Native Healthy Lifestyle: A Return to Balance

就在几十年前，心血管疾病(CVD)在美洲印第安人中还很少见，但今天它已经成为 这是导致这一人群死亡的主要原因，超过了普通人群的死亡率。减少 心血管风险，我们提出了一个整体的行为和生活方式干预计划，这是社区- 反应灵敏，文化相宜。这项干预计划将主要集中在行为 改变饮食和体力活动，这将导致心血管疾病危险因素的改善和 从而减少心血管疾病的发生。具体目标是： 1.为美国人设计和实施适合文化的行为干预计划 印度成年人(30-59岁)，他们患心血管疾病的风险很高，养成健康的饮食习惯和 体力活动。 2.使用双臂评估拟议的行为干预计划的有效性 可控设计。200名符合条件的美国印第安人男女将被随机分配 分为两组：(1)“干预”组，接受建议的干预计划；和(2) “对照组”，只接受常规的心血管健康信息和建议。两套 结果将被用来比较两组。主要成果衡量标准将是 行为改变的结果，包括卡路里摄入量、钠摄入量和水果和蔬菜 饮食消耗和体力活动计步器测量。次要结果衡量标准 包括体重(或BMI)、总甘油三酯、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇 糖化血红蛋白、空腹血糖、血压和尿白蛋白/肌酐比值。 3.如果成功，将干预计划传播到其他美洲印第安人部落和社区 以供实施。 我们假设干预组的参与者将改善他们的卡路里和钠的摄入量 与对照组相比，增加水果和蔬菜的摄入量和体力活动。这个 拟议的干预措施强调实现精神、心理、情感和身体上的平衡，这些是 传统的美国印第安人的健康和活力的元素。拟议的干预计划是 在印度社区的大量投入下开发，并可纳入部落健康计划。 我们相信成功的机会很高，而且在社会上是高度可持续的 终止本研究性研究。

Only decades ago cardiovascular disease (CVD) was rare in American Indians, but today it has become the leading cause of death for this population, exceeding rates in the general population. To reduce cardiovascular risk, we propose a holistic behavioral and lifestyle intervention program that is community- responsive and culturally appropriate. This intervention program will primarily focus on behavioral modification in diet and physical activity, which will lead to improvement of CVD risk factors and consequently reduction of CVD. The specific aims are: 1. To design and implement a culturally appropriate behavioral intervention program for American Indian adults (aged 30-59 years), who have high risk of developing CVD, to form healthy habits in diet and physical activity. 2. To evaluate the effectiveness of the proposed behavioral intervention program using a two-arm randimized controlled design. Two hundred eligible American Indian men and women will be randomized into two groups: (1) "intervention" groups, which receives the proposed intervention program, and (2) "control" group, which receives conventional cardiovascular health information and advice only. Two sets of outcome measures will be used to compare the two groups. The primary outcome measures will be behavioral modification outcomes, including caloric intake, sodium intake and fruit and vegetable consumption for diet and pedometer measurements for physical activity. The secondary outcome measures are CVD risk factor measures, including weight (or BMI), total triglyceride, HDL-cholesterol, LDL-cholesterol, HbA1c, fasting glucose, blood pressure and urinary albumin/creatinine ratio. 3. If successful, disseminate the intervention program to other American Indian tribes and communities for implementation. We hypothesize that participants in the intervention group will improve their caloric and sodium intake and increase fruit and vegetable consumption and physical activity when compared to the control group. The proposed intervention emphasizes achieving spiritual, mental, emotional and physical balance, which are elements of traditional American Indian wellness and vitality. The proposed intervention program is developed with much input from the Indian community and can be incorporated into tribal health programs. We believe it has a high probability of success and is highly sustainable in the community after the termination of this research study.