有效性 EBI条件。次要目标检查理论作用机制（例如，组织气候）和 两项维持战略的额外影响。通过实际的稳健实施和 可持续性模型（PRISM）和可达性-采用实施和维护（RE-AIM） 框架，目前的研究将使用混合方法，以适应不同的FBO的行动信念。本研究 是创新的，因为它实验性地测试了组织级的实施策略及其相关的 不同教派的拉丁裔FBO的行动机制。我们的发现将通过以下方式影响该领域： 为FBO中创新EBI的规模扩大提供严格的证据。如果成功， 目前的研究将为组织级的战略提供证据，这些战略包括采用、维持和 扩大PA干预措施以增加PA和减少慢性 在美国各地的FBOs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.