Yappalli Choctaw Road To Health

亚帕利·乔克托健康之路

基本信息

批准号：
9275955
负责人：
KARINA L. WALTERS
金额：
$ 62.95万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-06-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9275955
关键词：
Addictive Behavior Address Adherence Adult Alcohol abuse Alcohol or Other Drugs use American Indians Area Behavior Behavioral Binge Eating Brain Cessation of life Child Child Care Choctaw Nation of Oklahoma Chronic Collaborations Communities Community Developments Community Health Consumption Country Coupled Data Development Diabetes Mellitus Drug Addiction Drug abuse Drug usage Eating Behavior Economics Elements Enrollment Epidemic Ethnic group Evidence based program Exercise Exhibits Family Food Habits Future Generations Harm Reduction Health Health Promotion Health Services Heavy Drinking Individual Intervention Leadership Leisures Link Longitudinal Studies Mental Depression Mental Health Methods Minnesota Modeling Morbidity - disease rate Motivation National Institute of Drug Abuse Native Americans Non-Insulin-Dependent Diabetes Mellitus Obesity Oklahoma Overweight Parents Pattern Pharmaceutical Preparations Physical Capacity Physical activity Population Population Programs Premature Mortality Prevalence Prevention Primary Prevention Provider Public Health Randomized Research Research Infrastructure Research Personnel Research Priority Resources Risk Risk Reduction Site Stress and Coping Substance abuse problem Sustainable Development Taxes Time Tribes Twin Multiple Birth United States Universities Walking Washington Weight Woman adverse outcome alcohol and other drug authority base behavioral health community based participatory research cost cost effective design disorder prevention efficacy testing experience fast food health disparity interest leadership development meetings member model development motivational enhancement therapy multidisciplinary obesity prevention obesity risk physical conditioning physical inactivity programs public health relevance response skill acquisition skills stem success tribal community walking intervention

项目摘要

DESCRIPTION (provided by applicant): Obesity and substance abuse are increasingly prevalent, costly, and deadly--fueling a twin epidemic in the United States. The importance of addressing obesity and alcohol and other drug (AOD) use simultaneously is supported in part by recent research at NIDA linking the brain mechanisms that fuel drug addiction and compulsive eating behaviors. Although AOD abstention and abuse patterns vary considerably by region and tribe, American Indian (AI) drug-related deaths are 1.5 times higher than for all other ethnic groups in the US. AI women in particular exhibit significant disparities with other women in obesity and AOD prevalence and higher rates of premature mortality and morbidity as a result. Based on preliminary research, we have developed the Yappalli Choctaw Road to Health, a culturally focused, strengths-based outdoor experiential obesity-AOD risk prevention and health leadership program. The 3-month intervention (i.e., 3 individual meetings; 8 group-sessions + 2-day culture boot camp + 10-day Choctaw Trail of Tears walk) is grounded in the PI's Indiginest Stress-Coping Model and the Information-Motivational- Behavioral Skills framework, with activities consistent with Motivational Interviewing and leadership development principles. This RO1 application, prepared in response to PAR-11-346 (Interventions for Health Promotion and Disease Prevention in Native American Populations), proposes to evaluate the program among 150 at-risk adult Choctaw women across 5 regions of the Choctaw Nation of Oklahoma (CNO), where Native women have some of the highest obesity, physical inactivity, and excessive drinking prevalence in the country. We will conduct a longitudinal study using a cluster randomized stepped-wedge design to evaluate the intervention impact on the AOD and obesity prevention primary aims of: (1) substance use harm reduction (SUHR) and AOD use and intentions to use; and (2) reduction in weight/BMI and increase in leisure-time physical activity and healthful food habits. The project is multidisciplinary community-based participatory research collaboration among experienced AI researchers at the Universities of Washington and Minnesota and Choctaw behavioral health leaders and providers. A unique feature of the proposed project is its direction at both the university and tribal levels by Choctaws. The project is supported by pilot and tribal acceptability data; addresses a critical public health issue among a group experiencing considerable health disparities; and strengthens the research infrastructure in partnership with the Tribe. If efficacious, it has the potential for widespread dissemination and could be generalizable to other chronic co-occurring mental health and physical health conditions (e.g., diabetes and depression).

描述（由申请人提供）：肥胖和药物滥用日益普遍、成本高昂且致命——助长了美国的双重流行病。 NIDA 最近的研究部分支持了同时解决肥胖和酒精和其他药物 (AOD) 使用问题的重要性，该研究将助长药物成瘾和强迫性饮食行为的大脑机制联系起来。尽管 AOD 戒断和滥用模式因地区和部落而异，但美洲印第安人 (AI) 与毒品相关的死亡人数比美国所有其他族裔群体高 1.5 倍。 AI 女性在肥胖和 AOD 患病率方面与其他女性尤其表现出显着差异，因此过早死亡率和发病率较高。根据初步研究，我们开发了“Yappalli Choctaw 健康之路”，这是一个以文化为中心、基于优势的户外体验式肥胖 AOD 风险预防和健康领导计划。为期 3 个月的干预（即 3 次单独会议；8 次小组会议 + 2 天文化训练营 + 10 天乔克托泪迹步行）以 PI 的本土压力应对模型和信息-动机-行为为基础技能框架，其活动符合动机访谈和领导力发展原则。该 RO1 申请是为响应 PAR-11-346（美洲原住民健康促进和疾病预防干预措施）而准备的，建议在俄克拉荷马州乔克托族 5 个地区的 150 名高危成年乔克托妇女中评估该计划（ CNO），其中土著妇女的肥胖、缺乏运动和过度饮酒的患病率是该国最高的。我们将使用整群随机阶梯楔形设计进行纵向研究，以评估干预措施对 AOD 和肥胖预防的影响，主要目标是：（1）减少物质使用危害（SUHR）和 AOD 使用和使用意图； (2) 减轻体重/体重指数并增加休闲时间的体力活动和健康的饮食习惯。该项目是华盛顿大学和明尼苏达大学经验丰富的人工智能研究人员以及乔克托行为健康领导者和提供者之间基于多学科社区的参与性研究合作。拟议项目的一个独特之处在于它在大学和部落层面均由 Choctaws 进行指导。项目得到试点和部落可接受性数据的支持；解决了一个关键的公共卫生问题健康状况存在巨大差异的群体；并与部落合作加强研究基础设施。如果有效，它有可能广泛传播，并且可以推广到其他慢性并发的心理健康和身体健康状况（例如糖尿病和抑郁症）。