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，9600万成年人患有糖尿病前期。脱体教育中的种族和社会经济差异- 肥胖和糖尿病的流行是有充分证据的、广泛的和持久的。治本之策 健康不平等的原因对于了解并最终消除肥胖和糖尿病方面的差异至关重要。 赌注风险。美国住房和城市发展部(HUD)价值5000万美元的新社区 选择示范旨在测试帮助低收入家庭克服结构性障碍的策略 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。这个 演示提供了一个令人兴奋的、时间敏感的机会来研究这一新的目标住房移动的影响- 关于肥胖和糖尿病风险的城市规划，更广泛地说，提供了一个通过 哪些社区会影响低收入人群的肥胖和糖尿病风险。从2022年秋天开始， 大约16,000个家庭将参加一项随机对照试验：一组将接受压缩 大量的移动性服务，如保证金援助和房东外展服务，以促进向 低贫困社区和控制组将不会获得移动服务。这项拟议的项目， 流动机会消除差距代金券(Move)研究，将招募900户家庭- 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)滚动进入演示。我们将进行 基线和为期两年的面对面调查，以调查在多大程度上了解- 随意性移动服务与成人测量的BMI和HbA1c的变化以及 两年后儿童的BMI z评分与对照组(目标1)比较。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 这在干预组和控制组之间可能有所不同。这一目标的数据包括经过验证的问题- NILES，地理派生数据，以及参与者子集中关于身体活动的加速度计数据- 精神和睡眠。目标3使用深度定性访谈，通过以下方式更深入地挖掘潜在机制 搬到贫困程度较低的社区会影响肥胖和糖尿病的风险。拟议的研究 回应了最近国家呼吁创新研究住房流动性和社区对 Health and，与HUD和其他利益相关者合作，提供了一个时间敏感的机会，以提供基础、 政策相关知识，旨在减少肥胖和糖尿病方面的不平等现象。