The Mobility Opportunity Voucher to Eliminate Disparities (MOVED) Study: Obesity and Diabetes Risk in HUD's Community Choice Demonstration

消除差异的流动机会券 (MOVED) 研究：HUD 社区选择示范中的肥胖和糖尿病风险

• 批准号: 10721506
• 负责人: Craig Evan Pollack
• 金额: $ 160万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10721506
• 关键词: Accelerometer; Address; Adult; American; Area; Behavioral; Body mass index; Characteristics; Child; Collaborations; Communities; Community Developments; Congresses; Control Groups; Data; Data Collection; Deposition; Diabetes Mellitus; Diet; Enrollment; Exhibits; Experimental Designs; Family; Fees; Food; Funding; Geography; Glycosylated hemoglobin A; Health; Health Benefit; Health Promotion; Household; Housing; Inequity; Intervention; Interview; Knowledge; Life Cycle Stages; Literature; Low Income Population; Low income; Measures; Mediating; Mental Health; Neighborhoods; Obesity; Outcome; Participant; Pathway interactions; Persons; Physical activity; Play; Policies; Poverty; Poverty Areas; Prediabetes syndrome; Prevalence; Psychosocial Factor; Questionnaires; Randomized; Randomized, Controlled Trials; Research; Resources; Role; Sampling; Security; Services; Shapes; Site; Sleep; Social Work; Social support; Structural Racism; Surveys; Testing; Time; U.S. Department of Housing and Urban Development; adult obesity; arm; comparison control; contextual factors; cost; design; diabetes risk; disparity elimination; experience; experimental study; falls; follow-up; health care availability; health disparity; health inequalities; hospitalization rates; implementation barriers; innovation; lifestyle intervention; lower income families; obesity in children; obesity risk; outreach; programs; psychosocial; racial discrimination; racial disparity; racism; recruit; segregation; social; socioeconomic disparity; structural determinants; treatment group; violence exposure; voucher; walkability

Project Summary An estimated 41% of adults in the US and one in five of children are estimated to have obesity; over 37 million Americans have diabetes and 96 million adults have prediabetes. Racial and socioeconomic disparities in obe- sity and diabetes prevalence are well-documented, widespread, and persistent. Policies addressing the root causes of health inequities are critical to understanding and ultimately eliminating disparities in obesity and dia- betes risk. The U.S. Department of Housing and Urban Development’s (HUD’s) new, $50 million Community Choice Demonstration seeks to test strategies that help low-income households overcome structural barriers and entrenched racism that constrain their ability to move to lower-poverty ‘opportunity’ neighborhoods. The Demonstration offers an exciting, time-sensitive chance to study the impact of this new targeted housing mobil- ity program on obesity and diabetes risk, and, more broadly, provides a window into the mechanisms through which neighborhoods impact obesity and diabetes risk for low-income populations. Starting in the Fall of 2022, approximately 16,000 households will take part in a randomized controlled trial: one group will receive compre- hensive mobility services such as security deposit assistance and landlord outreach to facilitate moving to a lower-poverty neighborhood and a control group will not receive mobility services. This proposed project, the Mobility Opportunity Vouchers to Eliminate Disparities (MOVED) Study, will recruit 900 households en- rolled in the Demonstration from three sites (Pittsburgh, PA; Cleveland, OH; Nashville, TN). We will conduct baseline and 2-year follow-up in-person surveys to investigate the extent to which the receipt of comprehen- sive mobility services is associated with changes in measured BMI and HbA1c among adult and changes in BMI z-score among children after 2 years compared to the control group (Aim 1). Aim 2 investigates outcomes along the causal pathway, focusing on potential behavioral, psychosocial, contextual, and structural factors that may differ between the intervention and control groups. Data for this aim includes validated question- naires, geographically-derived data, and, among a subset of participants, accelerometry data on physical activ- ity and sleep. Aim 3 uses in-depth qualitative interviews to delve deeper into potential mechanisms through which moving to a lower-poverty neighborhood influences obesity and diabetes risk. The proposed research answers recent national calls for innovative research on the impact of housing mobility and neighborhoods on health and, working with HUD and other stakeholders, offers a time-sensitive chance to provide foundational, policy-relevant knowledge designed to reduce inequities in obesity and diabetes.

项目摘要 据估计，美国41%的成年人和五分之一的儿童患有肥胖症;超过3700万人 美国人患有糖尿病，9600万成年人患有前驱糖尿病。出窍后的种族和社会经济差异- 糖尿病和糖尿病的流行是有据可查的、广泛的和持久的。解决根源问题的政策 健康不公平的原因对于理解并最终消除肥胖和糖尿病的差异至关重要。 冒险。美国住房和城市发展部（HUD）新的5000万美元社区 选择示范旨在测试帮助低收入家庭克服结构性障碍的战略 以及根深蒂固的种族主义，限制了他们搬到贫困程度较低的“机会”社区的能力。的 示范提供了一个令人兴奋的，时间敏感的机会，研究这种新的有针对性的住房移动的影响， 城市计划对肥胖和糖尿病的风险，并更广泛地说，提供了一个窗口的机制， 哪些社区会影响低收入人群的肥胖和糖尿病风险。从2022年秋季开始， 大约16,000个家庭将参加一项随机对照试验：一组将接受比较， 安全存款援助和房东外展等综合流动服务，以促进搬到 贫困程度较低的社区和对照组将无法获得移动服务。这项拟议的项目， 移动机会消除差距（MOVED）研究，将招募900个家庭， 从三个地点（宾夕法尼亚州匹兹堡;俄亥俄州克利夫兰;田纳西州纳什维尔）参加了示威活动。我们会进行 基线和2年随访的面对面调查，以调查在多大程度上接受了hen- 强制性移动服务与成年人BMI和HbA 1c测量值的变化以及 与对照组相比，2年后儿童的BMI z评分（目标1）。目标2调查结果 沿着因果路径，关注潜在的行为、心理社会、背景和结构因素 干预组和对照组之间可能存在差异。用于此目的的数据包括经验证的问题- naires，地理衍生数据，以及在参与者的一个子集中，物理活动的加速度数据， 性和睡眠。Aim 3使用深入的定性访谈，通过以下方式深入研究潜在的机制： 搬到低贫困社区会影响肥胖和糖尿病的风险。拟议研究 回答了最近国家呼吁对住房流动性和社区的影响进行创新研究， 与HUD和其他利益相关者合作，提供了一个时间敏感的机会， 旨在减少肥胖和糖尿病不平等的政策相关知识。