Achieving American Indian Youth Energy and Mental Health Balance

项目摘要 美国印第安人（AI）青年的肥胖率是美国所有种族群体中最高的， 使他们处于不成比例的成年肥胖和肥胖驱动的代谢疾病包括糖尿病的风险中， 心血管疾病、高血压、中风和癌症。事实上，超过41.7%的儿童 霍皮族、帕斯夸亚基族、盐河皮马-马里亚印第安人社区的青少年， 亚瓦派阿帕契族--在这项研究中合作的部落社区--是肥胖的。健康 行为可以改变肥胖的风险和相关的发病率，如糖尿病和心血管疾病。到 为了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， 通过身心医学（MBM）的整合，改善情绪健康和应对技能。的目标 实现美国印第安青年能量和心理健康平衡（AYEM-B）研究是开发和测试一个 与文化相关的、社区主导的干预措施，其中纳入了MBM技能培训的原则， 父母/照顾者参与支持AI青少年实现健康的生活方式选择和降低风险 用于成人肥胖症和相关代谢疾病。 我们的假设是，参与社区主导的干预，包括MBM和家庭将 减少AI青少年（n=224）中与肥胖相关的慢性疾病风险因素，通过身体变化评估 质量指数z评分（主要结局）和中度/剧烈体力活动的客观指标， 6个月时的水果和蔬菜摄入量（次要结局）。我们将通过解决以下问题来验证我们的假设： 具体目标如下： 具体目标1：将现有的为期一周的AI青少年住宅健康营计划与 新的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 AI青少年（10-15岁）及其父母/照顾者的干预。 具体目标2：评估新建立的计划对体重指数z评分的初步疗效， 美国印第安青少年在基线、3个月和6个月时的体力活动和水果蔬菜摄入量 使用受试者内设计。此外，评估个体风险因素（血脂，血红蛋白A1 C， 空腹血糖）干预前后。 具体目标3：评估成功实施方案的指标和可持续性的潜力 在参与的部落社区，包括可接受性和相关性的参与者，父母，和 社区，和程序采用，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.