Dan River Region POPS: Partnerning for Obesity Planning and Sustainability

描述（由申请人提供）：丹河地区（DRR）是联邦政府指定的医疗服务不足地区/肥胖率高的人口。根据3项全面的社区需求评估，2010年建立了“丹河健康社区伙伴关系”（丹河健康社区伙伴关系使命宣言），“通过健康生活方式倡议，促进社区伙伴关系，在丹河地区抗击肥胖”。迄今为止，DRPHC 1)测试了一项成功的成人体重控制干预措施，2)发起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食品和体育活动环境的全面审计。该RFA为DRPHC儿童肥胖提供了一个解决额外和补充需求的机会。DRPHC新成立的小组委员会和社区咨询委员会（CAB），肥胖规划和可持续性合作（POPS），在准备这项提案时举行了会议，并讨论了让高需求家庭接受服务并参与儿童肥胖治疗的系统参与的必要性。POPS-CAB达成共识，认为在现有的CBPR伙伴关系中使用基于系统的方法，将允许开发具有长期可持续性潜力的与环境相关的干预措施。基于系统的方法包括，但也超越了，对主动性的有效性的关注，并处理更广泛的上下文问题，例如主动性的采用，实施，以及跨设置和交付人员的维护，以及在个人层面上达到和维护效果。本应用程序的总体目标是通过DRPHC POPS-CAB参与多个系统，并设计和测试儿童肥胖干预的原型。目前，pop - cab的成员包括丹维尔宾夕法尼亚州卫生区、儿童保健中心、丹维尔公园娱乐和旅游、男孩和女孩俱乐部，以及一个跨学科的学术调查小组。我们的第一个目标是评估在刚果民主共和国制定、实施和维持减少儿童肥胖倡议的社区能力。为了实现这一目标，将使用一个并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。公共卫生和卫生保健系统将采用三个阶段的反复干预测试/形成性反馈循环来实现这一目标。伙伴关系成员将持续开会，讨论定性和定量结果，并作出调整以改进战略。成功的指标包括降低儿童BMI z分数，多个系统的参与，以及区域评估研究证据并将这些证据纳入可持续实践的能力。最终目标是一种儿童肥胖干预措施，可以在DRR的这些系统中进行大规模测试。

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.