Exploring Food Insecurity and Pilot Testing a Diabetes Nutrition Education Program and Healthy Food Access Service for American Indian and Alaska Native Adults with Type 2 Diabetes

探索粮食不安全并为患有 2 型糖尿病的美洲印第安人和阿拉斯加原住民成年人试点测试糖尿病营养教育计划和健康食品获取服务

• 批准号: 10671503
• 负责人: Sarah A Stotz
• 金额: $ 15.05万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671503
• 关键词: Address; Adult; Alaska Native; American Indians; Area; Behavior; Beverages; Biometry; Blood Glucose; Blood Pressure; Body Weight; Body mass index; Caring; Cities; Clinic; Clinical; Clinical Trials; Colorado; Communities; Data; Data Analyses; Data Collection; Data Set; Development; Diabetes Mellitus; Diabetic Diet; Dietary Intervention; Disparity; Eating; Educational Activities; Educational Curriculum; Educational workshop; Environment; Environmental Pollution; Evidence based intervention; Farm; Food; Food Access; Foundations; Funding; Glycosylated hemoglobin A; Goals; Habits; Health; Health Food; Healthcare; Healthy Eating; Household; Intake; International; Intervention; Intervention Studies; Knowledge; Life; Marketing; Measures; Medical; Mentored Research Scientist Development Award; Mentors; Methodology; Methods; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Oklahoma; Outcome; Participant; Pilot Projects; Population; Positioning Attribute; Poverty; Problem Solving; Process; Public Health; Randomized; Research; Research Design; Research Methodology; Research Personnel; Rural Community; Science; Secure; Self Efficacy; Services; Site; Sodium; Strategic Planning; Surveys; Testing; Training; Transportation; Tribes; Universities; Waiting Lists; Water; Work; career; career development; design; diabetes education; diabetes management; diabetes self-management; effective intervention; effectiveness study; effectiveness trial; experience; farmer; fast food; food insecurity; food security; good diet; health disparity; improved; intervention participants; learning strategy; novel; nutrition; nutrition education; pilot test; portion control; pragmatic study; pragmatic trial; programs; saturated fat; secondary analysis; skills; social health determinants; symposium; therapy design; urban Native American; urban area

PROJECT SUMMARY / ABSTRACT Healthy nutrition habits are key to managing type 2 diabetes (T2D). However, American Indian and Alaska Natives (AI/ANs) often lack access to healthy food and disproportionately experience food insecurity. Food insecurity, defined as lack of consistent access to enough food for an active, healthy life, negatively impacts one’s ability to manage blood sugar and body weight. I am pursuing a K01 Mentored Research Scientist Development Award to fill critical training gaps in the areas of quantitative data analysis of intervention studies and effectiveness and pragmatic study design. In order to effectively bridge my prior training and research experience to obtain my first R01, I have carefully developed a mentored training plan that strategically supports my research aims for this K01 award. I am currently Co-Investigator on a study team that developed a culturally responsive diabetes nutrition education curriculum for AI/AN adults with T2D, entitled “What Can I Eat? Healthy Choices for AI/ANs with T2D” (WCIE). WCIE includes interactive, hands-on nutrition education learning activities, including portion control, decreasing sugary beverages and saturated fat, and problem solving for barriers to healthful eating. In January 2020 we launched a tribally-supported, 6-site, waitlist control design test of WCIE. In June 2021, we will complete data collection with 150 AI/AN adults who have T2D. Data will include 3 timepoints for immediate intervention and 5 for waitlist intervention participants over 6 months with surveys (nutrition knowledge, behavior, self-efficacy) and clinical outcomes (BMI, blood pressure, and HbA1c). Though WCIE does not include a specific food insecurity intervention, we included a household food insecurity measure at all data collection timepoints. In Aim #1 of this proposed K01 I will examine the relationship between food insecurity and clinical WCIE outcomes in the existing dataset through secondary analysis to utilize my new intervention quantitative data analysis skills and advance understanding of the moderating effect of food insecurity on diabetes nutrition education and T2D outcomes among AI/ANs. In Aim #2 I will design/pilot test WCIE with added service to improve healthy food access and evaluate its feasibility/impact on T2D outcomes at an urban AI/AN- serving clinic in Oklahoma City, OK. We will work with the Oklahoma City clinic to identify their need for a healthy food access service in the following domains: transportation, availability of healthy food, or affordability of healthy food. Aim #2 will provide me the opportunity to utilize my new training in effectiveness and pragmatic trials study design and quantitative data analysis of intervention studies. My detailed training plan includes formal coursework at the University of Colorado Anschutz Medical Campus, seminars, workshops/conferences on AI/AN health research, and support from my mentors who are experts and leaders in the area of AI/AN diabetes health, AI/AN health interventions, T2D and food insecurity interventions, and quantitative/study design methodology. The proposed training plan and aims will provide me with a set of skills and expertise needed to successfully obtain R01 funding and become a leader in diabetes health disparities intervention science.

