"Cause it's family talking to you": Children acting as change agents for adult food and physical activity behaviors in American Indian households in the Upper Midwestern United States
"Cause it's family talking to you": Children acting as change agents for adult food and physical activity behaviors in American Indian households in the Upper Midwestern United States
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DOI：
10.1177/0907568214538290
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发表时间：
2015-08-01
影响因子：
1.9
通讯作者：
Gittelsohn, Joel
中科院分区：
文献类型：
--
作者：
Gadhoke, Preety;Christiansen, Karina;Gittelsohn, Joel
本文介绍了OPREVENT形成阶段的研究结果，OPREVENT是一项针对美国中西部两个保留地的美国印第安人家庭的试点肥胖预防干预试验。我们描述了美国印第安人儿童作为变革者在奥吉布瓦和波塔瓦托米保留地影响成人食物和身体活动行为的过程。这项研究借鉴了Bronfenbrenner和Ceci的社会生态模型，并将Daniel的弹性理论扩展到针对弱势儿童的实践中。通过有目的的抽样，我们访问了168名社区成员，其中包括25名6至13岁的儿童，采用成人深度访谈和配对儿童访谈、家庭小组访谈、焦点小组访谈和社区研讨会。结果显示，6名10-13岁的美国印第安人儿童扮演着变革推动者的角色。我们提出了一个社会生态学的概念框架来指导我们理解和应用儿童作为成人健康行为的变革者的方法，其中包括文化认同(宏观系统)、机构和社区支持(中间系统)、通过安全基础的家庭支持(微观系统)以及儿童的归属感、自尊、自我效能、知识和行为作为变革者(个人内部因素)。复原力和脆弱性是贯穿儿童整个发展阶段的多个系统的动态过程，以支持他们的能力。最后，我们对OPREVENT试点项目进行了考虑，并讨论了将儿童发展为成人健康行为改变的变革剂理论框架的未来方向。
This article presents research findings from the formative phase of OPREVENT, a pilot obesity prevention intervention trial for American Indian households on two reservations in the Upper Midwestern United States. We describe processes by which American Indian children acting as change agents influence adult food and physical activity behaviors on an Ojibwa and a Potawatomi reservation. This study borrows from Bronfenbrenner and Ceci's socio-ecological model and extends Daniel's resiliency theory for practice with vulnerable children. Using purposive sampling, we interviewed 168 community members, including 25 children between 6 and 13 years of age, using adult in-depth and paired-child interviews, household group interviews, focus groups, and community workshops. Results reveal that six American Indian children, 10-13 years old, were acting as change agents. We propose a socio-ecological conceptual framework to guide our understanding and application of a children as change agent approach for adult health behaviors which includes cultural identity (macro-system), institutional and community support (mezzo-system), family support through a secure base (micro-system), and children's sense of belonging, self-esteem, self-efficacy, knowledge, and actions as change agents (intrapersonal factors). Resiliency and vulnerability are dynamic processes that intersect the multiple systems throughout children's developmental stages to bolster their agency. We conclude with considerations for the OPREVENT pilot project and discuss future directions for developing a child as change agent theoretical framework for adult health behavior change.