A Community e-Health Promotion Program Addressing Oklahoma's Urban Disparities

 描述(由申请人提供)：尽管有许多公共卫生计划，但非裔美国人社区的健康差距仍然存在。在俄克拉荷马州，健康差距的很大一部分可以归因于高比例的不健康生活方式选择。在服务不足的社区中，许多俄克拉荷马州人没有充分利用医疗保健，因此，全民健康改善需要能够影响社区健康文化的方法，而不仅仅是常规的临床环境。计算机化的健康风险评估(HRA)在一定条件下成功地促进了个体行为的改变。将成功的电子健康应用与新的实施方法相结合的增强型HRA也有可能减少健康差距，这些方法侧重于改善个人风险的呈现、量身定做和目标导向的护理建议以及持续的健康指导。然而，在服务不足的社区环境中进行的电子健康技术研究很少。关注面临健康差距的少数群体的研究就更少了。我们建议研究一种增强的、基于网络的HRA，它在初级保健中成功实施，结合个性化的、目标导向的健康规划，并由健康指导促进。我们选择了以信仰为基础的环境，以最大限度地扩大我们在文化上适合社区的范围。与Faithful，Fit和Strong Health Collaborative合作，我们建议进行一项交错的、顺序的eHealth实施研究，有三组会众。每个团体将举办一个健康节，以满足其会众的需求。对这项研究感兴趣的成年参与者将在健康节上登记。参与者(N=125)将在健康节期间完成HRA并会见他们的健康教练。在接下来的4个月里，参与者将设定他们的目标，制定行动计划，并与健康教练一起评估他们的进展。他们将在4个月的强化训练后完成第二次HRA，然后是一段逐渐减少的训练时间。在社区干预结束时，所有参与者将完成满意度调查，并将被邀请参加焦点小组，以提供他们的经验反馈。这项创新的电子健康技术试点研究的结果将使我们能够在基于信仰的健康协作的所有成员会众中设计一项更大、更明确的实施试验。我们的研究还将有助于将循证临床指南转化为实践，并创建路线图 让其他组织(其他信仰社区、学校、老年中心)让他们的社区参与到技术赋能的预防和健康促进中来。

 DESCRIPTION (provided by applicant): Health disparities in the African American community persist in spite of numerous public health programs. In Oklahoma, a substantial part of the health gap can be attributed to high rates of unhealthy lifestyle choices. Many Oklahomans in underserved communities underutilize health care, therefore, population-wide health improvement requires approaches that can influence health culture in communities, beyond the regular clinical environment. Computerized Health Risk Assessments (HRAs) have successfully promoted individual behavior change under certain conditions. Enhanced HRAs that combine successful eHealth applications with novel implementation approaches that focus on improved presentation of personal risks, tailored and goal-directed care recommendations, and ongoing health coaching also have the potential to reduce health disparities. However, few eHealth technology studies have been conducted in underserved community settings. Even fewer studies have focused on minority populations facing health disparities. We propose to study an enhanced, web-based HRA that was implemented successfully in primary care, coupled with personalized, goal-directed health planning and facilitated by health coaching. Faith-based settings were selected to maximize our culturally appropriate reach into the community. Working in collaboration with the Faithful, Fit and Strong Health Collaborative, we propose to conduct a staggered, sequential eHealth implementation study, with three groups of congregations. Each group will host a health festival, tailored to meet the needs of their congregation. Adult participants who are interested in the study will be enrolled at the health festival. Participants (N=125) will complete the HRA at the health festival and meet their health coach. Over the next 4 months, participants will set their goals, develop an action plan and evaluate their progress with the health coaches. They will complete a second HRA after 4 months of intensive coaching, followed by a period of gradually tapered coaching. At the end of the community intervention, all participants will complete a satisfaction survey and will be invited to participate in a focus grou to provide feedback about their experiences. The findings from this innovative eHealth technology pilot study will allow us to design a larger and more definitive implementation trial across all member congregations of the faith-based health collaborative. Our study will also facilitate the translation of evidence-based clinical guidelines into practice and create a roadmap for other organizations (other faith communities, schools, senior centers) to engage their communities in technology- empowered prevention and health promotion.