项目总结/摘要 健康的营养习惯是管理2型糖尿病（T2 D）的关键。然而，美洲印第安人和阿拉斯加 土著人（AI/AN）往往无法获得健康食品，并且不成比例地经历粮食不安全。食品 不安全，定义为缺乏持续获得足够的食物来维持积极、健康的生活， 控制血糖和体重的能力。我正在追求K 01指导研究科学家 发展奖，以填补干预研究定量数据分析领域的关键培训空白 有效性和务实的研究设计。为了有效地衔接我之前的训练和研究 为了获得我的第一个R 01，我仔细制定了一个指导性的培训计划， 我的研究目标是这个K 01奖。我目前是一个研究团队的共同研究员，该团队开发了一种文化上的 为患有T2 D的AI/AN成人提供响应式糖尿病营养教育课程，题为“我能吃什么？健康 T2 D患者AI/AN的选择”（WCIE）。WCIE包括互动的、动手的营养教育学习活动， 包括部分控制，减少含糖饮料和饱和脂肪，以及解决 健康饮食。2020年1月，我们推出了一个由部落支持的6个站点的WCIE候补控制设计测试。 2021年6月，我们将完成对150名患有T2 D的AI/AN成年人的数据收集。数据将包括3个时间点 立即干预和5名等待干预参与者超过6个月的调查（营养 知识、行为、自我效能）和临床结局（BMI、血压和HbA 1c）。虽然WCIE 不包括具体的粮食不安全干预措施，我们在所有数据中包括家庭粮食不安全措施 采集时间点。在这一拟议的K 01的目标#1中，我将研究粮食不安全与 现有数据集中的临床WCIE结局，通过二次分析利用我的新干预措施 定量数据分析技能，并进一步了解粮食不安全对粮食安全的调节作用， AI/AN中的糖尿病营养教育和T2 D结局。在目标#2中，我将设计/试点测试WCIE，并添加 改善健康食品获取并评估其可行性/对城市AI/AN T2 D结果的影响的服务- 俄克拉荷马州的一家诊所。我们将与俄克拉荷马州市诊所合作，以确定他们对健康的需求。 在以下领域提供食品获取服务：交通、健康食品的供应或健康食品的可负担性 食物目标2将为我提供机会，利用我在有效性和务实试验研究方面的新培训 干预研究的设计和定量数据分析。我的详细培训计划包括正式的 科罗拉多大学安舒茨医学院的课程，研讨会，讲习班/会议， AI/AN健康研究以及我的导师的支持，他们是AI/AN糖尿病领域的专家和领导者 健康，AI/AN健康干预措施，T2 D和粮食不安全干预措施，以及定量/研究设计 方法论拟议的培训计划和目标将为我提供一套所需的技能和专业知识， 成功获得R 01基金，成为糖尿病健康差异干预科学的领导者。

项目成果

eHealth, family-based interventions, and multilevel approaches to pediatric weight management: a scoping review.

电子健康、基于家庭的干预措施和儿科体重管理的多层次方法：范围界定审查。

• DOI: 10.1093/nutrit/nuad160
• 发表时间: 2024
• 期刊: Nutrition reviews
• 影响因子: 6.1
• 作者: Henes,SarahT;Stotz,SarahA;Riggs,SandraE;Yang,Hsuan-Mein
• 通讯作者: Yang,Hsuan-Mein

All systems are interrelated: Multilevel interventions with indigenous communities.

所有系统都是相互关联的：与土著社区的多层次干预。

• DOI: 10.1016/j.cct.2022.107013
• 发表时间: 2023
• 期刊: Contemporary clinical trials
• 影响因子: 2.2
• 作者: Johnson-Jennings,MichelleD;Rink,Elizabeth;Stotz,SarahA;Magarati,Maya;Moore,RolandS
• 通讯作者: Moore,RolandS