Achieving American Indian Youth Energy and Mental Health Balance

实现美洲印第安人青少年能量和心理健康的平衡

基本信息

批准号：
10324594
负责人：
FRANCINE C GACHUPIN
金额：
$ 55.98万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-13 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10324594
关键词：
Address Adolescent Adopted Adoption American Indians Apache Attention Behavior Body mass index Cardiovascular Diseases Caregivers Child Child Rearing Chronic Disease Communities Community Actions Consumption Coping Skills Diabetes Mellitus Ensure Equilibrium Ethnic group Faculty Family Family Relationship Foundations Glycosylated hemoglobin A Goals Health Health behavior Healthy Eating High Prevalence Home Home environment Hypertension Individual Intake Intervention Intervention Studies Knowledge Lead Life Life Cycle Stages Lipids Malignant Neoplasms Measures Mental Health Metabolic Diseases Mind-Body Intervention Modeling Morbid Obesity Morbidity - disease rate Obesity Outcome Parents Participant Persons Physical activity Poverty Pueblo Race Research Risk Risk Factors Rivers Schools Sodium Chloride Specificity Strenuous Exercise Stress Stroke Testing Time Trauma Tribes Trust United States Weight Well in self Work Yavapai Youth adolescent health adult obesity adverse childhood events aged base behavior change cardiometabolic risk cardiometabolism cost design disorder prevention fasting glucose fruits and vegetables health disparity healthy lifestyle improved intervention delivery novel obesity prevention obesity risk post intervention preventive intervention primary outcome programs racial and ethnic disparities secondary outcome skills skills training social determinants socioeconomic disparity success tribal Nation tribal community

项目摘要

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.

项目概要美洲印第安人（AI）青年的肥胖患病率是美国所有族裔中最高的，使他们面临成人肥胖和肥胖驱动的代谢疾病（包括糖尿病）的不成比例的风险，事实上，超过41.7%的儿童患有心血管疾病、高血压、中风和癌症。以及来自霍皮部落、帕斯卡亚基部落、盐河皮马-马里科帕印第安社区的青少年，以及亚瓦派阿帕奇民族（Yavapai Apache Nation）——参与拟议研究的部落社区——存在肥胖问题。行为可以改变肥胖风险和相关疾病，如糖尿病和心血管疾病。增强我们努力的影响力，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）的整合来提高情绪健康和应对技巧。实现美洲印第安人青少年能量和心理健康平衡（AYEM-B）研究旨在开发和测试与文化相关、社区主导的干预措施，其中结合了 MBM 技能培训和父母/看护者的参与，支持人工智能青少年选择健康的生活方式并降低风险用于成人肥胖及相关代谢疾病。我们的假设是，参与包括 MBM 和家庭在内的社区主导的干预措施将会根据身体变化评估，减少 AI 青少年 (n=224) 与肥胖相关的慢性疾病危险因素质量指数 z 分数（主要结果）以及中等/剧烈体力活动的客观测量和 6 个月时的水果和蔬菜摄入量（次要结果）我们将通过解决以下问题来检验我们的假设。以下具体目标：具体目标 1：将现有的为期一周的人工智能青少年住宿健康营计划与新颖的 MBM 和家长参与组成部分，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：评估新制定的体重指数 z 评分计划的初步效果，美洲印第安青少年基线、3 个月和 6 个月时的体力活动以及水果和蔬菜摄入量此外，还使用受试者内设计来评估个体风险因素（血脂、血红蛋白 A1C、空腹血糖）干预前和干预后。具体目标 3：评估计划成功实施的指标和可持续性潜力整个参与的部落社区，包括对父母的可接受性和相关性，以及社区和计划的采用、可行性、保真度和成本。