Wakaya: Rising Up for Choctaw Youth Health

瓦卡亚：为乔克托青少年健康而奋起

• 批准号: 10630155
• 负责人: Michelle D Johnson-Jennings
• 金额: $ 64.84万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10630155
• 关键词: Acceleration; Address; Adolescence; Adolescent; Adult; Age; Alcohols; American Indians; Area; Behavioral; Body mass index; Cardiovascular Diseases; Cessation of life; Choctaw; Choctaw Nation of Oklahoma; Chronic; Chronic Disease; Communities; Consumption; Country; County; Coupled; Data; Deterioration; Development; Diabetes Mellitus; Diet; Dietary Intervention; Diffusion; Disparity; Environment; Environmental Health; Epidemic; Event; Focus Groups; Food; Food Habits; Green space; Harvest; Health; Immersion; Individual; Intervention; Intervention Studies; Interview; Leadership; Life Style; Maps; Mediating; Modeling; Modernization; Morbidity - disease rate; Motivation; National Institute on Minority Health and Health Disparities; Native Americans; Nature; Non-Insulin-Dependent Diabetes Mellitus; Nutritional; Obesity; Oklahoma; Participant; Pathway interactions; Pattern; Physical activity; Population; Poverty; Premature Mortality; Prevalence; Qualitative Methods; Randomized; Research; Risk; Risk Factors; Role; Substance abuse problem; Testing; Time; Tobacco; Trauma; Tribes; Unhealthy Diet; United States Department of Agriculture; Waiting Lists; Walking; Weight; Woman; Work; Youth; active lifestyle; alcohol tobacco and other drug use; behavior change; behavioral health; built environment; community organizations; control trial; design; epidemiologic data; experience; food desert; health disparity; illicit drug use; improved; indexing; innovation; intervention effect; leadership development; motivational enhancement therapy; native youth; nutrition; obesity prevention; physical inactivity; poor health outcome; premature; preservation; primary outcome; programs; prospective; response; secondary outcome; sedentary lifestyle; skills; sociodemographics; stem; success; trial design; tribal community; tribal leader; visual map

Empirical data indicate American Indian youth are vulnerable to ill health due to adverse socio-demographic indices and little physical activity, sedentary behaviors and inadequate nutrition. These factors, which form a toxic triangle of risk, are compounded by behavioral risks factors such as alcohol, tobacco, and other drug use (ATOD). If current patterns persist, by 2050 one out of three youth from the Choctaw Nation of Oklahoma, the third largest AI tribe, will be living with Type 2 diabetes and 70% of the Nation will be obese. Wakaya: Rising Up for Choctaw Youth Health, is an experiential, outdoor, nature-based program grounded in Choctaw values. It is a multi-level intervention that integrates components of motivational interviewing, the information- motivation-behavioral skills model, the Positive Youth Leadership Development framework, and the NIMHD Multilevel Socio-Ecological Research Framework. With a prospective two-group randomized waitlist-control trial design among 176 at-risk Choctaw youth (ages 14-18 years), we will assess the culturally grounded intervention's impact on the primary outcomes of physical activity, sedentary behavior, and healthful food habits; as well as the secondary outcomes of weight/BMI; and ATOD. Additionally, guided by the NIMHD Multilevel Socioecological Framework, we will examine the potential mechanisms of change by analyzing how pathway variables (e.g., nature connectedness) mediate intervention effects. Finally, through Topic Modeling of qualitative interview data and Ripple Effect Mapping via youth participant and tribal leader focus groups (n=64), we will explore the community-level impact of Wakaya and create a visual map representing the interconnected ripple effects of the intervention into the community. The program, supported by promising preliminary data on this approach among adults and acceptability data from youth, involves a 3-month outdoor intervention (with 4 individual sessions, weekly group sessions, 2 overnight culture immersion camps (7 days total), and a 4-day Choctaw Trail of Tears walk. Additionally, the intervention builds youth health leadership and community organizing skills. The research team comprises experts in American Indian health from academe as well as Choctaw Nation and collaborative efforts among two tribal Departments- Historic Preservation and Behavioral Health. Findings will be disseminated scientifically as well as shared with the tribe for programmatic implementation. If efficacious, this intervention will provide evidence for interventions that promote physical activity and nutrition programs that target green spaces, community gardens, natural/nature trails, and built environments. The proposed study provides significant and practical information in several areas, including the feasibility of delivering interventions in nature-based settings across multilevel stakeholders. Should it be efficacious, the program has potential for widespread adaptation and dissemination to other tribal communities and could be generalizable to other chronic co-occurring physical activity and food habit-related conditions.

经验数据表明，由于不利的社会人口特征，美国印第安青年很容易受到健康不良的影响 指数和体力活动少、久坐行为和营养不足。这些因素，构成了 有毒三角风险，由酒精、烟草和其他药物使用等行为风险因素复合而成 （ATOD）。如果目前的模式持续下去，到 2050 年，俄克拉荷马州乔克托族的三分之一的年轻人 第三大人工智能部落将患有 2 型糖尿病，并且 70% 的国家将患有肥胖症。若谷：崛起 Up for Choctaw Youth Health 是一项以乔克托价值观为基础的体验式户外自然计划。 它是一种多层次的干预措施，整合了动机性访谈、信息- 动机-行为技能模型、积极青年领导力发展框架和 NIMHD 多层次社会生态研究框架。前瞻性两组随机等候名单对照 在 176 名高危乔克托青年（14-18 岁）中进行试验设计，我们将评估具有文化基础的 干预对体力活动、久坐行为和健康食品主要结果的影响 习惯；以及体重/BMI 等次要结果；和 ATOD。此外，在 NIMHD 的指导下 多层次的社会生态框架，我们将通过分析如何改变潜在的机制 路径变量（例如自然连通性）介导干预效果。最后，通过主题建模 通过青年参与者和部落领袖焦点小组（n=64）进行定性访谈数据和涟漪效应图绘制， 我们将探索 Wakaya 的社区层面的影响，并创建一个代表相互关联的视觉地图 干预对社区的连锁反应。该计划得到了有希望的初步数据的支持 这种方法在成年人中以及青少年的可接受性数据中涉及为期 3 个月的户外干预（其中 4 个人课程、每周小组课程、2 个隔夜文化沉浸营（共 7 天）和 4 天 乔克托泪痕步道。此外，该干预措施还建立了青年健康领导力和社区 组织能力。研究团队由学术界和美洲印第安人健康领域的专家组成 乔克托民族和两个部落部门之间的合作努力 - 历史保护和行为 健康。研究结果将以科学方式传播，并与部落共享以进行规划 执行。如果有效，这种干预措施将为促进身体健康的干预措施提供证据。 针对绿色空间、社区花园、自然/自然步道和建筑的活动和营养计划 环境。拟议的研究提供了多个领域的重要且实用的信息，包括 在基于自然的环境中跨多层次利益相关者提供干预措施的可行性。应该是 该计划有效，有可能广泛适应并传播到其他部落社区 并且可以推广到其他慢性同时发生的体力活动和饮食习惯相关的疾病。