MOCHA Moving Forward: a CBPR investigation of chronic disease prevention in older, low-income African-American men

 描述（申请人提供）：本研究采用社区为本的前瞻性研究方法，以达致三个研究目的：（1）找出可纳入由主要研究者发展的扩展少数族裔压力模式的因素;（2）评估有色人种健康意识（MOCHA）计划的有效性，以及使用叙事沟通策略的增强型MOCHA+计划，在一项随机对照试验中降低压力和慢性疾病的风险;（3）确定那些对低收入非洲裔美国人的压力和健康有影响的个人、人际和社会结构因素。MOCHA计划是一个基层，社区驱动的倡议，以解决生活在斯普林菲尔德MA的低收入非洲裔美国人所经历的健康差距的沉重负担的结果。人道协调部的方案是由基督教青年会地方分会和州公共卫生部之间的公私合作维持的。MOCHA计划旨在以综合方式同时解决有色人种的身体，心理，社会和精神需求。它包括 一个为期12周的计划，包括：（1）每周两次60分钟的中等强度有氧运动;（2）小组讨论有色人种面临的问题，特别是社会对黑人男子气概的定义的潜在有害影响以及相关的压力、暴力、抑郁和药物滥用问题;（3）与慢性病控制有关的健康主题课程，如营养、肥胖、高血压、健身和健康的社会决定因素。在使用CBPR方法时，大学研究人员将在研究的所有阶段与人道协调部指导委员会合作，从确定主要研究问题，到确定人道协调部模型中隐含的中介因素，再到利用适当的研究工具回答主要研究问题，收集和分析数据，以适当的方式向不同的受众传播研究结果。建议的研究方法包括：MOCHA参与者的个人访谈，数字故事（DST）研讨会的人种学现场观察，调查问卷和生理指标，如皮质醇，血压和BMI的收集。这项研究的结果将有助于确定有效的干预措施，以解决低收入非洲裔美国男性的健康差距和有效的慢性病预防规划的传播。

 DESCRIPTION (provided by applicant): The research is designed to use a Community-Based Participatory Research (CBPR) approach to achieve three research objectives: (1) to identify factors that can be incorporated into expanded Minority Stress Model developed by the PI; (2) to evaluate the effectiveness of the Men of Color Health Awareness (MOCHA) program, and an enhanced MOCHA+ program that uses narrative communication strategies, in lowering stress and risk of chronic diseases in a randomized controlled trial; and (3) to determine those individual, interpersonal and social structural factors that have an impact on stress and the health of low income African- American men. The MOCHA program is the result of a grassroots, community-driven initiative to address the heavy burden of health disparities experienced by low-income African-American men living in Springfield MA. The MOCHA program is sustained by a public - private collaboration between the local chapter of the YMCA and the state Department of Public Health. The MOCHA program is designed to address the physical, mental, social, and spiritual needs of men of color simultaneously in an integrated fashion. It consists of a 12-week program comprised of: (1) 60-minutes of moderately intensive aerobic exercise twice a week; (2) small group discussions of issues facing men of color, in particular, the potentially harmful effects of socially constructed definitions of black masculinity and associated issues of stress, violence, depression and substance abuse; (3) classes on health topics pertinent to chronic disease control, such as nutrition, obesity, high blood pressure, fitness and the social determinants of health. In utilizing a CBPR methodology, university researchers will partner with the MOCHA Steering Committee in all phases of the research, from identifying the main research questions, to identifying mediating factors implicit in the MOCHA model to utilizing appropriate research instruments to answer the primary research question, to data collection and analysis, to disseminating the results of the research, in appropriate fashion, to different audiences. The proposed research methods include: individual interviews of MOCHA participants, ethnographic field observations of digital storytelling (DST) workshops, survey questionnaires and the collection of physiological measures such as cortisol, blood pressure, and BMI. The results of this research will contribute to the identification of effective interventins to address health disparities in low-income African-American men and the dissemination of effective chronic disease prevention programming.