Native Healthy Lifestyle: A Return to Balance

描述（由申请人提供）： 就在几十年前，心血管疾病（CVD）在美洲印第安人中还很罕见，但今天它已成为这一人群的主要死亡原因，超过了一般人群的死亡率。为了降低心血管风险，我们提出了一个整体的行为和生活方式干预计划，是社区响应和文化上适当的。该干预计划将主要集中在饮食和体力活动方面的行为改变，这将导致CVD风险因素的改善，从而减少CVD。具体目标是： 1.设计和实施一个文化上合适的行为干预计划，为美国印第安成年人（30-59岁），谁有发展心血管疾病的高风险，形成健康的饮食习惯和体育活动。 2.采用两组随机对照设计评价拟议的行为干预方案的有效性。200名符合条件的美国印第安人男性和女性将被随机分为两组：（1）“干预”组，接受拟议的干预计划，（2）“对照”组，仅接受传统的心血管健康信息和建议。将使用两组结局指标比较两组。主要结局指标将是行为改变结局，包括热量摄入、钠摄入、饮食中的水果和蔬菜摄入以及身体活动的计步器测量。次要结局指标为CVD风险因素指标，包括体重（或BMI）、总甘油三酯、HDL-胆固醇、LDL-胆固醇、HbA 1c、空腹血糖、血压和尿白蛋白/肌酐比值。 3.如果成功，将干预方案传播到其他美洲印第安部落和社区实施。 我们假设，与对照组相比，干预组的参与者将改善他们的热量和钠摄入量，增加水果和蔬菜的摄入量和体育活动。拟议的干预措施强调实现精神、心理、情感和身体的平衡，这是传统的美国印第安人健康和活力的要素。拟议的干预方案是在印第安社区的大量投入下制定的，可以纳入部落卫生方案。我们相信，在本研究结束后，它有很高的成功概率，并且在社区中具有高度的可持续性。

DESCRIPTION (provided by applicant): 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 randomized 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.