Achieving American Indian Youth Energy and Mental Health Balance

项目总结 美国印第安人(AI)青年是美国所有种族中肥胖率最高的， 将他们置于成人肥胖和肥胖驱动的代谢性疾病(包括糖尿病)的不成比例的风险中， 心血管疾病、高血压、中风和癌症。事实上，超过41.7%的儿童 和来自霍皮部落、帕斯夸亚基部落、盐河皮马-马里科帕印第安人社区的青少年，以及 雅瓦派阿帕奇民族--参与这项拟议研究的部落社区--都很肥胖。健康状况 行为可以改变肥胖风险和相关的疾病，如糖尿病和心血管疾病。至 加强我们努力的影响，我们认识到干预必须包括父母的支持和关注 通过心身医学(MBM)的整合，提高情绪幸福感和应对技能。的目标是 实现美国印第安人青年能量和心理健康平衡(AYEM-B)研究是开发和测试 与文化相关的、社区主导的干预措施，纳入了MBM技能培训和 父母/照顾者的参与，以支持人工智能青年实现健康的生活方式选择和降低风险 适用于成人肥胖和相关代谢性疾病。 我们的假设是，参与包括MBM和家庭在内的社区主导的干预将 减少人工智能青少年肥胖相关慢性病风险因素(n=224)，通过身体变化进行评估 质量指数z-Score(主要结果)和中等/剧烈体力活动和 6个月时的水果和蔬菜摄入量(次要结果)。我们将通过以下方式测试我们的假设： 以下是具体目标： 具体目标1：将现有为期一周的人工智能青少年住宿健康夏令营计划与 新颖的MBM和父母参与组成部分，以建立为期6个月的社区主导的肥胖预防 对人工智能青少年(10-15岁)及其父母/照顾者的干预。 具体目标2：评估新建立的体重指数z评分方案的初步疗效， 基线、3个月和6个月时美国印第安人青少年的体力活动和水果和蔬菜摄入量 使用受试者内部设计。此外，评估个体危险因素(血脂、血红蛋白A1C、 空腹血糖)干预前后。 具体目标3：评价成功执行方案的指标和可持续性潜力 跨参与部落社区，包括对参与者、家长和 社区和计划采用率、可行性、保真度和成本。

PROJECT SUMMARY American Indian (AI) youth have the highest prevalence of obesity of all ethnic groups in the United States, placing them at disproportionate risk for adult obesity and obesity-driven metabolic disease including diabetes, cardiovascular disease, high blood pressure, stroke, and cancer. In fact, greater than 41.7% of the children and adolescents from the Hopi Tribe, Pascua Yaqui Tribe, Salt River Pima-Maricopa Indian Community, and the Yavapai Apache Nation—tribal communities collaborating in the proposed study—are obese. Health behaviors can modify obesity risk and associated morbidities such as diabetes and cardiovascular disease. To enhance the impact of our efforts, we recognize the intervention must include parental support and attention to emotional well-being and coping skills through the integration of mind-body medicine (MBM). The goal of the Achieving American Indian Youth Energy and Mental Health Balance (AYEM-B) Study is to develop and test a culturally-relevant, community-led intervention that incorporates the principles of MBM skills training and parental /caregiver engagement to support AI youth in achieving healthy lifestyle choices and in reducing risk for adult obesity and related metabolic diseases. Our hypothesis is that participation in a community-led intervention that includes MBM and the family will reduce obesity-related chronic disease risk factors in AI adolescents (n=224), as assessed by changes in body mass index z-score (primary outcome) and the objective measures of moderate/vigorous physical activity and fruit and vegetable intake (secondary outcomes) at 6 months. We will test our hypothesis by addressing the following specific aims: Specific Aim 1: Integrate an existing week-long residential wellness camp program for AI adolescents with novel MBM and parental engagement components to establish a 6-month community-led obesity prevention intervention for AI adolescents (aged 10–15 years) and their parents/caregivers. Specific Aim 2: Assess the preliminary efficacy of the newly established program on body mass index z-score, physical activity and fruit and vegetable intake in American Indian adolescents at baseline, 3 and 6 months using a within-subjects design. Also, evaluate changes in individual risk factors (lipids, hemoglobin A1C, fasting glucose) pre- and post-intervention. Specific Aim 3: Evaluate indicators of successful program implementation and the potential for sustainability across participating tribal communities, including acceptability and relevance to participants, parents, and the community, and program adoption, feasibility, fidelity, and costs.