Pilot Project 1: Planning for Sustainability of Evidence-based Interventions

摘要 循证干预措施的开发者希望保持他们努力的有益健康结果 并在较长的一段时间内“维持”它们，即使在捐助机构提供外部支持之后， 资助人被终止。基于社区参与式研究，我们的跨学科研究 研究小组已经制定了一系列有效的干预措施，重点是解决癌症差异， 基于与300家美容院，80家理发店和3000多家 客户不幸的是，尽管有有效的证据，当研究完成时，这些 项目通常不会继续。拟议的试点外联项目的目标是， 系统地调查影响FITShop可持续性的因素，FITShop是一个最近的理发店， 以证据为基础的干预措施，旨在促进非裔美国人的身体活动。这 混合方法，两阶段概念验证研究将在3年内进行，并以规划为指导， 我们将从Shediac-Rizkallah & Bone（1998）和Scheirer的工作中采用可持续发展方法 （2013年）。在第一阶段，目标1-3，我们将进行130次访谈和社区讨论小组， 影响可持续性的三个假设因素：1）广泛的社会、政治和经济 较大社区的因素; 2）组织影响（理发店和护发行业）;以及，3） 与FITShop干预相关的计划设计和实施因素。利用这些结果， 第二阶段将实施理论指导的方法，以维持北部达勒姆的FITShop干预措施 卡罗莱纳-癌症发病率和死亡率不成比例地高的社区（目标4）。 与最初的FITShop研究一致，我们将测量6个月的体力活动结果（例如， 在10家理发店的100名顾客中， （Activograph/FITBit）和自我报告（CHART）测量。这项研究将产生重要的新知识， 如何1）遵循理论知情的过程来规划循证干预措施的可持续性; 2） 确定并致力于推进可持续性成果的理论和开发新的衡量标准（例如， 在个人一级维持健康福利，组织/社区能力建设，以及 方案编制的制度化）;以及，3）评估FITShop在多大程度上可以维持在一个 社区我们的研究结果具有重要的意义，通过开发一种新的方法来规划早期 第一个供资期，以维持干预措施，并将加强下一代的可持续性， 以证据为基础的干预措施，以帮助消除持续的健康和癌症差距。

Abstract Developers of evidence-based interventions want to maintain the beneficial health outcomes of their efforts and “sustain” them over an extended period of time, even after external support from a donor agency or funder is terminated. Grounded in community-based participatory research, our interdisciplinary research team has produced a wide array of effective interventions focused on addressing cancer disparities and based on a strong, 15 year partnership with 300 beauty salons, 80 barbershops, and over than 3000 customers. Unfortunately, and despite evidence of effectiveness, when the study was completed, these programs were typically not continued. The goal of the proposed pilot outreach project is to rigorously and systematically investigate factors that influence the sustainability of FITShop, a recent barbershop-based, evidence-based intervention designed to promote physical activity among African American men. This mixed-methods, two-phase proof-of-concept study will occur over 3 years and be guided by a planning for sustainability approach we will adapt from the work of Shediac-Rizkallah & Bone (1998) and Scheirer (2013). In Phase 1, Aims 1-3, we will conduct 130 interviews and community discussion groups to explore three hypothesized set of factors that influence sustainability: 1) Broad social, political and economic factors in the larger community; 2) Organizational influences (barbershop and hair care industry); and, 3) Program design and implementation factors that relate to the FITShop intervention. Using these results, Phase 2 will implement a theory-guided approach to sustain the FITShop intervention in Durham, North Carolina – a community with disproportionately high cancer incidence and mortality rates (Aim 4). Consistent with the original FITShop study, we will measure six month physical activity outcomes (e.g. maintenance of health benefits) among 100 customers from 10 barbershops using both objective (Actigraph/FITBit) and self-report (CHART) measures. This study will yield important new knowledge about how to 1) follow a theory-informed process to plan for sustainability of evidence-based interventions; 2) identify and work to advance theory and develop new measures of sustainability outcomes (e.g. maintenance of health benefits at the individual level, organizational/community capacity building, and institutionalization of programming); and, 3) assess the extent to which FITShop can be sustained in one community. Our results have important implications by developing a new approach to plan early in the initial funding period to sustain interventions, and, will enhance the sustainability of the next generation of evidence-based interventions, to help eliminate persistent health and cancer disparities.