Community Health Through Engagement and Environmental Renewal
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 915
- 试验地点
- 1
- 主要终点
- Problem Behaviors in Children Ages 11 to 16 Years.
研究概览
简要总结
Community Health from Engagement and Environmental Renewal (CHEER) will leverage previous Centers for Disease Control and Prevention (CDC) community engagement projects to reach and intervene on a high need population. Disadvantage and poverty have long-term and transgenerational adverse impacts on social interaction and cohesion and residents' emotional and physical health. Mothers living and raising children in these conditions face multiple stressors without the community support previous generations relied on. Decades of research on American cities have connected the social, economic, and physical characteristics of neighborhoods with a lack of social cohesion, inability to maintain shared norms of acceptable behavior,and increases in health disparities and risky behaviors. Social cohesion and collective efficacy inversely associate with depression among youth. In a parallel manner, improved parenting practices and youth behavior directly associate with neighborhood social interactions and social cohesion. While these associations are suggestive, CHEER will directly test causal hypotheses at the neighborhood and family levels in a randomized control trial, that can significantly advance the evidence base for public health interventions: Family Youth Intervention (FYI) and an Environment: Social and Physical Intervention (ESPI) to increase social interaction, social cohesion, and collective efficacy and influence wellbeing of mothers and their youth.
详细描述
Aim 1 Family System: To test the effect of FYI on primary outcomes of youth psychosocial behaviors and sexual risk compared to a Wait List Control.
1a. FYI will significantly improve our primary outcomes of externalizing (e.g. impulsivity, violence, theft) and internalizing (e.g. depression, withdrawal, anxiety, loneliness) behaviors and early and risky sex (i.e. sexual initiation at less than 16 years of age and sexual intercourse without a condom) (Effectiveness).
- b. FYI will significantly lower parental stress, improve maternal emotional health, enhance parenting skills and improve youth Social and Emotional Competence (SEC) to change primary outcomes (Mediation).
Aim 2 Community System: To test the effect of ESPI on neighborhood environment compared to Wait List Control. 2. a. ESPI significantly will increase our primary outcomes of social interaction, social cohesion, collective efficacy, and shared norms compared to wait list control (Effectiveness).
2b. Engaging residents in community-designed and -led projects to develop common spaces will significantly improve neighborhood perceptions (e.g. attractiveness, safety) and provide opportunities for residents to interact to change primary outcomes (Mediation).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 11 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •For FYI, parents who reside in the FYI intervention neighborhood (North Titusville, South Titusville, Rising -West Princeton, and Belview Heights) and have a child age 11-16 years.
- •For ESPI, residents who live in the ESPI intervention neighborhoods (North Titusville, South Titusville, Druid Hills, and Fountain Heights).
排除标准
- •For FYI, does not met the above requirements and did not consent to participate.
- •For ESPI, not residing in one of the above neighborhoods and did not consent to participate.
研究组 & 干预措施
Family Youth Intervention (FYI)
The primary objective of FYI is to evaluate the effectiveness of a theory-based, peer-supported family strengthening intervention on the primary outcomes in a sample of 120 parent-child pairs living in resource-poor urban neighborhoods in Birmingham. For FYI, we will utilize community health advisors (CHAs) to implement the intervention. CHAs will be recruited from each FYI neighborhood and will be trained in research ethics. CHAs will assist and support FYI participants in mastering the sequential skills of the 12 modules designed to improve maternal, youth, and family functioning. Additionally, CHAs will provide emotional social support that is helpful, hopeful, and trustful.
干预措施: Community Health through Engagement and Environmental Renewal (CHEER) (Behavioral)
ESPI Environment: Social and Physical Intervention (ESPI)
ESPI will enroll 500 community members to examine the effect of blight elimination through lot recovery on primary outcomes of improved social interaction, social cohesion around common neighborhood norms, and collective efficacy to effect change in the neighborhoods . Neighborhood residents will select a cluster of lots (2-3) for lot recovery that are highly visible in the neighborhood (e.g. on a main thoroughfare). The community residents will lead the neighborhood projects. In some cases, neighborhood residents will personally undertake all or part of the greening projects.
干预措施: Community Health through Engagement and Environmental Renewal (CHEER) (Behavioral)
Wait-List Control
The two communities will get ESPI, upon completion of the study.
干预措施: Community Health through Engagement and Environmental Renewal (CHEER) (Behavioral)
FYI and ESPI
Two of the eight neighborhoods will receive both FYI and ESPI intervention.
干预措施: Community Health through Engagement and Environmental Renewal (CHEER) (Behavioral)
结局指标
主要结局
Problem Behaviors in Children Ages 11 to 16 Years.
时间窗: Baseline, 1-week and 6-month Follow-up
Three items asked have the child ever been suspended from school and within the past 12 months prior to the baseline survey have they smoked cigarettes or drunk alcohol. Participants choose 1 for yes and 0 for no. The range is form 0 to 3, where 3 describes a higher problematic behavior. Three questions were asked at 1-week and 6 month follow-up: have they been suspended from school, smoked cigarettes or drunk alcohol since baseline.
Age of Sexual Initiation
时间窗: Baseline
Year of age at sex. Two variables were used to measure sexual initiation. Answer choices ranged continuously from 1 (10 years old) to 9 (18 years or older).
Number of Participants Who Participates in Risky Sex
时间窗: Baseline
Follow-up questions for individuals endorsing sexual initiation to assess risky sex behavior. The count was assessed on how often did the participant had sex without a condom.
Project on Human Development in Chicago Neighborhoods: Community Survey- Cohesion Index Subscale
时间窗: Baseline, 12-month Follow up 1 and 18-month Follow up 2
Project on Human Development in Chicago Neighborhoods: Community Survey assesses city-level variables relating to neighborhood structure. This scale consisted of 7 items that were measured on a scale of 1 to 6. The range of scores are from 7 to 35. The mean score was analyzed where the higher the score the community interaction was the worst.
Number of Participants Who Like Living in Their Neighborhood
时间窗: Baseline
Survey item on whether they like or dislike living their neighborhood.
Project on Human Development in Chicago Neighborhoods: Community Survey- Neighborhood Perception
时间窗: Baseline, 12-month Follow up and 18-month Follow-up
Project on Human Development in Chicago Neighborhoods: Community Survey assesses city-level variables relating to neighborhood structure. Three items on a scale of 1 to 6, were used to measure how participants perceive their neighborhood. The range of the scores were from 3 to 12. The mean score was analyzed where the higher the score is a better overall perception of their neighborhood.
Social Contacts and Resources Scale
时间窗: Baseline, 12- month Follow up 1, and 18-month Follow up 2
Social Contacts and Resources Scale, a 5-item measure of social activities with their neighbors. Responses ranged from 1 (never) to 4 (often). a total mean score were derived where higher scores indicating greater social contact. The scores range from 5 to 20.
次要结局
- Parent-Adolescent Communication(Baseline, 1-week and 6-month follow up)
- Parental Nurturance(Baseline, 1-week and 6-month follow up)
- Family Functioning(Baseline, 1-week and 6-month follow up)
- Coping(Baseline, 1-week and 6-month follow up)
- Perceived Depression(Baseline, 1-week and 6-month follow up)
- Social Support(Baseline, 1-week and 6-month follow up)
- The World Health Organization Quality of Life Brief Scale(Baseline, 1-week and 6-month follow up)
- Punitive Discipline Scale(Baseline, 1-week and 6-month follow up)
- Parental Monitoring Scale(Baseline, 1-week and 6-month follow up)
研究者
Jeffery Walker
Professor
University of Alabama at Birmingham