Wakaya: Rising Up for Choctaw Youth Health

瓦卡亚：为乔克托青少年健康而奋起

• 批准号: 10405324
• 负责人: Michelle D Johnson-Jennings
• 金额: $ 68.28万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10405324
• 关键词: Address; Adolescence; Adolescent; Adult; Age; Alcohols; American Indians; Area; Behavioral; Body mass index; Cardiovascular Diseases; Cessation of life; Choctaw; Choctaw Nation of Oklahoma; Chronic; Chronic Disease; Communities; Consumption; Country; County; Coupled; Data; Deterioration; Development; Diabetes Mellitus; Diet; Dietary Intervention; Diffusion; Environment; Environmental Health; Epidemic; Event; Focus Groups; Food; Food Habits; Gardenal; Green space; Harvest; Health; Immersion; Individual; Intervention; Intervention Studies; Interview; Leadership; Life Style; Mediating; Modeling; Modernization; Morbidity - disease rate; Motivation; National Institute on Minority Health and Health Disparities; Native Americans; Nature; Non-Insulin-Dependent Diabetes Mellitus; Nutritional; Obesity; Oklahoma; Outcome; Participant; Pathway Analysis; Pattern; Physical activity; Population; Poverty; Premature Mortality; Prevalence; Qualitative Methods; Randomized; Research; Risk; Risk Factors; Role; Substance abuse problem; Testing; Time; Tobacco; Trauma; Tribes; Unhealthy Diet; United States Department of Agriculture; Ursidae Family; Waiting Lists; Walking; Weight; Woman; Work; Youth; active lifestyle; alcohol tobacco and other drug use; base; behavior change; behavioral health; built environment; control trial; design; efficacious intervention; epidemiologic data; experience; food desert; health disparity; illicit drug use; improved; indexing; innovation; intervention effect; leadership development; motivational enhancement therapy; native youth; nutrition; obesity prevention; physical inactivity; premature; preservation; primary outcome; programs; prospective; response; secondary outcome; sedentary lifestyle; skills; sociodemographics; stem; success; trial design; tribal community; tribal leader; visual map

Empirical data indicate American Indian youth are vulnerable to ill health due to adverse socio-demographic indices and little physical activity, sedentary behaviors and inadequate nutrition. These factors, which form a toxic triangle of risk, are compounded by behavioral risks factors such as alcohol, tobacco, and other drug use (ATOD). If current patterns persist, by 2050 one out of three youth from the Choctaw Nation of Oklahoma, the third largest AI tribe, will be living with Type 2 diabetes and 70% of the Nation will be obese. Wakaya: Rising Up for Choctaw Youth Health, is an experiential, outdoor, nature-based program grounded in Choctaw values. It is a multi-level intervention that integrates components of motivational interviewing, the information- motivation-behavioral skills model, the Positive Youth Leadership Development framework, and the NIMHD Multilevel Socio-Ecological Research Framework. With a prospective two-group randomized waitlist-control trial design among 176 at-risk Choctaw youth (ages 14-18 years), we will assess the culturally grounded intervention's impact on the primary outcomes of physical activity, sedentary behavior, and healthful food habits; as well as the secondary outcomes of weight/BMI; and ATOD. Additionally, guided by the NIMHD Multilevel Socioecological Framework, we will examine the potential mechanisms of change by analyzing how pathway variables (e.g., nature connectedness) mediate intervention effects. Finally, through Topic Modeling of qualitative interview data and Ripple Effect Mapping via youth participant and tribal leader focus groups (n=64), we will explore the community-level impact of Wakaya and create a visual map representing the interconnected ripple effects of the intervention into the community. The program, supported by promising preliminary data on this approach among adults and acceptability data from youth, involves a 3-month outdoor intervention (with 4 individual sessions, weekly group sessions, 2 overnight culture immersion camps (7 days total), and a 4-day Choctaw Trail of Tears walk. Additionally, the intervention builds youth health leadership and community organizing skills. The research team comprises experts in American Indian health from academe as well as Choctaw Nation and collaborative efforts among two tribal Departments- Historic Preservation and Behavioral Health. Findings will be disseminated scientifically as well as shared with the tribe for programmatic implementation. If efficacious, this intervention will provide evidence for interventions that promote physical activity and nutrition programs that target green spaces, community gardens, natural/nature trails, and built environments. The proposed study provides significant and practical information in several areas, including the feasibility of delivering interventions in nature-based settings across multilevel stakeholders. Should it be efficacious, the program has potential for widespread adaptation and dissemination to other tribal communities and could be generalizable to other chronic co-occurring physical activity and food habit-related conditions.

经验数据表明，由于不利的社会人口结构，美国印第安人青年容易受到健康问题的影响 指标和体力活动少，久坐行为和营养不足。这些因素，形成了一个 有毒的风险三角，加上行为风险因素，如酒精、烟草和其他药物的使用 (ATOD)。如果目前的模式持续下去，到2050年，来自俄克拉何马州乔克托民族的三分之一的年轻人， 第三大人工智能部落，将患有2型糖尿病，全国70%的人将肥胖。Wakaya：崛起 Up for Choctaw Young Health是一个以乔克托价值观为基础的体验式、户外、基于自然的计划。 这是一种多层次的干预，整合了激励性访谈的组成部分，信息- 动机-行为技能模型、积极青年领导力发展框架和NIMHD 多层次社会生态研究框架。采用前瞻性两组随机等待名单对照 在176名高危乔克托青年(年龄14-18岁)中进行试验设计，我们将评估文化根深蒂固的 干预对体力活动、久坐行为和健康食物的主要结果的影响 习惯；以及体重/体重指数的次要结果；以及ATOD。此外，在NIMHD的指导下 多层次的社会生态框架，我们将通过分析 途径变量(例如，自然连通性)调节干预效果。最后，通过对主题的建模 通过青年参与者和部落首领焦点群体的定性访谈数据和涟漪效应图(n=)， 我们将探索Wakaya的社区级影响，并创建一张可视化地图，代表互联的 干预对社区的连锁反应。该计划得到了有希望的初步数据的支持 这一方法在成年人中的可接受性数据来自年轻人，包括为期3个月的户外干预(4 个人课程、每周小组课程、2个通宵文化沉浸营(共7天)和4天 乔克托泪水小径行走。此外，干预措施还建立了青年健康领导力和社区 组织能力。研究小组由来自学术界的美洲印第安人健康专家以及 乔克托民族与两个部落部门--历史保护和行为部门之间的合作努力 健康。调查结果将以科学的方式传播，并与部落分享方案 实施。如果有效，这种干预将为促进身体健康的干预提供证据。 活动和营养计划，目标是绿地、社区花园、自然/自然步道，并建立 环境。拟议的研究在几个领域提供了重要和实用的信息，包括 在以自然为基础的环境中向多层利益攸关方提供干预措施的可行性。应该是吗？ 该方案卓有成效，有可能被广泛改编并传播到其他部落社区 并可推广到其他慢性共生体力活动和饮食习惯相关的疾病。