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

描述（由申请人提供）：本研究的总体目标是开发和评估以社区为基础的健康促进项目（Piciryaratggun Calritllerkaq，或通过健康的生活方式健康生活）的有效性，该项目旨在增加Yup'ik爱斯基摩村庄与心血管健康相关的行为：体育活动，营养和减轻压力。Piciryaratggun Calritllerkaq是基于阿拉斯加费尔班克斯大学（UAF）阿拉斯加土著健康研究中心（CANHR）在阿拉斯加西海岸7个Yup'ik社区进行的一项关于肥胖、糖尿病和心血管疾病的研究。拟议的项目将以CANHR赠款下的一个项目开始的阿拉斯加土著社区健康促进研究为基础。Piciryaratggun Calritllerkaq是与东道社区和地区部落保健公司合作开发的。长期目标是将该项目发展成为在该区域进行健康促进的一个模式。该项目的具体目标是：(1)在干预过程中，以三个6个月的间隔评估中间指标（即营养、身体活动、压力、应对、社会支持、健康）和结果变量（体重、血压、血脂）的改善情况；(2)检验中间变量、结果变量和协变量之间的关系；(3)对Piciryaratggun Calritllerkaq进行形成性评估，以确定模型的优缺点。目标样本将是参与村成年人口的60%，约120人。该研究将采用纵向设计，包括在春季或秋季进行的6次测量。我们假设，这种以文化为基础的促进健康的社区发展方法将增加身体活动，增加自给食品和/或健康替代品的消费，并降低压力水平。这些行为的改变和参与者的幸福感预计与保护性血脂因子、健康体重和健康血压的增加有关。该项目将审查这种心血管健康方法如何发展地方基础设施、知识基础和进程，以鼓励和维持持久的生活方式改善。虽然以社区为基础的预防和健康促进项目在其他社区（主要是城市）取得了成功，但在阿拉斯加州的Yup'ik社区还没有尝试采取这种方法。该项目提供了将科学知识与土著知识和传统相结合的机会，以改善阿拉斯加土著人民的心血管健康。

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.