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

项目摘要 在美国，含糖饮料（SSB）是最大的单一食物卡路里来源。 SSB的摄入量在美洲原住民（NA）中不成比例地高。有强大的和一致的 记录高SSB消费与许多健康问题（例如肥胖， 糖尿病，癌症，心脏病）; NA承担了所有这些健康问题的不成比例的负担，特别是 NA男人。 NA健康必须在更广泛的殖民主义历史背景下考虑， 新来港定居人士所处的健康环境的现有社会决定因素。回顾这一历史背景， 这对于有意义地解决NA人群中的健康不平等至关重要。然而，很少有研究将NA 价值观与健康的社会决定因素，历史背景，和饮食变化使用部落指导， 适当的文化方式。 我们会针对导致患上SSB的主要饮食风险因素，以及在了解 殖民主义在NA健康行为不平等中的作用。由该研究团队开发和测试的SIPsmartER 是一种SSB干预措施，在农村，主要是白色，每天减少SSB摄入量227千卡（-326，-127） 和女性人群从基线至6个月。我们建议调整和整合SIPsmartER在 传统的长曲棍球NA活动，通过一个理论框架，连接NA的历史背景， 创造SIPsmartER长曲棍球。在NA中，长曲棍球是一种与 well-being.我们的部落领袖要求针对多种健康状况进行饮食干预 同时承认健康的社会决定因素。这些领导人建议以长曲棍球为基础， 因为这项活动经常吸引NA男性。 我们将把SIPsmartER改编成SIPsmartER长曲棍球。我们将建立一个理论框架， 将殖民主义的历史后果与当前NA健康结果的不平等联系起来，包括SSB 摄入然后，我们将使用一个集群随机对照试验，目标是来自两个农村的六个长曲棍球队中的60名男子 Seneca Nation of Indians（英语：Seneca Nation）总体目标是检查初步的 SIPsmartER长曲棍球在2组中的疗效（SIPsmartER长曲棍球与替代治疗对照）为3 评估（基线、6个月、18个月）设计。具体目标1：建立一个基于证据的文化 为NA男性提供适当的SSB干预，将其独特的历史背景融入SIPsmartER 到SIPsmartER长曲棍球。具体目标2：实施并确定SIPsmartER的初步疗效 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.