Health Resilience Among American Indians in Arizona

项目总结（见说明）： 美国印第安人的肥胖和适应性策略使用CDC的社会生态模型（SEM）以及弹性和快速评估，反应和评价（RARE）的方法来调查生活方式的变化和肥胖相关的美国印第安人之间的医患沟通生活在保留地。将在社区和政策层面制定战略，并为CAIR、地方健康政策联盟和社区利益攸关方的活动提供信息。伙伴关系 包括三个为美国印第安人服务机构：一个CHC，一个城市印第安人保健中心，和一个医院附属的儿童肥胖诊所。 目标包括：1）确定当前的知识，态度，信仰，和行为，在美国印第安人中，通过生活方式的改变，增加健身和表现出的弹性2）评估患者-供应商关于超重和肥胖的沟通3）制定基于证据的，文化上适当的战略，以促进健康的生活方式和4）制定政策和程序建议。快速评估将用于在家庭和临床环境中进行有关肥胖诊断和寻求健康行为的定性和定量研究。参与者将包括医疗保健提供者，以及在过去两年中血压，A1 C和/或BMI显着改善的个人和儿童（以及护理人员）。RARE将包括在方法和分析以及数据收集方面培训和雇用社区人种学家。方法将包括访谈、调查、焦点小组和观察相结合。在研究和分析结束时，社区民族志学家将制定一套符合RARE方法的循证战略。在研究和分析结束时，社区民族志学家将制定一套符合RARE方法的循证战略。战略将为美国印第安人恢复力中心（CAIR）社区咨询委员会，合作伙伴机构和致力于采用健康生活方式的美国印第安人提供政策和程序建议。

PROJECT SUMMARY (See Instructions): Obesity and Adaptive Strategies among American Indians Living off Reservation uses the CDCs Social Ecological Model (SEM) as well as resilience and Rapid Assessment, Response and Evaluation (RARE) approaches to investigate lifestyle changes and obesity related to physician-patient communication among American Indians living off reservation. Strategies will be designed at the community and policy levels and will inform the activities of CAIR, a local wellness policy coalition and community stakeholders. Partnerships include three agencies that serve American Indians: a CHC, an urban Indian health care center, and a hospital affiliated obesity clinic for children. Aims include: 1) Identify current knowledge, attitudes, beliefs, and behaviors among American Indians related to increased fitness and demonstrated resilience through lifestyle changes 2) Assess patient ~provider communication about overweight and obesity 3) Develop evidence-based, culturally appropriate strategies to promote healthy lifestyles and 4) Make policy and procedural recommendations. Rapid assessment will be used to conduct qualitative and quantitative research in homes and clinical settings regarding obesity diagnoses and health-seeking behaviors. Participants will include health care providers, and individuals and children (and caregivers) who have shown a marked improvement in blood pressure, A1C and/or BMI over the past two years. RARE will include the training and employment of Community Ethnographers on methods and analysis and data collection. Methods will include a combination of interviews, surveys, focus groups, and observations. At the conclusion of research and analysis Community Ethnographers will develop a set of evidence-based strategies in keeping with RARE methodology. At the conclusion of research and analysis Community Ethnographers will develop a set of evidence-based strategies in keeping with RARE methodology. Strategies will inform policy and procedural recommendations to the Center for American Indian Resilience (CAIR) Community Advisory Board, partner agencies, and American Indian people working to adopt healthy lifestyles.