Yappalli Choctaw Road To Health

亚帕利·乔克托健康之路

• 批准号: 9275955
• 负责人: KARINA L. WALTERS
• 金额: $ 62.95万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9275955
• 关键词: Addictive Behavior; Address; Adherence; Adult; Alcohol abuse; Alcohol or Other Drugs use; American Indians; Area; Behavior; Behavioral; Binge Eating; Brain; Cessation of life; Child; Child Care; Choctaw Nation of Oklahoma; Chronic; Collaborations; Communities; Community Developments; Community Health; Consumption; Country; Coupled; Data; Development; Diabetes Mellitus; Drug Addiction; Drug abuse; Drug usage; Eating Behavior; Economics; Elements; Enrollment; Epidemic; Ethnic group; Evidence based program; Exercise; Exhibits; Family; Food Habits; Future Generations; Harm Reduction; Health; Health Promotion; Health Services; Heavy Drinking; Individual; Intervention; Leadership; Leisures; Link; Longitudinal Studies; Mental Depression; Mental Health; Methods; Minnesota; Modeling; Morbidity - disease rate; Motivation; National Institute of Drug Abuse; Native Americans; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Oklahoma; Overweight; Parents; Pattern; Pharmaceutical Preparations; Physical Capacity; Physical activity; Population; Population Programs; Premature Mortality; Prevalence; Prevention; Primary Prevention; Provider; Public Health; Randomized; Research; Research Infrastructure; Research Personnel; Research Priority; Resources; Risk; Risk Reduction; Site; Stress and Coping; Substance abuse problem; Sustainable Development; Taxes; Time; Tribes; Twin Multiple Birth; United States; Universities; Walking; Washington; Weight; Woman; adverse outcome; alcohol and other drug; authority; base; behavioral health; community based participatory research; cost; cost effective; design; disorder prevention; efficacy testing; experience; fast food; health disparity; interest; leadership development; meetings; member; model development; motivational enhancement therapy; multidisciplinary; obesity prevention; obesity risk; physical conditioning; physical inactivity; programs; public health relevance; response; skill acquisition; skills; stem; success; tribal community; walking intervention

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).

描述(申请人提供)：肥胖和药物滥用越来越普遍，代价越来越高，而且越来越致命--在美国助长了一种双重流行病。同时解决肥胖、酒精和其他药物使用(AOD)的重要性在一定程度上得到了NIDA最近的研究的支持，该研究将助长药物成瘾和强迫进食行为的大脑机制联系起来。尽管戒毒和滥用AOD的模式因地区和部落的不同而有很大差异，但美国印第安人(AI)与毒品有关的死亡人数是美国所有其他种族的1.5倍。特别是人工智能妇女在肥胖和AOD患病率方面与其他妇女存在显着差异，结果是过早死亡率和发病率更高。在前期研究的基础上，我们开发了Yappalli Choctaw健康之路，这是一个注重文化、基于优势的户外体验式肥胖-AOD风险预防和健康领导计划。为期3个月的干预(即3次个人会议；8次小组会议+2天文化新兵训练营+10天乔克托泪道步行)以PI的最大压力应对模式和信息-动机-行为技能框架为基础，其活动符合激励性面谈和领导力发展原则。这份RO1申请是为响应PAR-11-346(美国原住民人口健康促进和疾病预防干预措施)而准备的，旨在对俄克拉荷马州乔克托民族(CNO)5个地区的150名高危成年乔克托妇女进行评估，这些地区的土著妇女肥胖、缺乏运动和过度饮酒的流行率是全国最高的。我们将采用整群随机阶梯设计进行纵向研究，以评估干预对AOD和肥胖预防的影响，主要目标是：(1)减少物质使用伤害(Suhr)和AOD使用和使用意图；(2)减少体重/BMI，增加休闲体育活动和健康饮食习惯。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与乔克托行为健康领导者和提供者之间的多学科社区参与式研究合作。拟议项目的一个独特特点是乔克陶斯在大学和部落两级的指导。该项目 得到了飞行员和部落可接受性数据的支持；解决了以下关键公共卫生问题 这是一个健康差距很大的群体；并与部落合作加强研究基础设施。如果有效，它有可能广泛传播，并可推广到其他慢性共生心理健康和身体健康疾病(例如糖尿病和抑郁症)。