Yappalli Choctaw Road To Health

描述（由申请人提供）：肥胖和药物滥用日益普遍、昂贵和致命——在美国助长了一种双重流行病。同时解决肥胖、酒精和其他药物（AOD）使用问题的重要性在一定程度上得到了NIDA最近的研究的支持，该研究将导致药物成瘾和强迫饮食行为的大脑机制联系起来。尽管AOD的戒除和滥用模式因地区和部落而有很大差异，但美国印第安人（AI）与药物相关的死亡率是美国所有其他种族的1.5倍。特别是非洲裔妇女在肥胖和急性阻塞性肺病患病率方面与其他妇女存在显著差异，因此过早死亡率和发病率较高。基于初步研究，我们开发了Yappalli Choctaw健康之路，这是一个以文化为中心、以优势为基础的户外体验性肥胖- aod风险预防和健康领导项目。为期3个月的干预（即3次个人会议；8次小组会议+ 2天的文化训练营+ 10天的Choctaw泪路行走）以PI的最原始压力应对模型和信息-动机-行为技能框架为基础，活动符合动机访谈和领导力发展原则。这份RO1申请是根据PAR-11-346（美洲土著人口健康促进和疾病预防干预措施）编制的，建议在俄克拉何马州乔克托族（CNO）的5个地区的150名有风险的成年乔克托妇女中评估该计划，这些地区的土著妇女是该国肥胖、缺乏运动和过度饮酒患病率最高的地区。我们将进行一项纵向研究，采用聚类随机楔形设计来评估干预对AOD和肥胖预防的影响，主要目的是：(1)减少物质使用危害（SUHR）和AOD的使用和使用意图；(2)减轻体重/体重指数，增加闲暇时间的体育活动和健康的饮食习惯。该项目是华盛顿大学和明尼苏达大学经验丰富的人工智能研究人员以及乔克托行为健康领导者和提供者之间的多学科、基于社区的参与性研究合作。拟议项目的一个独特之处是由乔克托族在大学和部落两级进行指导。这个项目

DESCRIPTION (provided by applicant): Obesity and substance abuse are increasingly prevalent, costly, and deadly--fueling a twin epidemic in the United States. The importance of addressing obesity and alcohol and other drug (AOD) use simultaneously is supported in part by recent research at NIDA linking the brain mechanisms that fuel drug addiction and compulsive eating behaviors. Although AOD abstention and abuse patterns vary considerably by region and tribe, American Indian (AI) drug-related deaths are 1.5 times higher than for all other ethnic groups in the US. AI women in particular exhibit significant disparities with other women in obesity and AOD prevalence and higher rates of premature mortality and morbidity as a result. Based on preliminary research, we have developed the Yappalli Choctaw Road to Health, a culturally focused, strengths-based outdoor experiential obesity-AOD risk prevention and health leadership program. The 3-month intervention (i.e., 3 individual meetings; 8 group-sessions + 2-day culture boot camp + 10-day Choctaw Trail of Tears walk) is grounded in the PI's Indiginest Stress-Coping Model and the Information-Motivational- Behavioral Skills framework, with activities consistent with Motivational Interviewing and leadership development principles. This RO1 application, prepared in response to PAR-11-346 (Interventions for Health Promotion and Disease Prevention in Native American Populations), proposes to evaluate the program among 150 at-risk adult Choctaw women across 5 regions of the Choctaw Nation of Oklahoma (CNO), where Native women have some of the highest obesity, physical inactivity, and excessive drinking prevalence in the country. We will conduct a longitudinal study using a cluster randomized stepped-wedge design to evaluate the intervention impact on the AOD and obesity prevention primary aims of: (1) substance use harm reduction (SUHR) and AOD use and intentions to use; and (2) reduction in weight/BMI and increase in leisure-time physical activity and healthful food habits. The project is multidisciplinary community-based participatory research collaboration among experienced AI researchers at the Universities of Washington and Minnesota and Choctaw behavioral health leaders and providers. A unique feature of the proposed project is its direction at both the university and tribal levels by Choctaws. The project is supported by pilot and tribal acceptability data; addresses a critical public health issue among a group experiencing considerable health disparities; and strengthens the research infrastructure in partnership with the Tribe. If efficacious, it has the potential for widespread dissemination and could be generalizable to other chronic co-occurring mental health and physical health conditions (e.g., diabetes and depression).