Understanding the Role of the Food Environment on Diet and Health in Rural American Indian Communities: the Strong Heart Food Environment Study

了解食物环境对美国农村印第安人社区饮食和健康的作用：强心食物环境研究

• 批准号: 10560211
• 负责人: Amanda Mae Fretts
• 金额: $ 57.87万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10560211
• 关键词: Address; American Heart Association; American Indians; Ancillary Study; Behavioral; Biological; Biological Markers; Blood Pressure; Body mass index; Cardiovascular Diseases; Central obesity; Cohort Studies; Communities; Consumption; Data; Diabetes Mellitus; Diet; Dietary Assessment; Dietary Fiber; Eating; Economic Factors; Economics; Enrollment; Environment; Family; Family Study; Feasibility Studies; Fishes; Food; Food Preferences; Foundations; Future; Genetic; Goals; Health; Health Food; Healthy Eating; Heart; High Density Lipoprotein Cholesterol; Household; Hypertension; Indian reservation; Individual; Intake; Intervention; Interview; Knowledge; Measures; Methods; Morbidity - disease rate; Neighborhoods; Nutrition Assessment; Obesity; Outcome; Participant; Persons; Physical environment; Pilot Projects; Policies; Psychosocial Factor; Reporting; Research; Research Activity; Reservations; Resources; Risk Factors; Role; Rural; Rural Community; Sampling; Smoking; Sodium; Tribes; Triglycerides; Unhealthy Diet; Urban Community; Work; built environment; cardiovascular health; cardiovascular risk factor; cohort; combat; contextual factors; cost; design; fasting glucose; food environment; food insecurity; food security; fruits and vegetables; good diet; hypercholesterolemia; improved; informant; insight; member; mortality; nutrition; programs; rural Americans; social culture; social factors; sugar; sweetened beverage; tribal Nation; tribal community

The research activities proposed in this application address a pressing need in American Indian (AI) communities to better understand multi-level (i.e., community- , household- , and individual- level) factors in the physical and socio-cultural environment that impact diet and cardiovascular diseases. The premise of the proposed project was informed by: (1) our previous work in the Strong Heart Study (SHS) and the Strong Heart Family Study (SHFS)—the largest multi-tribal cohort studies of risk factors for cardiovascular disease in AIs in the USA—that highlighted the exceedingly high burden of obesity and poor diet quality among AIs; and (2) findings from our Healthy Food, Healthy Families Feasibility Study—a small pilot study in a SHS/SHFS community that assessed the major barriers and facilitators to eating healthy. Although the SHS/SHFS has followed more than 4,000 AIs from 12 rural communities for the past 34 years, all data collected as part of the study has focused on individual-level biological and behavioral factors associated with cardiovascular diseases; no data has been collected on multi-level components of the physical or sociocultural food environments in this cohort. As such, we have incomplete knowledge about the influence of these domains on diet and cardiovascular health in these rural AI communities. To address these gaps, we will leverage existing data from the SHS/SHFS, and add comprehensive assessments of multi-level factors related to the physical and socio-cultural environment (factors selected based on previous pilot work) that may impact diet and cardiovascular health to the upcoming SHS/SHFS exam in 12 rural AI communities. For this project, we will assess associations of community-level (e.g., food outlet availability, food cost, norms around healthy eating), household-level (e.g., food insecurity, food outlet accessibility; food preferences), and individual-level (e.g., perceived nutrition environment) aspects of the physical and socio- cultural environment with diet (reported intake of fruits and vegetables; sugar-sweetened beverages) and cardiovascular risk factors (BMI; fasting glucose) among SHS/SHFS participants from 12 tribes. We will also assess the influence of participation in nutrition assistance programs (i.e., supplemental nutrition assistance program (SNAP) or the Food Distribution Program on Indian Reservations) on diet and cardiovascular risk factors (i.e., reported intake of fruits and vegetables; sugar-sweetened beverages; BMI; fasting glucose). Exploratory outcomes include: HDL cholesterol, triglycerides, systolic blood pressure, incident diabetes and incident cardiovascular diseases. Greater efforts are needed to understand the most salient factors that impact diet and cardiovascular health in rural Tribal communities. This ancillary study will leverage existing resources from the SHS/SHFS, while adding a comprehensive dietary assessment, measures of food security, and assessments of nutrition economic and neighborhood environments to the study.

本申请中提出的研究活动解决了美洲印第安人（AI）的迫切需求。 社区更好地理解多层次（即，社区、家庭和个人层面）的因素 影响饮食和心血管疾病的物质和社会文化环境。的前提 建议的项目是由：（1）我们以前的工作在强大的心脏研究（SHS）和强大的心脏 家庭研究（SIFS）- 美国-该报告指出认可机构的肥胖负担极高，饮食质素欠佳;及（2） 我们的健康食品，健康家庭可行性研究的结果-一个小型的SHS/SHS试点研究 社区评估了健康饮食的主要障碍和促进因素。虽然SHS/SHFS 在过去的34年里，我们跟踪了来自12个农村社区的4,000多名人工智能，所有收集的数据都是 研究集中在与心血管疾病相关的个体水平的生物和行为因素上， 疾病;没有收集关于物质或社会文化食物的多层次组成部分的数据 环境在这个群体中。因此，我们对这些领域的影响了解不完全， 饮食和心血管健康在这些农村AI社区。为了弥补这些差距，我们将利用现有的 从SHS/SHFS的数据，并添加与物理相关的多层次因素的综合评估， 和社会文化环境（根据以前的试点工作选择的因素），可能会影响饮食和 在12个农村AI社区即将举行的SHS/SHFS考试中，心血管健康。 在这个项目中，我们将评估社区一级的协会（例如，食品出口的可用性，食品成本， 健康饮食规范）、家庭层面（例如，粮食不安全，粮食出口的可获得性;粮食 偏好），以及个人级别（例如，感知营养环境）的身体和社会方面， 文化环境与饮食（报告的水果和蔬菜摄入量;含糖饮料）和 来自12个部落的SHS/SHS参与者中的心血管危险因素（BMI;空腹血糖）。我们还将 评估参与营养援助计划的影响（即，补充营养援助 计划（SNAP）或印第安人保留地食品分配计划）对饮食和心血管风险的影响 因素（即，报告的水果和蔬菜摄入量;含糖饮料; BMI;空腹血糖）。 探索性结局包括：高密度脂蛋白胆固醇、甘油三酯、收缩压、糖尿病发病率和 心血管疾病 需要更大的努力来了解影响饮食和心血管疾病的最显著因素。 农村部落社区的卫生。这项辅助研究将利用社会科学及人文科学部门/社会科学及家庭服务部门的现有资源， 同时增加了全面的饮食评估、粮食安全措施和营养评估， 经济和邻里环境的研究。