Preventing CVD in Native Populations: Traditional Living

描述（由申请人提供）：美国印第安人和阿拉斯加原住民遭受最高的健康差异率，如心血管疾病，其中生活方式是一个关键的风险因素。行为改变干预措施，已试图与AlAN日期经常纳入本地文化成分作为一种手段，使干预文化相关。他们通常不以土著文化和土著智慧作为社区力量和基础来激发干预措施的动机和设计。这里提出的项目是从CBPR为基础的硕士论文，确定了10天的沉浸在传统文化和生活方式的经验-传统生活挑战（TLC）-其次是3个月的后续期，继续在浸泡期间开始的变化，作为一种机制，围绕健康的社区振兴。该项目将是亚利桑那大学和Salish Kootenai学院（SKC）之间的合作，以设计和试点基于社区的CVD风险降低干预措施，使用TLC作为激励和健康承诺的基础。本申请提出了一个为期2年的规划过程，将实现以下目标：在SKC建立NIH资助研究的能力;在部落卫生部门、文化领袖、部落理事会和其他相关部落单位之间开展合作;确定最合适的年龄-性别和风险因素目标人群;选择和评估相关结果指标和潜在效应量;通过一个完整的试点过程，包括干预和数据收集的所有方面，评估项目的可行性;并设计一项全面的研究，作为R 01提交。规划过程和随后的研究将由内部和外部咨询小组指导，外部咨询小组确保科学完整性（通过科学顾问）和传播到其他部落社区的相关性（通过部落成员）。这是一项研究方案的第一步，该方案将首先在萨利希部落和库特奈部落联盟内全面实施，随后进行多社区传播试验，可能在外部咨询委员会代表的AIAN社区之间进行。

DESCRIPTION (provided by applicant): American Indians and Alaska Natives AlANs suffer the highest rates of health disparities, such as CVD, where lifestyle is a key risk factor. Behavior change interventions that have been attempted to date with AlANs have frequently incorporated native cultural components as a means of making the intervention culturally relevant. They have usually NOT started with native culture and indigenous wisdom as the community strength and foundation upon which to stimulate the motivation for and design of an intervention. The project proposed here develops from a CBPR-based masters' thesis that identified a 10-day immersion experience in traditional culture and life-ways - the Traditional Living Challenge (TLC) - followed by a 3- month follow-up period for continuing the changes begun during the immersion, as a mechanism for community revitalization around wellness. This project will be a collaboration between the University of Arizona and Salish Kootenai College (SKC) to design and pilot a community-based CVD risk reduction intervention using the TLC as the basis for motivation and commitment to wellness. This application proposes a 2-year planning process that will accomplish the following goals: build capacity for NIH-funded research at SKC; develop collaborations among the tribal health department, cultural leaders, tribal council, and other relevant tribal units; identify the most appropriate age-gender and risk factor target population segment; choose and evaluate relevant outcome measures and potential effect size; evaluate the feasibility of the project through a full pilot process including all aspects of intervention and data collection; and design a full-scale study for submission as an R01. The planning process and subsequent study will be guided by Internal and External Advisory Groups, with the External Advisory Group assuring scientific integrity (via the scientific consultants) and relevance for dissemination to other tribal communities (via the tribal members). This is the first step in a program of research that would lead first to full-scale implementation within the Confederated Salish and Kootenai Tribes and subsequently to a multi-community dissemination trial, potentially among AIAN communities represented on the External Advisory Board.