Translating a nutrition intervention thru WIC & Minority Health Promotion Centers

描述(由申请人提供)：拟议研究的目的是进行转化性研究，以研究传播一种量身定制的营养干预措施的过程，该干预措施已被证明在改善不同低收入受众的水果和蔬菜(FV)摄入量方面有效，这是NCI资助的名为Your Health Life/Su Vida Saludable(YHS/SVS)的功效研究的一部分。拟议的研究将系统地研究和描述成功地将YHL/SVS干预转化为两种不同类型地点的既定做法的过程：少数民族健康促进中心(MHPC)和国际扶轮社与罗德岛合作的WIC诊所 岛屿卫生部(RIDH)。这项研究将确定最佳的传播策略，以使这一干预计划能够传播到国际扶轮内外的类似环境。拟议研究的主要目标是：1.开展形成性研究，包括与目标受众、RIDH主要官员、MHPC和WIC工作人员等关键利益攸关方进行焦点小组和重点访谈，以适应YHL/SVS干预的内容和形式，以满足这些受众/环境的需求，并为翻译试点提供干预和评估协议和工具；2.在20个站点(及其客户)进行翻译试点，使用各种定性和定量评估措施评估传播过程，包括覆盖范围、采用、实施、保真度等；3.汇编来自翻译试点的数据，并使用它来制定计划，以便在整个国际扶轮和其他州传播干预措施。第二个目标将是：1.比较改编的YHL/SVS干预的有效性和对照干预(传统的自助材料)在参与者的FV摄入(和心理社会中介)方面的有效性；2.比较翻译性先导研究和先前的YHL/SVS随机疗效试验的效果大小； 3.评价改良型YHL/SVS干预对公众健康的影响。这项为期三年的研究将分三个阶段进行。YO1的第一阶段将包括与主要利益攸关方进行形成性研究，以适应YHL/SVS干预的内容和形式，以满足这些受众/环境的需求，为干预实施计划以及评估方法、工具和措施提供信息，以满足利益攸关方的需求/优先事项。在YO2开始的第二阶段将是一项翻译试点研究，有6个MHPC和14个WIC站点(半随机接受定制的 干预和半随机接受对照干预)和1400名受试者研究和评价干预措施的翻译。第三阶段将是翻译研究的继续，所有地点都将接受量身定做的干预。在Y03结束时，我们将汇编翻译研究试点研究的数据，并使用它来制定一个计划，将干预措施传播到整个国际扶轮和其他州。

DESCRIPTION (provided by the applicant): The purpose of the proposed research is to conduct translational research to study the process of disseminating a tailored nutrition intervention that has been shown to be efficacious in improving fruit and vegetable (FV) intake in diverse low income audiences as part of a NCI-funded efficacy study entitled Your Healthy Life/Su Vida Saludable (YHS/SVS). The proposed research will systematically study and characterize the process of successfully translating the YHL/SVS intervention into the established practice of two different types of sites: Minority Health Promotion Centers (MHPC) and WIC clinics in RI in partnership with the Rhode Island Department of Health (RIDH). The research will ascertain optimal diffusion strategies to enable this intervention program to be disseminated to similar settings throughout and beyond RI. Primary aims of the proposed research are: 1. To conduct formative research including focus groups and focused interviews with key stakeholders including the target audience, key RIDH officials, MHPC and WIC staff to inform adaptations of the content and format of the YHL/SVS intervention so that it meets the needs of these audiences/settings, and to inform the intervention and evaluation protocols and tools for the translational pilot; 2. To conduct a translational pilot with 20 sites (and their clients) to evaluate the process of dissemination including reach, adoption, implementation, fidelity, etc. using a variety of qualitative and quantitative evaluation measures; 3. To compile data from the translational pilot and use it to create a plan for disseminating the intervention throughout RI and into other states. Secondary aims will be to 1. To compare the effectiveness of the adapted YHL/SVS intervention to the effectiveness of a comparison intervention (traditional self help material) in terms of change in FV intake (and psychosocial mediators) of participants; 2. To compare the effect size achieved in the translational pilot study with the effect size achieved in the previous YHL/SVS randomized efficacy trial; and 3. To measure the public health impact of the adapted YHL/SVS intervention. The three year study will have three phases. Phase 1 in YO1 will include formative research with key stakeholders to inform adaptations of the content and format of the YHL/SVS intervention so that it meets the needs of these audiences/settings, to inform the plans for intervention implementation, and the evaluation methods, tools and measures so they meet the needs/priorities of the stakeholders. Phase II beginning in YO2 will be a translational pilot study with 6 MHPC and 14 WIC sites (half randomized to receive the tailored intervention and half randomized to receive the comparison intervention) and 1400 of their clients to study and evaluate the translation of the intervention. Phase III will be a continuation of the translation study with all sites receiving the tailored intervention. At the end of YO3, we will compile data from the translation research pilot study and use it to create a plan for disseminating the intervention throughout RI and into other states.