Dan River Region POPS: Partnerning for Obesity Planning and Sustainability

描述(由申请人提供)：丹河地区(DRR)是联邦政府指定的肥胖率较高的医疗服务不足地区/人口。作为对3项综合社区需求评估的回应，丹河健康社区伙伴关系(DRPHC)于2010年成立，“旨在促进社区伙伴关系，通过健康生活方式倡议在丹河地区与肥胖作斗争”(DRPHC使命声明)。到目前为止，DRPHC 1)测试了成功的成人体重控制干预措施，2)启动了以青少年为重点的社区花园和即时休息倡议，3)继续完成对整个DRR的食物和身体活动环境的全面审计。这种RFA提供了一个机会来解决DRPHC儿童肥胖症的一个额外的和补充的需求领域。DRPHC的一个新成立的小组委员会和社区咨询委员会(CAB)，肥胖规划和可持续发展伙伴关系(POPS)，在准备这项提案时举行了会议，讨论了在高需求家庭接受服务并可以参与儿童肥胖症治疗的系统中参与的必要性。持久性有机污染物--CAB达成共识，认为在现有的CBPR伙伴关系内使用基于系统的方法，将能够制定具有长期可持续性潜力的与具体情况相关的干预措施。基于系统的方法包括，但也超越了对倡议有效性的关注，并解决了更广泛的背景问题，如跨环境和交付人员的倡议采用、实施和维护，以及个人层面的影响和维护。该应用程序的总体目标是通过DRPHC POPS-CAB使用多个系统，并设计和测试儿童肥胖干预原型。POPS-CAB目前的成员包括宾夕法尼亚州丹维尔卫生区、儿童保健中心、丹维尔公园娱乐和旅游以及男孩和女孩俱乐部，以及一个跨学科的学术调查团队。我们的第一个目标是评估社区在DRR中制定、实施和维持儿童肥胖减少倡议的能力。为了实现这一目标，将使用同时进行的混合方法研究设计，并指导RE-AIM框架的社区能力维度和组织层面维度(即采用、实施和维护)。第二个目标是确定新开发的干预措施的潜在覆盖范围、有效性、可行性和成本。在公共卫生和保健系统中，将使用三个阶段的迭代干预测试/形成性反馈循环来实现这一目标。伙伴关系成员将持续举行会议，讨论质量和数量结果，并作出调整，以改进战略。成功的指标包括儿童体重指数z分数的降低、多个系统的参与以及评估研究证据并将这些证据纳入可持续实践的区域能力。最终目标是儿童肥胖干预，为DRR中这些系统的大规模测试做好准备。 相关性(见说明)：将以系统为基础的方法与为解决肥胖问题而建立的以社区为基础的参与性研究联盟相结合，对于制定与背景相关的儿童肥胖战略大有可为。与提供系统合作，确定和调整以证据为基础的儿童肥胖症干预措施，很有可能增加保健不同社区中未得到充分服务的青年的覆盖面，刺激地方系统之间更高的适应能力，并促进长期可持续性。

DESCRIPTION (provided by applicant): The Dan River Region (DRR) is a federally designated medically under-served area/population with high rates of obesity. In response to 3 comprehensive community needs assessments The Dan River Partnership for a Healthy Community (DRPHC) was established in 2010 "to foster community partnership to combat obesity in the Dan River Region through healthy lifestyle initiatives" (DRPHC mission statement). To date the DRPHC 1) tested a successful adult weight control intervention, 2) initiated youth-focus community garden and instant recess initiatives, and 3) continues to complete a comprehensive audit of the food and physical activity environment across the DRR. This RFA provided an opportunity to address an additional and complimentary area of need for the DRPHC childhood obesity. A newly formed subcommittee and community advisory board (CAB) of the DRPHC, Partnering for Obesity Planning and Sustainability (POPS), met in preparation of this proposal and discussed the need to engage systems where high need families received services and could participate in childhood obesity treatment. The POPS-CAB came to consensus that using a systems-based approach, within the existing CBPR partnership, would allow for the development of a contextually relevant intervention with the potential for long-term sustainability. Systems-based approaches include, but also move beyond, a focus on initiative effectiveness and address broader contextual issues such as initiative adoption, implementation, and maintenance across settings and delivery staff as well as reach and maintenance of effects at the individual level. The general goal of this application is to engage multiple systems through the DRPHC POPS-CAB and design and test prototype childhood obesity interventions. The current membership of the POPS-CAB includes Danville Pittsylvania Health District, Children's Healthcare Center, Danville Parks Recreation & Tourism, and Boys & Girls Club, along with an interdisciplinary team of academic investigators. Our first aim is to assess community capacity to develop, implement, and sustain a childhood obesity reduction initiative in the DRR. To accomplish this aim a concurrent mixed-method study design will be used and guide dimensions of community capacity and organizational level dimensions of the RE-AIM framework (i.e., adoption, implementation, and maintenance). The second aim is to determine the potential reach, effectiveness, feasibility, and cost of the newly developed interventions. Three stages of iterative intervention testing/formative feedback loops in a public health and healthcare system will be used to achieve this aim. The partnership members will meet on an ongoing basis to discuss the qualitative and quantitative results and make adaptations to improve the strategies. Indicators of success include reduced child BMI z-scores, the engagement of multiple systems, and regional capacity to evaluate research evidence and integrate this evidence into sustainable practices. The end goal is a childhood obesity intervention that is ready for large scale testing across these systems in the DRR. RELEVANCE (See instructions): Integrating a systems-based approach with a community-based participatory research coalition established to address obesity holds great promise for developing contextually relevant childhood obesity strategies. Partnering with delivery systems to identify and adapt evidenced-based childhood obesity interventions has high potential to increase the reach of underserved youth in health disparate communities, stimulate higher adaptation among local systems, and promote longer term sustainability.