强心、健康社区 2.0:针对农村妇女的心血管疾病预防干预措施》的过程评估结果。

IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS
Jacob Szeszulski, Laura J Rolke, Priscilla Ayine, Regan Bailey, Margaret Demment, Galen D Eldridge, Sara C Folta, Meredith L Graham, Alexandra L MacMillan Uribe, Andrew McNeely, Miriam E Nelson, Kristin Pullyblank, Chad Rethorst, David Strogatz, Rebecca A Seguin-Fowler
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引用次数: 0

摘要

背景:强健心脏、健康社区 2.0(SHHC-2.0)是一项为期 24 周的心血管疾病预防计划,它能有效改善美国纽约 11 个农村城镇妇女的体育锻炼和营养行为以及临床结果。本研究对 SHHC-2.0 的实施情况进行了评估,以便为进一步推广该干预措施做好准备:这项过程评估以医学研究委员会的建议为指导,采用定量和定性的方法,让项目负责人和参与者(即 40 岁以上的女性)参与其中。定量评估包括检查注册和保留数据、参与者调查和课后完成的忠诚度检查表。描述性统计和比较性统计用于评估实施措施:计划覆盖范围、参与者出席率、提供的剂量、计划长度、感知效果、忠实度和参与者满意度。定性评估包括使用半结构化指南进行的焦点小组(13 人)和访谈(4 人);使用定向内容分析法和迭代分类法对录音和记录誊本进行演绎编码和分析。探讨了不同城镇之间以及干预组和候补对照组之间的比较:城镇内的平均覆盖率为合格人口的 7.5%(范围为 0.7-15.7%)。平均出席率为 59.8%(范围为 42.0-77.4%)。领导者提供的平均剂量占课程内容的 86.4%(范围为 73.5-95.2%)。48 节课的平均课时长度为 51.8 ± 4.8 分钟。领导者的感知效果评分平均为(4.1 ± 0.3)分(满分为 5 分)。课程内容的忠实度为 81.8%(范围为 67.4-93.2%)。参与者对整个计划(88.8%)和他们获得的健康益处(72.9%)表示 "非常满意"。定性分析显示,参与者:(1) 获得了新的知识和愉快的体验;(2) 认为自己在体育锻炼、营养和/或健康方面有所改善;(3) 在体育锻炼和健康饮食方面仍然面临一些障碍,其中与社会支持有关的障碍有所减少;(4) 对领导者和小组结构的评价较高,对研究内容的意见不一:SHHC-2.0具有广泛的影响力,在很大程度上达到了预期目标,参与者对该计划及其健康益处表示高度满意。我们的研究结果拓展了在农村社区实施心血管疾病预防计划的最佳实践。临床试验注册:www.Clinicaltrials: gov #NCT03059472。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women.

Background: Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns. This study evaluated the delivery of SHHC-2.0 to prepare the intervention for further dissemination.

Methods: This process evaluation was guided by the Medical Research Council recommendations and engaged program leaders and participants (i.e., women over age 40) using quantitative and qualitative methods. The quantitative evaluation included examination of enrollment and retention data, a participant survey, and a fidelity checklist completed after classes. Descriptive and comparative statistics were used to assess implementation measures: program reach, participant attendance, dose delivered, program length, perceived effectiveness, fidelity, and participant satisfaction. The qualitative evaluation included focus groups (n = 13) and interviews (n = 4) using semi-structured guides; audio was recorded and transcripts were deductively coded and analyzed using directed content analysis and iterative categorization approaches. Comparisons across towns and between intervention and waitlist control groups were explored.

Results: Average reach within towns was 7.5% of the eligible population (range 0.7-15.7%). Average attendance was 59.8% of sessions (range 42.0-77.4%). Average dose delivered by leaders was 86.4% of curriculum components (range 73.5-95.2%). Average session length was 51.8 ± 4.8 min across 48 sessions. Leaders' perceived effectiveness rating averaged 4.1 ± 0.3 out of 5. Fidelity to curricular components was 81.8% (range 67.4-93.2%). Participants reported being "more than satisfied" with the overall program (88.8%) and the health benefits they obtained (72.9%). Qualitative analysis revealed that participants: (1) gained new knowledge and enjoyable experiences; (2) perceived improvements in their physical activity, nutrition, and/or health; (3) continued to face some barriers to physical activity and healthy eating, with those relating to social support being reduced; and (4) rated leaders and the group structure highly, with mixed opinions on the research elements.

Conclusions: SHHC-2.0 had broad reach, was largely delivered as intended, and participants expressed high levels of satisfaction with the program and its health benefits. Our findings expand on best practices for implementing cardiovascular disease prevention programs in rural communities.

Clinical trials registration: www.

Clinicaltrials: gov #NCT03059472.

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来源期刊
CiteScore
13.80
自引率
3.40%
发文量
138
审稿时长
4-8 weeks
期刊介绍: International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, peer-reviewed journal offering high quality articles, rapid publication and wide diffusion in the public domain. IJBNPA is devoted to furthering the understanding of the behavioral aspects of diet and physical activity and is unique in its inclusion of multiple levels of analysis, including populations, groups and individuals and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas.
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