Developing a multi-component intervention to address cardiometabolic disease (CMD) risk in Samoan children

制定多成分干预措施来解决萨摩亚儿童的心脏代谢疾病 (CMD) 风险

• 批准号: 10740178
• 负责人: Courtney Cheu Lin Choy
• 金额: $ 11.85万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740178
• 关键词: 11 year old; 13 year old; 4 year old; 8 year old; Active Learning; Address; Affect; Age; Americas; Area; Award; Behavioral; Belief; Blood Pressure; Body fat; Body mass index; Cardiometabolic Disease; Child; Child Health; Clinical Trials; Cohort Studies; Communities; Country; Data; Development; Disease Marker; Early Intervention; Effectiveness; Enrollment; Ensure; Environment; Environmental Risk Factor; Epidemiology; Evaluation; Faculty; Focus Groups; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Goals; Growth; Health; High Prevalence; Human Biology; Income; Infrastructure; Intervention; Interview; Life; Life Style; Longitudinal Studies; Mentors; Mentorship; Methods; Modeling; Obesity; Outcome; Overweight; Pacific Islander; Pacific Islands; Personal Satisfaction; Phase; Polynesian; Population; Populations at Risk; Positioning Attribute; Prediabetes syndrome; Prevalence; Prevention; Probability; Public Health; Qualitative Methods; Qualitative Research; Reduce health disparities; Research; Research Training; Resource-limited setting; Risk; Risk Factors; Samoa; Samoan; Scientist; Southeastern Asia; Testing; Training; Underserved Population; United States; Work; beneficiary; blood pressure elevation; boys; cardiometabolic risk; career development; cohort; combat; cost; diabetic; disorder risk; efficacious intervention; ethnic minority population; evidence base; experience; girls; health assessment; high risk; implementation framework; implementation science; indexing; innovation; leadership development; learning strategy; member; modifiable risk; multi-component intervention; multidisciplinary; pilot test; primary caregiver; programs; racial minority population; scale up; skills; tenure track; therapy development; usability

PROPOSAL SUMMARY The goal of the proposed K99/R00 award is to support Dr. Courtney Choy’s development into an independent community-engaged implementation scientist, with a focus on epidemiology and leveraging quantitative and qualitative data to address noncommunicable, cardiometabolic disease (CMD) risk in Pacific Islander children. Although they are among the most at risk of CMD, few efficacious interventions or innovations to address CMDs have reached Pacific Islander communities. The objective of this proposal is to develop and implement a context- specific, multi-component intervention to address CMD risk in Samoan children. Samoa, a middle-income Polynesian country with a large global diaspora, experiences among the highest CMD prevalence in the world. Existing data from the Ola Tuputupua’e (‘Growing Up’) cohort study, which this proposal will leverage, suggests that risk emerges early in life. Half of the enrolled children were affected by either obesity, elevated blood pressure, and/or high glycated hemoglobin (HbA1c) by the age of 9. During the K99 training phase, Dr. Choy will (1) extend her epidemiological training and use growth mixture modeling to inform intervention targets and timing and (2) gain new skills in qualitative methods, and implementation science to select and contextually adapt an intervention for use in Samoa. The Active Implementation Frameworks and evidence-based best practices in Pacific Islander communities will guide intervention development and implementation, which will take place in the R00 phase. The result will be a multi-component intervention for Samoan children that targets the age period in which markers of CMD risk (body mass index, blood pressure, and HbA1c) are most sensitive to modifiable behavioral and environmental risk factors. Further, the multi-component intervention will incorporate at least two evidence-based lifestyle/behavioral change strategies to address CMD risk factors, utilize existing infrastructure and local capacity (with an implementation team) and align with community-identified priorities. Preliminary evidence of the feasibility, acceptability, and effectiveness of the developed intervention among children in Samoa will produce a scalable program with the potential for replication in other Pacific Islander populations and comparable low-resource settings. To achieve career development goals and ensure a successful transition to independence, Dr. Choy has established an exceptional training environment, developed experiential learning activities to apply newly gained skills from didactic coursework, and assembled a multidisciplinary mentorship team with expertise in public health, implementation science, clinical trials, human biology, epidemiology, and Pacific Islander health. The mentorship, research training, leadership and career development activities proposed will ensure that at the conclusion of this award, Dr. Choy will be well-positioned to extend the methods developed to Pacific Islanders in the US, who are among the fastest-growing racial and ethnic minority groups and –because of their high CMD risk– are the ideal beneficiaries of early intervention to reduce health disparities.

提案摘要 K99/R 00奖项的目标是支持蔡博士发展成为一名独立的 社区参与的实施科学家，重点是流行病学和利用定量和 定性数据，以解决太平洋岛民儿童的非传染性心脏代谢疾病（CMD）风险。 虽然他们是最容易患CMD的人群，但很少有有效的干预措施或创新来解决CMD。 已经到达太平洋岛民社区。本提案的目标是制定和实施一个背景- 具体的、多组成部分的干预措施，以解决萨摩亚儿童的CMD风险。萨摩亚，中等收入国家 波利尼西亚国家拥有大量的全球侨民，是世界上CMD患病率最高的国家之一。 来自奥拉Tuputupua 'e（“成长”）队列研究的现有数据表明， 这种风险在生命的早期就出现了。一半的儿童患有肥胖症， 高血压和/或糖化血红蛋白（HbA 1c）。在K99培训阶段，蔡博士 将（1）扩大她的流行病学培训，并使用增长混合模型为干预目标提供信息， 时间和（2）获得定性方法和实施科学的新技能，以选择和适应环境 在萨摩亚进行干预。积极执行框架和循证最佳做法 太平洋岛民社区将指导干预措施的制定和实施， R 00阶段。其结果将是为萨摩亚儿童采取多方面的干预措施， 其中CMD风险标志物（体重指数，血压和HbA 1c）对可改变的 行为和环境风险因素。此外，多组成部分的干预措施将包括至少两个 基于证据的生活方式/行为改变策略，以解决CMD风险因素，利用现有基础设施 和地方能力（有一个执行小组），并与社区确定的优先事项保持一致。初步 证据的可行性，可接受性，和有效性的开发干预儿童中， 萨摩亚将制定一个可扩展的方案，有可能在其他太平洋岛民中推广， 低资源配置。实现职业发展目标，确保成功过渡到 独立性，蔡博士建立了一个特殊的培训环境，开发了体验式学习， 开展活动，应用从教学课程中新获得的技能，并建立多学科指导机制 拥有公共卫生、实施科学、临床试验、人类生物学、流行病学和 太平洋岛民的健康指导、研究培训、领导才能和职业发展活动 建议将确保在这个奖项结束时，蔡博士将处于有利地位，以扩大方法 发展到美国的太平洋岛民，他们是增长最快的种族和少数民族群体之一， 而且--由于他们的高CMD风险--是早期干预减少健康差距的理想受益者。