A novel sugar-sweetened beverage reduction intervention for Native American men

项目摘要 在美国，含糖饮料(SSB)是卡路里的最大单一食物来源。 在印第安人(NA)中，SSB的摄入量不成比例地高。有很强的一致性 记录高SSB消费与众多健康问题之间关系的数据(例如肥胖、 糖尿病、癌症、心脏病)；北美在所有这些健康问题上承担着不成比例的负担，特别是 那就是男人。 必须在殖民主义的更广泛的历史背景下考虑北美健康，因为殖民主义促成了 NAS所处的健康状况的现有社会决定因素。结合这一历史背景是 对于有意义地解决北非人群中的健康不平等问题至关重要。然而，很少有研究将NA 价值观与健康、历史背景和饮食变化的社会决定因素一起使用部落指导的 与文化相适应的方法。 我们将针对SSB的主要饮食风险因素，除了对 殖民主义在北美健康行为不平等中的作用。由该研究团队SIPSmartER开发和测试 是一种SSB干预，在以白人为主的农村地区每天减少SSB摄入量227千卡(-326，-127) 女性人口从基线到6个月。我们建议将SIPSmartER调整和集成到 曲棍球传统NA活动的理论框架，将NA历史背景与 创建SIPSmarter Lacrosse的健康不平等。在北美，长曲棍球是一种祖先活动，与 幸福。我们的部落首领要求进行针对多种健康状况的饮食干预 同时承认健康的社会决定因素。这些领导人建议在曲棍球比赛的基础上继续发展， 因为这项活动有固定的男性参与。 我们将SIPSmarter适配到SIPSmarter Lacrosse中。我们将制定一个理论框架， 将殖民主义的历史后果与当前北美健康结果的不平等联系在一起，包括社会保障 入口处。然后我们将使用集群RCT，目标是嵌套在来自两个农村的六支曲棍球队中的60名男子 塞涅卡印第安人民族的保留地/领地。总的目标是审查初步的 SIPSmarter Lacrosse在A 2组(SIPSmarter Lacrosse与替代治疗对照)中的疗效为3 评估(基线、6个月、18个月)设计。具体目标1：创建以证据为基础的文化 为NA男性提供适当的SSB干预，在适应SIPSmartER时结合他们独特的历史背景 致SIPSmarter Lacrosse。具体目标2：实施和确定SIPSmartER的初步效果 长曲棍球，以减少SSB的消耗。

Project Summary In the United States, sugar-sweetened beverages (SSB) is the largest single food source of calories. The intake of SSB is disproportionately high among Native Americans (NA). There are strong and consistent data documenting relationships among high SSB consumption and numerous health issues (e.g. obesity, diabetes, cancers, heart disease); NA bear a disproportionate burden of all of these health issues, particularly NA men. NA health must be considered within a broader historical context of colonialism that has contributed to the existing social determinants of health landscape in which NAs live. Incorporating this historical context is critical to meaningfully address health inequities within NA populations. Yet few studies have integrated NA values with social determinants of health, historical context, and dietary change using a tribally-guided, culturally-appropriate approach. We will target the major dietary risk factor of SSB, in addition to noticeable gaps in understanding the role of colonialism in NA health behavior inequities. Developed and tested by this research team, SIPsmartER is an SSB intervention that reduced SSB intake by 227kcal (-326,-127) per day in a rural, predominately White and female population from baseline to 6 months. We propose to adapt and integrate SIPsmartER within the traditional NA activity of lacrosse through a theoretical framework that connects NA historical context with health inequities to create SIPsmartER Lacrosse. Among NA, lacrosse is an ancestral activity associated with well-being. Our tribal leaders have asked for a dietary intervention that would target multiple health conditions while acknowledging social determinants of health. These leaders suggested building on the game of lacrosse, as this activity engages NA men regularly. We will adapt SIPsmartER into SIPsmartER Lacrosse. We will develop a theoretical framework that links the historical consequences of colonialism with current inequities in NA health outcomes, including SSB intake. We will then use a cluster RCT that targets 60 men nested within six lacrosse teams from two rural reservations/territories from the Seneca Nation of Indians. The overall goal is to the examine the preliminary efficacy of SIPsmartER Lacrosse in a 2 group (SIPsmartER Lacrosse vs. alternative treatment control) by 3 assessment (Baseline, 6-month, 18-month) design. Specific Aim 1: Create an evidence-based culturally appropriate SSB intervention for NA men that integrates their unique historical context in adapting SIPsmartER to SIPsmartER Lacrosse. Specific Aim 2: Implement and determine the initial efficacy of SIPsmartER Lacrosse to reduce SSB consumption.