The Okla Achukma Project

项目总结 深南美洲原住民(DSNA)糖尿病、肥胖症和高血压的发病率很高，而且 因此，它们正过早地死去。标准生活方式干预，将知识和技能提升到 通过改善心脏代谢来促进更健康的饮食和活动行为降低慢性病风险 健康结果。标准的生活方式干预方法主要针对知识分子和 在个人层面上的健康的物理领域。然而，标准生活方式有很大的局限性。 针对部落社区的干预。这些问题包括辍学率高和出席率低。 这在很大程度上是由于缺乏家庭社会支持和对该计划不感兴趣。我们的研究表明 DNAs对预防慢性病感到无助，当他们有家庭社会支持时，他们吃得更好。 加强社会和文化方面的标准干预措施应涉及社会和精神领域 健康，分别通过加强家庭对饮食和体育活动行为的支持，以及重建宿命论 以积极的观点思考，利用传统文化价值观，突出传统文化的优势 练习。因此，Okla Achukma项目的长期目标是在文化和社会上产生一种 加强可在南方腹地部落内持续的干预措施，以减少慢性病差距 和过早死亡。我们的中心假设是健康的精神和社会领域的整合 进入标准的生活方式干预方法将显著提高出勤率、保留率和 Dsna的心脏代谢特征。我们将采用以社区为基础的参与式方法，在过去的基础上再接再厉 研究，现有的基础设施，以及与部落首领的合作，以实现拟议的目标。我们的 目的是评估健康的精神和社会领域作为多层次的可行性和有效性， 标准生活方式干预对健康结果和计划的文化和社会促进作用 数字系统工程网络体系之间的互动。将实施随机对照试验，以评估社会和 对标准生活方式干预的文化强化。基于NDPP的Move&Eat 2 Live(ME2L) 计划将是在个人层面上针对两个领域的标准方法。增强了社交能力 干预(是，否)×文化强化干预(是，否)×5个时间段(干预前、干预后 干预，6个月、9个月、12个月)混合模型Manova，受试者之间(社会 增强、文化增强)和对象内(时间段)因素将被用来分析这些 数据。拟议的工作将确定社会和文化增强对个人和 共同致力于数字社会网络体系的健康成果和项目参与度。总体而言，干预将提供新的 在部落社区内可持续的生活方式管理方法的进步，以减少 病态失调者的发病率和过早死亡率。

PROJECT SUMMARY Deep South Native Americans (DSNA) have high rates of diabetes, obesity, and hypertension, and consequently, are dying prematurely. Standard lifestyle interventions that advance knowledge and skills to promote healthier eating and activity behaviors mitigate chronic disease risk by improving cardiometabolic health outcomes. The standard lifestyle intervention approach predominantly targets the intellectual and physical domains of health at the individual level. However, there are major limitations of standard lifestyle interventions targeting tribal communities. These include large dropout rates and poor session attendance, largely attributed to lack of family social support and disinterest in the program. Our research has shown DSNAs feel helpless about preventing chronic disease and eat better when they have family social support. Social and cultural enhancement of standard interventions should address social and spiritual domains of health, respectively, by bolstering family support of diet and physical activity behaviors and reframing fatalistic thinking with positive views that leverage traditional cultural values and highlight strengths from traditional practices. Thus, the long-term goal of the Okla Achukma Project is to produce a culturally and socially enhanced intervention that can be sustained within Deep South tribes to reduce chronic disease disparities and premature mortality. Our central hypothesis is that the integration of spiritual and social domains of health into the standard lifestyle intervention approach will significantly improve attendance, retention, and cardiometabolic profiles of DSNA. We will use a community based participatory approach to build on past research, existing infrastructure, and collaborations with tribal leaders to accomplish the proposed aims. Our aim is to assess the feasibility and effectiveness of the spiritual and social domains of health as multi-level, cultural and social enhancements of a standard lifestyle intervention on health outcomes and program engagement among DSNA. A randomized control trial will be implemented to assess the impact of social and cultural enhancements on a standard lifestyle intervention. The NDPP-based Move & Eat 2 Live (ME2L) program will be the standard approach that targets two domains at the individual level. A social enhanced intervention (yes, no) x cultural enhanced intervention (yes, no) X 5 time periods (pre-intervention, post- intervention, 6-month, 9-month, 12-month) mixed model MANOVA with between subjects (social enhancement, cultural enhancement) and within subjects (time period) factors will be used to analyze these data. The proposed work will determine what social and cultural enhancements contribute both individually and collectively to health outcomes and program engagement of DSNA. Overall, the intervention will provide new advancements in lifestyle management approaches that are sustainable within tribal communities to reduce morbidity and premature mortality among DSNA.