The Native Proverbs 31 Health Project

土著箴言 31 健康项目

• 批准号: 8049362
• 负责人: Ronny A Bell
• 金额: $ 22.2万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8049362
• 关键词: Adolescent; Adult; African American; American Indians; Behavior; Body mass index; Cardiovascular Diseases; Church; Cigarette; Collaborations; Communities; Community Health; Community Participation; County; Data; Daughter; Decision Making; Development; Diet; Educational Curriculum; Ethnic group; Family; Family Practice; Fatty acid glycerol esters; Fiber; Fostering; Funding; Gatekeeping; General Population; Healed; Health; Health Educators; Health behavior; Health behavior outcomes; Health education; Heart; Intervention; Joints; Life; Lumbee tribe; Mississippi; Modeling; Movement; National Center on Minority Health and Health Disparities; Native Americans; Non-Insulin-Dependent Diabetes Mellitus; North Carolina; Not Hispanic or Latino; Obesity; Outcome Study; Physical activity; Play; Population; Poverty; Prevention program; Prevention strategy; Primary Prevention; Process Assessment; Proverb; Research; Reservations; Risk Factors; Rivers; Role; Rural; Self Efficacy; Smokeless Tobacco; Staging; Stroke; Time; Tobacco use; Training; Tribes; Universities; Woman; Work; arm; base; cardiovascular disorder prevention; cardiovascular disorder risk; community setting; design; disorder prevention; experience; forest; fruits and vegetables; healing; health disparity; health equity; innovation; intervention program; medical schools; primary outcome; programs; racial and ethnic; randomized trial; response; saturated fat; secondary outcome; sedentary; self esteem

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) rates have increased dramatically among American Indians in recent years. Modifiable CVD risk factors, such as obesity, type 2 diabetes, sedentary behavior, and tobacco use are generally higher in most American Indian communities compared to non-Hispanic whites, although there is limited understanding of the unique cultural aspects of appropriate CVD primary prevention strategies in these populations. The Lumbee Indian tribe, a non-reservation tribe with a population of about 50,000, is the largest American Indian tribe east of the Mississippi River, and is largely concentrated in Robeson County, in southeastern North Carolina (NC). This county is largely rural, has a high poverty rate, and is almost equally divided among American Indians, African Americans and non-Hispanic whites. Limited available data indicate that CVD and its risk factors are very high among American Indians in North Carolina in general and Lumbees in particular. The Lumbee tribe is largely Christian, and the church is a very important component of Lumbee culture, providing opportunities to develop church-based health interventions in this population. The proposed project, entitled, "The Native Proverbs 31 Health Project," is in response to RFA-MD-10-004 (NCMHD Innovative Faith-based Approaches to Health Disparities Research). This project is designed to develop, implement and evaluate a CVD prevention program among Lumbee Indian women in Robeson County, NC, focusing on the biblical messages in Proverbs 31. The following aims will be performed 1) Based on prior research and formative work in the community, collaboratively develop a community-based, culturally appropriate CVD intervention program for Lumbee Indian women in Robeson County, NC, focusing on the health-related messages in biblical passage in Proverbs 31; 2) Implement a 6-month CVD intervention program in four Lumbee Indian churches in Robeson County, NC, using a community health / lay health educator model. 3) Evaluate the community-based, culturally appropriate CVD intervention program on diet, physical activity and tobacco use among Lumbee women using a two-armed randomized trial with a cluster design and delayed intervention for control churches. Our primary outcomes for this study will be changes in health behaviors (diet, physical activity) and movement along the transtheoretical model stages of change for tobacco use. Secondary outcomes will include changes in body mass index (BMI) and changes in self-efficacy and self-esteem. We will conduct process assessments to determine the level of feasibility in the development and delivery of the intervention materials. This model could be adapted for other American Indian churches as well as churches of other racial/ethnic groups. PUBLIC HEALTH RELEVANCE: Project Narrative The proposed project entitled The Native Proverbs 31 Health Project is in response to RFA-MD-10-004. The project is designed to develop, implement and evaluate a church-based CVD prevention program among Lumbee Indian women in Robeson County, NC. The program will focus on an educational curriculum based on the biblical messages in Proverbs 31, which focuses on the behaviors of the "virtuous woman." The primary outcomes include changes in diet, physical activity and tobacco use and secondary outcomes in BMI, self-efficacy and self-esteem.

描述（由申请人提供）：近年来，美国印第安人的心血管疾病（CVD）发病率急剧上升。可改变的心血管疾病危险因素，如肥胖、2型糖尿病、久坐行为和烟草使用，在大多数美洲印第安人社区中普遍高于非西班牙裔白人，尽管对这些人群中适当的心血管疾病一级预防策略的独特文化方面的了解有限。蓝比印第安部落是一个非保留地部落，人口约5万，是密西西比河以东最大的美洲印第安部落，主要集中在北卡罗来纳州东南部的罗布森县。这个县大部分是农村，贫困率很高，美国印第安人、非洲裔美国人和非西班牙裔白人几乎平分。有限的现有数据表明，心血管疾病及其危险因素在北卡罗莱纳的美国印第安人中普遍很高，特别是在蓝蜂族中。蓝比部落主要是基督徒，教会是蓝比文化的一个非常重要的组成部分，为在这一人口中发展以教会为基础的卫生干预提供了机会。拟议的项目名为“土著谚语31健康项目”，是对RFA-MD-10-004 （NCMHD创新的基于信仰的健康差异研究方法）的回应。该项目旨在发展、实施和评估北卡罗来纳州罗布森县蓝比印第安妇女心血管疾病预防计划，重点关注箴言31章中的圣经信息。以下目标将实现1)基于先前的研究和社区的形成性工作，为北卡罗来纳州罗布森县的蓝比印第安妇女合作开发一个以社区为基础、文化上合适的心血管疾病干预计划，重点关注箴言31章圣经段落中与健康相关的信息；2)在北卡罗来纳州罗布森县的四个蓝比印第安教堂实施为期6个月的心血管疾病干预计划，采用社区健康/非专业健康教育者模式。3)评估基于社区的、文化上适宜的兰比妇女饮食、身体活动和烟草使用的心血管疾病干预方案，采用双臂随机试验、集群设计和对照教堂的延迟干预。我们这项研究的主要结果将是健康行为（饮食、身体活动）和运动在烟草使用变化的跨理论模型阶段的变化。次要结果将包括身体质量指数（BMI）的变化以及自我效能和自尊的变化。我们将进行过程评估，以确定开发和提供干预材料的可行性水平。这种模式可以适用于其他美国印第安人教会以及其他种族/民族群体的教会。