Health Resilience Among American Indians in Arizona

项目总结(见说明)： 居住在保留地的美国印第安人中的肥胖和适应策略使用疾控中心社会生态模型(SEM)以及恢复力和快速评估、反应和评估(REARE)方法来调查居住在保留地的美国印第安人的生活方式变化和肥胖与医患沟通有关。将在社区和政策层面制定战略，并将为CAIR、当地健康政策联盟和社区利益攸关方的活动提供信息。伙伴关系 包括三家为美国印第安人提供服务的机构：一家CHC，一家印度城市卫生保健中心，以及一家附属于医院的儿童肥胖诊所。 目标包括：1)确定美国印第安人当前的知识、态度、信念和行为，这些知识、态度、信念和行为与通过改变生活方式增强健康和展现韧性有关；2)评估患者与提供者关于超重和肥胖的沟通；3)开发基于证据的、文化上适当的策略，以促进健康的生活方式；4)提出政策和程序建议。快速评估将用于在家庭和临床环境中进行关于肥胖诊断和寻求健康行为的定性和定量研究。参与者将包括医疗保健提供者，以及在过去两年中血压、糖化血红蛋白和/或体重指数有显著改善的个人和儿童(和照顾者)。RARE将包括对社区人种学家进行方法、分析和数据收集方面的培训和雇用。方法将包括访谈、调查、焦点小组和观察相结合。在研究和分析结束时，社区人种学家将制定一套以证据为基础的战略，与罕见的方法保持一致。在研究和分析结束时，社区人种学家将制定一套以证据为基础的战略，与罕见的方法保持一致。战略将为美国印第安人复原力中心(CAIR)社区咨询委员会、合作机构和致力于采用健康生活方式的美国印第安人提供政策和程序建议。

PROJECT SUMMARY (See Instructions): Obesity and Adaptive Strategies among American Indians Living off Reservation uses the CDCs Social Ecological Model (SEM) as well as resilience and Rapid Assessment, Response and Evaluation (RARE) approaches to investigate lifestyle changes and obesity related to physician-patient communication among American Indians living off reservation. Strategies will be designed at the community and policy levels and will inform the activities of CAIR, a local wellness policy coalition and community stakeholders. Partnerships include three agencies that serve American Indians: a CHC, an urban Indian health care center, and a hospital affiliated obesity clinic for children. Aims include: 1) Identify current knowledge, attitudes, beliefs, and behaviors among American Indians related to increased fitness and demonstrated resilience through lifestyle changes 2) Assess patient ~provider communication about overweight and obesity 3) Develop evidence-based, culturally appropriate strategies to promote healthy lifestyles and 4) Make policy and procedural recommendations. Rapid assessment will be used to conduct qualitative and quantitative research in homes and clinical settings regarding obesity diagnoses and health-seeking behaviors. Participants will include health care providers, and individuals and children (and caregivers) who have shown a marked improvement in blood pressure, A1C and/or BMI over the past two years. RARE will include the training and employment of Community Ethnographers on methods and analysis and data collection. Methods will include a combination of interviews, surveys, focus groups, and observations. At the conclusion of research and analysis Community Ethnographers will develop a set of evidence-based strategies in keeping with RARE methodology. At the conclusion of research and analysis Community Ethnographers will develop a set of evidence-based strategies in keeping with RARE methodology. Strategies will inform policy and procedural recommendations to the Center for American Indian Resilience (CAIR) Community Advisory Board, partner agencies, and American Indian people working to adopt healthy lifestyles.