CHEER Program for Community Health

(CHEER Trial)

Overseen By Jeff T Walker, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Alabama at Birmingham

Disqualifiers: Not residing in specified neighborhoods, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

779 Participants Needed

Trial Summary

What is the purpose of this trial?

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.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the CHEER treatment for Community Health?

The research on community health improvement plans and hospital health promotion programs suggests that engaging communities and implementing strategic health initiatives can lead to positive health outcomes. For example, the Allies Against Asthma program showed that community engagement can improve health outcomes, indicating that similar community-focused approaches like CHEER may be effective. ^{1 2 3 4 5}

How is the CHEER treatment different from other treatments for community health?

The CHEER treatment is unique because it focuses on community engagement and environmental renewal, involving community members in defining and improving their own health through a broad, inclusive approach that integrates various aspects of community life, such as housing, education, and transportation, rather than just focusing on individual health issues. ^{6 7 8 9 10}

Research Team

Jeff T Walker, PhD

Principal Investigator

University of Alabama at Birmingham

Eligibility Criteria

The CHEER trial is for residents of specific neighborhoods (North Titusville, South Titusville, Druid Hills, Fountain Heights) and parents with a child aged 11-16 in certain areas (including Rising-West Princeton, Belview Heights). It's aimed at those experiencing the stress of poverty and seeking community support.

Inclusion Criteria

I live in the specified area and have a child aged 11-16.

For ESPI, residents who live in the ESPI intervention neighborhoods (North Titusville, South Titusville, Druid Hills, and Fountain Heights)

Exclusion Criteria

For ESPI, not residing in one of the above neighborhoods and did not consent to participate.

For FYI, does not meet the above requirements and did not consent to participate.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Family Youth Intervention (FYI)

Participants engage in a family strengthening intervention with community health advisors to improve maternal, youth, and family functioning.

12 weeks

Weekly sessions

Environment: Social and Physical Intervention (ESPI)

Community members engage in neighborhood projects to improve social interaction, cohesion, and collective efficacy.

12 weeks

Community-led projects

Follow-up

Participants are monitored for changes in psychosocial behaviors, social cohesion, and other outcomes.

18 months

6- and 18-month follow-up assessments

Treatment Details

Interventions

• Community Health through Engagement and Environmental Renewal (CHEER)

Trial Overview CHEER aims to improve family relations and reduce neighborhood blight. It tests two interventions: Family Youth Intervention (FYI) for parenting practices and youth behavior; Environment: Social & Physical Intervention (ESPI) to boost social cohesion.

Participant Groups

Group I: Wait-List Control Experimental Treatment 1 Intervention

The two communities will get ESPI, upon completion of the study.

Group II: Family Youth Intervention (FYI) Active Control 1 Intervention

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.

Group III: FYI and ESPI Active Control 1 Intervention

Two of the eight neighborhoods will receive both FYI and ESPI intervention.

Group IV: ESPI Environment: Social and Physical Intervention (ESPI) Active Control 1 Intervention

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.

Who Is Running the Clinical Trial?

University of Alabama at Birmingham

Lead Sponsor

Trials

1,677

Recruited

2,458,000+

Centers for Disease Control and Prevention

Collaborator

Trials

902

Recruited

25,020,000+

References

1. England pubmed.ncbi.nlm.nih.gov

Community health improvement plan: Study protocol for Kansas City's intervention and implementation evaluation. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Hospital health promotion: swimming or sinking in an upstream business? [2017]

3. United States pubmed.ncbi.nlm.nih.gov

Raising the bar. [2006]

4. United States pubmed.ncbi.nlm.nih.gov

Seeing Community Benefit broadly. Everybody wins when hospitals collaborate with others to serve their communities. [2005]

5. United States pubmed.ncbi.nlm.nih.gov

Policy and system change and community coalitions: outcomes from allies against asthma. [2019]

6. England pubmed.ncbi.nlm.nih.gov

Effectiveness of the Promising Neighbourhoods community program in 0-to 12-year-olds: A difference-in-difference analysis. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Development and Impact of a Worksite Wellness Champions Program. [2022]

8. Germany pubmed.ncbi.nlm.nih.gov

Communities defining environmental health: examples from the Colorado (U.S.A.) Healthy Communities Initiative. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Project Salsa: development and institutionalization of a nutritional health promotion project in a Latino community. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

People Improving the Community's Health: community health workers as agents of change. [2018]