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

受资助的赠款或项目摘要 尽管体力活动(PA)对预防心血管疾病(CVD)和其他 慢性疾病，很少有成年拉丁人符合PA指南。鉴于信仰的核心作用 拉美裔社区内的组织(FBO)及其对 他们的成员，FBO是健康促进的理想环境。以证据为基础的方法 增加PA和减少肥胖，如信念在行动中，但很少有PA干预去 比例。加强FBO领导和社区卫生能力的实施战略 实施EBI的工人(推动者)可以促进他们的接受。我们建议加强 行动中的信念，三个组织级别的战略，旨在提高计划的适合性和 成效：1)培训FBO领导人健康促进2)定制消息以增强适合度 在行动中的信念和每个独特的FBO背景之间，以及3)授权推广者 倡导组织变革。鉴于需要改进维持健康的战略 在社区环境中，我们建议测试两个额外的维持措施的影响 战略：1)加强社区合作，2)提供技术支持。我们 将使用群集化RCT设计进行第二类混合有效性实施试验，以 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FBO将被随机分配到标准EBI条件(Faith in Action AS 最初实施)，增强条件(标准条件+组织级别 实施战略)，或增强+可持续条件(增强实施 条件+维持战略)。我们将在基线上收集定量和定性数据， 基线后6个月、12个月和18个月。这项拟议的研究旨在：1)测试短期 组织一级执行战略在2个增强条件下的长期影响 关于组织结果与标准EBI条件的比较，2)检查个人 在两种增强条件下，拉丁裔(n=812)在FBO中的可及性和有效性 达到标准的EBI条件。次要目标检查行动的理论机制(例如， 组织气候)和两个维持战略的额外影响。由 实用可靠的实施和可持续发展模式(PRISM)和达到实效- 采用实施和维护(RE-AIM)框架，本研究将使用 混合方法使信仰在行动中适应不同的FBO。这项研究具有创新性，因为它 试验性地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。我们的发现将影响 通过提供严格衍生的证据，证明创新的EBI在FBO中的规模。如果 如果成功，当前研究的结果将提供组织层面的证据 吸纳、维持战略和扩大规模的一般性实施战略 PA干预措施，以增加PA和减少全美FBO的慢性病。

Abstract of funded grant or project 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 a 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.