Disseminating Effective Community-Led Programs to Elimanate Diabetes Disparities

描述（由申请人提供）：糖尿病流行病，不成比例地影响黑人和拉丁美洲人，可以通过导致体重减轻的生活方式干预来遏制。不幸的是，这些项目要么不针对最脆弱的低收入少数群体，要么在研究资金消失后不复存在。七年前，东哈莱姆的社区和学术领袖聚集在一起，利用基于社区的参与性研究来制定一项干预措施，以可持续地减少健康差距，并使用严格的方法对其进行评估。合作伙伴开发了HEED，这是一个低成本，文化和经济上合适的，以同伴为主导的社区糖尿病预防计划，并招募了400名患有糖尿病前期的黑人和拉丁美洲成年人参加一项以社区为基础的多地点随机对照试验，以测试其对体重变化的影响。HEED导致了显著的体重减轻，饮食改善和平均葡萄糖水平在这个主要是低收入，讲西班牙语，没有保险，教育不足的人口。我们现在的目标是在生活在东哈莱姆的34 000名糖尿病高危成年人和为他们服务的324个社区组织中传播HEED。为了实现这一目标，我们的合作伙伴关系将使用理论驱动的实施战略：1）通过评估组织和个人的传播障碍和促进因素，确定广泛传播HEED的方法; 2）通过定制亲自HEED研讨会和开发I-HEED在线研讨会，翻译HEED以供日常使用; 3）利用社会和组织网络、社会媒体和经济激励措施大力传播HEED; 4）评估我们的传播工作的范围、影响和影响，比较不同方法的有效性，并确定经济上可持续的模式; 5）通过持续的伙伴关系和结构化的学习机会，提高社区成员参与未来研究的能力，以造福社区。我们将利用所吸取的经验教训，提供宝贵的见解，这将阿西斯其他人在现实世界中传播循证卫生干预措施，以消除健康差距。

DESCRIPTION (provided by applicant): The diabetes epidemic, which disproportionately impacts Blacks and Latinos, can be stemmed through lifestyle interventions that lead to weight loss. Unfortunately, these programs either do not target the most vulnerable, low-income minority populations, or cease to exist when their research funding disappears. Seven years ago, community and academic leaders in East Harlem came together to use community-based participatory research to develop an intervention that would sustainably reduce health disparities and evaluate it using rigorous methods. Partners developed HEED, a low-cost, culturally and economically appropriate, peer-led community-based diabetes prevention program, and recruited 400 Black and Latino adults with pre-diabetes to a community-based, multisite randomized controlled trial to test its impact on weight change. HEED led to statisticall significant weight loss, improvements in diet and a leveling of average glucose in this predominantly low-income, Spanish-speaking, uninsured, undereducated population. We now aim to disseminate HEED among the 34,000 adults living in East Harlem at heightened risk for diabetes and the 324 community organizations who serve them. To accomplish this, our partnership will use theoretically-driven implementation strategies to: 1) Identify ways to widely disseminate HEED through assessing organizational and individual barriers to, and facilitators of dissemination; 2) Translate HEED for everyday use by tailoring in-person HEED workshops and developing I-HEED online workshops; 3) Robustly disseminate HEED using social and organizational networks, social media, and economic incentives; 4) Evaluate the extent, reach, and impact of our dissemination efforts, compare effectiveness of different approaches, and identify economically sustainable models; 5) Increase the capacity of community members to engage in future research for community benefit through continued partnership and structured learning opportunities. We will use lessons learned to contribute valuable insights that will assis others in real-world dissemination of evidence-based health interventions to eliminate health disparities.