PATHWAYS--FULL SCALE STUDY

描述 路径项目是一项全面的、以学校为基础的干预措施 帮助减少美洲原住民儿童的肥胖症。3、4和5级 来自6个美洲印第安州的40所学校参与其中：皮马/马里科帕， 托霍诺·奥奥德姆、纳瓦霍人、白山阿帕奇人、奥格拉拉·拉科塔人和四川人 拉科塔。干预是通过六个国家的代表实施的 联合国和四所合作大学：约翰·霍普金斯大学， 新墨西哥大学、亚利桑那大学和 北卡罗来纳大学是明尼苏达州的第五所大学， 作为协调中心。路径的设计是一种随机的、 包括以下成分的对照试验：体力活动、食物 服务、课堂课程和家庭参与。NHLBI资助了一项 三年的可行性研究，其结果汇总在提案中， 现在，PI正在申请资金，以开始全面的研究， 在五年的时间内进行。 意义 这项研究的目的是制定一个全面的计划，即 以学校为本，倡导健康饮食行为，增加体育锻炼 美国儿童的活动。其具体目标是减少 美国印第安人儿童中肥胖的流行情况。主要成果 变量是干预三年后的体脂百分比。这个 调查人员已经证明，美国印第安人的患病率更高 肥胖症。此外，在检查NHANES II和HANES-MA时 国家参考集，美国印第安人儿童的比例明显高于 几乎每个年龄段和性别群体的BMI。通过将超重定义为 超过参考人口的第85个百分位数，美国印第安人 与NHANES-2人口相比，儿童死亡率为39%，与NHANES-2人口相比，为28.6% 与汉族人-马族的关系。调查人员选择了 干预学校里的孩子。他们选择了3年级、4年级和5年级 发育年龄似乎对学习健康知识和 技能。他们指的是其他研究，这些研究已经尝试了较老的程序 儿童和青少年的成功率非常低。

DESCRIPTION The Pathways Project is a comprehensive, school-based intervention designed to help reduce obesity in Native American children. Grades 3, 4, and 5 in forty schools from six American Indian nations are involved: Pima/Maricopa, Tohono O'odham, Navajo, White Mountain Apache, Oglala Lakota, and Sicangu Lakota. The intervention is implemented through representatives of the six nations and four cooperating universities: The Johns Hopkins University, the University of New Mexico, the University of Arizona, and the University of Minnesota with a fifth institution, the University of North Carolina, serving as the Coordinating Center. The design of Pathways is a randomized, controlled trial with the following components: physical activity, food service, classroom curriculum, and family involvement. The NHLBI funded a three-year feasibility study, whose results are summarized in the proposal, and now the PI's are requesting funding to begin the full-scale study, to be carried out over a five-year period. SIGNIFICANCE The purpose of this study is to develop a comprehensive program that is school-based to promote healthy eating behaviors and increased physical activity in American children. The specific aim is to decrease the prevalence of obesity in American Indian children. The major outcome variable is percent body fat after three years of intervention. The investigators have documented that American Indians have a higher prevalence of obesity. In addition, when examining the NHANES II and HHANES-MA national reference sets, American Indian children have significantly higher BMIs for nearly every age and sex group. By defining overweight as exceeding the 85th percentile of the reference population, American Indian children have 39% compared with the NHANES-2 population and 28.6% compared with the HHANES-MA population. The investigators selected the strategy of intervening in school children. They have selected grades 3, 4 and 5 since developmental age appears to be critical for learning health knowledge and skills. They refer to other studies which have tried programs in older children and adolescents with a very low rate of success.