The Okla Achukma Project

奥克拉阿楚玛项目

• 批准号: 10687415
• 负责人: Jennifer Lemacks
• 金额: $ 69.54万
• 依托单位: UNIVERSITY OF SOUTHERN MISSISSIPPI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-19 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10687415
• 关键词: Address; Age; Attention; Attitude; Behavior; Behavioral Sciences; Body mass index; Chronic Disease; Clinical Trials; Collaborations; Communities; Data; Deep South; Development; Diabetes Mellitus; Diet; Disease Management; Dropout; Eating; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Exclusion; Family; Fostering; Future; Goals; Health; Health behavior; Healthy Eating; Hypertension; Individual; Infrastructure; Intervention; Knowledge; Life Style; Louisiana; Maintenance; Medicine; Mississippi; Modeling; Morbidity - disease rate; Native Americans; Obesity; Outcome; Physical activity; Premature Mortality; Prevention; Public Health; Randomized Controlled Trials; Research; Risk Factors; Social Impacts; Social support; Support System; Thinking; Time; Tribes; Weight; Work; base; cardiometabolic risk; cardiometabolism; cultural values; disease disparity; disorder risk; effectiveness evaluation; evidence base; family support; health data; health goals; improved; lifestyle intervention; obesity management; physical conditioning; post intervention; premature; prevent; programs; response; skills; social; success; theories; tribal community; tribal leader

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.

项目摘要 深南美洲原住民（DSNA）糖尿病、肥胖和高血压的发病率很高， 因此，过早死亡。标准的生活方式干预，提高知识和技能， 促进更健康的饮食和活动行为，通过改善心脏代谢来降低慢性疾病的风险。 健康成果。标准的生活方式干预方法主要针对知识分子和 在个人层面上的物理健康领域。然而，标准的生活方式有很大的局限性， 针对部落社区的干预措施。这些问题包括辍学率高和上课出勤率低， 主要原因是缺乏家庭社会支持和对该方案不感兴趣。我们的研究表明 DSNA对预防慢性病感到无助，当他们有家庭社会支持时，他们会吃得更好。 在社会和文化方面加强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， 实践因此，Okla Achukma项目的长期目标是在文化和社会上产生一个 加强干预，可在深南部落内持续，以减少慢性病的差异 和过早死亡。我们的中心假设是，整合精神和社会领域的健康 标准的生活方式干预方法将显着提高出勤率，保留， 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， 研究、现有的基础设施以及与部落领袖的合作，以实现拟议的目标。我们 目的是评估精神和社会健康领域的可行性和有效性， 标准生活方式干预对健康结果和计划的文化和社会增强 与DSNA的合作。将实施一项随机对照试验，以评估社会和 在标准生活方式干预的基础上进行文化提升。移动和吃2生活（ME2L） 计划将是标准的方法，目标是两个领域的个人水平。一个社会增强 干预（是，否）x文化强化干预（是，否）X 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）和受试者内（时间段）因素将用于分析这些 数据拟议的工作将确定社会和文化的改善对个人和 共同的健康成果和DSNA的项目参与。总的来说，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方面取得进展， 发病率和过早死亡率。