Preventing CVD in Native Populations: Traditional Living

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DESCRIPTION (provided by applicant): American Indians and Alaska Natives AlANs suffer the highest rates of health disparities, such as CVD, where lifestyle is a key risk factor. Behavior change interventions that have been attempted to date with AlANs have frequently incorporated native cultural components as a means of making the intervention culturally relevant. They have usually NOT started with native culture and indigenous wisdom as the community strength and foundation upon which to stimulate the motivation for and design of an intervention. The project proposed here develops from a CBPR-based masters' thesis that identified a 10-day immersion experience in traditional culture and life-ways - the Traditional Living Challenge (TLC) - followed by a 3- month follow-up period for continuing the changes begun during the immersion, as a mechanism for community revitalization around wellness. This project will be a collaboration between the University of Arizona and Salish Kootenai College (SKC) to design and pilot a community-based CVD risk reduction intervention using the TLC as the basis for motivation and commitment to wellness. This application proposes a 2-year planning process that will accomplish the following goals: build capacity for NIH-funded research at SKC; develop collaborations among the tribal health department, cultural leaders, tribal council, and other relevant tribal units; identify the most appropriate age-gender and risk factor target population segment; choose and evaluate relevant outcome measures and potential effect size; evaluate the feasibility of the project through a full pilot process including all aspects of intervention and data collection; and design a full-scale study for submission as an R01. The planning process and subsequent study will be guided by Internal and External Advisory Groups, with the External Advisory Group assuring scientific integrity (via the scientific consultants) and relevance for dissemination to other tribal communities (via the tribal members). This is the first step in a program of research that would lead first to full-scale implementation within the Confederated Salish and Kootenai Tribes and subsequently to a multi-community dissemination trial, potentially among AIAN communities represented on the External Advisory Board.