Health Promotion in a Yup'ik Community: Improving Health Through Collaboration

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DESCRIPTION (provided by applicant): The overall goal of this research is to develop and evaluate the effectiveness of a community-based health promotion project (Piciryaratggun Calritllerkaq, or Healthy Living through a Healthy Lifestyle) targeted at increasing behaviors related to cardiovascular health in a Yup'ik Eskimo village: physical activity, nutrition, and stress reduction. Piciryaratggun Calritllerkaq was based on a study of obesity, diabetes and cardiovascular disease conducted by the Center for Alaska Native Health Research (CANHR) at the University of Alaska Fairbanks (UAF) (NCRR 5P20RR016430) in 7 Yup'ik communities on the west coast of Alaska. The proposed project will build upon the research on health promotion in Alaska Native communities begun by one of the projects under the CANHR grant. Piciryaratggun Calritllerkaq has been developed in collaboration with the host community and the regional Tribal Health Corporation. The long-term goal is to develop this project into a model for conducting health promotion in the region. The specific aims for the project are to: (1) Assess the improvement on the intermediate (i.e., nutrition, physical activity, stress, coping, social support, wellness) and outcome variables (weight, blood pressure, blood lipid profile) at three 6-month intervals over the course of the intervention; (2) Examine the relationships between the intermediate variables, outcome variables, and covariates; and (3) Conduct a formative evaluation of Piciryaratggun Calritllerkaq to identify the strengths and weaknesses of the model. The targeted sample will be 60% of the adult population of the participating village, approximately 120 people. The study will utilize a longitudinal design that will include 6 measurements taken either in the spring or the fall. We hypothesize that this culturally-based community-development approach to health promotion will increase physical activity, increase consumption of subsistence foods and/or healthy substitutes, and decrease stress levels. Changes in these behaviors and participants' sense of wellbeing are expected to be related to an increase in protective blood lipid factors, healthy weight, and healthy blood pressure. The project will examine the specific ways in which this approach to cardiovascular health can develop a local infrastructure, knowledge base, and process to encourage and maintain lasting life style improvements. Although community-based prevention and health promotion projects have been successful in other communities (mostly urban), there has been no attempt to take this approach in Alaska's Yup'ik communities. This project provides an opportunity to integrate scientific knowledge with indigenous knowledge and traditions to improve the cardiovascular health of Alaska Native people.