Enhancing capacity in faith-based organizations to implement and sustain multilevel innovations to improve physical activity

项目总结 尽管体育锻炼(PA)对预防心血管疾病(CVD)和其他慢性疾病有好处 疾病，很少有成年拉丁人符合PA的指导方针。鉴于信仰组织(FBO)的核心作用 在拉丁裔社区及其对其成员福祉的承诺中，FBO是理想的环境 为了促进健康。增加PA和减少肥胖的循证方法，如信仰 行动是存在的，但巴勒斯坦权力机构的干预很少达到规模。加强FBO能力的实施战略 领导者和社区卫生工作者(推动者)实施EBI可以促进其接受。我们建议 在行动中通过三种组织层面的战略来增强行动信念，这些战略旨在提高计划的适合性和 有效性：1)培训FBO领导人进行健康促进2)定制消息传递以增强信仰之间的契合度 在行动中和每个独特的FBO背景下，以及3)授权推动者倡导组织变革。 鉴于需要改进策略以维持社区环境中的健康计划，我们建议测试 另外两个维持战略的影响：1)加强社区合作和2)提供 技术支持。我们将使用集群式随机对照试验进行第二类混合有效性实施试验 旨在测试建议的实施战略对组织级变革的影响以及 对不同FBO的个体行为进行为期12个月的干预和6个月的随访。32名联邦快递员将成为 随机分配到标准EBI条件(最初实施的行动中的信念)，增强的 条件(标准条件+组织级实施战略)或增强+可持续发展 条件(改进的执行条件+维持战略)。我们将收集量化和 基线、基线后6个月、12个月和18个月的定性数据。建议的研究旨在： 1)测试组织级实施战略在2中的短期和长期影响 组织结果条件与标准EBI条件的比较，2)检查个人的可达性 与标准条件相比，在2个增强条件下，拉丁裔(n=812)在FBO中的有效性 埃比的情况。次要目标审查行动的理论机制(例如，组织氛围)和 两个维持战略的额外影响。由实际可靠的实施和 可持续性模型(PRISM)和REACH有效性-采用实施和维护(RE-AIM) 框架，目前的研究将使用混合的方法来使信仰在行动中适应不同的非营利组织。这项研究 具有创新性，因为它通过实验测试组织级别的实施策略及其关联 来自不同教派的拉丁裔FBO的行动机制。我们的发现将对该领域产生以下影响 为创新的EBI在FBO中的放大提供了严格派生的证据。如果成功，调查结果来自 目前的研究将为组织层面的吸收、维持和 扩大PA干预以增加PA和减少慢性病的概括性实施战略 疾病在美国各地的FBO中流行。

PROJECT SUMMARY Despite the benefits of physical activity (PA) to prevent cardiovascular disease (CVD) and other chronic diseases, few adult Latinas meet PA guidelines. Given the central role of faith-based organizations (FBOs) within the Latino community and their commitment to the well-being of their members, FBOs are ideal settings for health promotion. Evidence-based approaches for increasing PA and reducing obesity such as Faith in Action exist, but few PA interventions go to scale. Implementation strategies that enhance the capacity of FBO leaders and community health workers (promotoras) to implement EBIs can facilitate their uptake. We propose to enhance Faith in Action with three organization-level strategies designed to increase program fit and effectiveness: 1) training FBO leaders in health promotion 2) tailoring messaging to enhance fit between Faith in Action and each unique FBO context, and 3) empowering promotoras to advocate for organizational change. Given the need to improve strategies to sustain health programs in community settings, we propose to test the influence of two additional sustainment strategies: 1) strengthening community collaborations and 2) providing technical support. We will conduct a hybrid type II effectiveness-implementation trial using a clustered RCT design to test the impact of the proposed implementation strategies on organization-level change and individual behavior in diverse FBOs for a 12-month intervention and 6-month follow-up. Thirty-two FBOs will be randomly assigned to a Standard EBI condition (Faith in Action as originally implemented), an Enhanced condition (Standard condition + organizational-level implementation strategies), or Enhanced + Sustainment condition (Enhanced implementation condition + sustainment strategies). We will collect quantitative and qualitative data at baseline, 6 months, 12 months, and 18 months post baseline. The proposed study aims to: 1) Test the short and long-term impacts of organization-level implementation strategies in 2 Enhanced conditions on organizational outcomes compared to the Standard EBI condition, 2) Examine individual reach and effectiveness among Latinas (n=812) in FBOs in the 2 Enhanced conditions compared to the Standard EBI condition. Secondary aims examine theoretical mechanisms of action (e.g., organizational climate) and the additional impact of two sustainment strategies. Informed by the Practical Robust Implementation and Sustainability Model (PRISM) and Reach Effectiveness-Adoption Implementation and Maintenance (RE-AIM) frameworks, the current study will use mixed methods to adapt Faith in Action to diverse FBOs. This research is innovative because it experimentally tests organization-level implementation strategies and their associated mechanism of action in Latino FBOs' from diverse denominations. Our findings will impact the field by providing rigorously derived evidence for the scale-up of innovative EBIs in FBOs. If successful, findings from the current study will provide evidence of organizational-level strategies for uptake, sustainment, and generalizable implementation strategies for scale-up of PA interventions to increase PA and reduce chronic disease in FBOs across the US.