Obesity/overweight has been declared an epidemic and is among the most significant challenges facing the world today. Overweight/obesity in childhood is a major risk factor for severe negative health, psychological, and social outcomes. Native American populations have the highest prevalence of obesity among North American youth. Obesity in children is the result of physical inactivity and (or) consuming excess calories, which are influenced synergistically by individual, community and societal level factors such as income, employment, education, food security, stress, and social environments. These factors can be modified to reduce inequalities in health, and specifically, the risk of childhood obesity. Montana ranks low in the nation (46th) for overall prevalence of childhood overweight/obesity. Our recent surveillance study, however, of five rural Indian reservations in the state found approximately 57% of American Indian children and adolescents, ages 5-19 years old were overweight or obese. Very few obesity prevention trials have targeted, and none have been successful at, preventing childhood obesity in this high-risk population. The setting for this proposal is the Flathead Indian Reservation in northwest Montana where the minority of the population is American Indian and the majority of the population is mostly white. On the reservation, two parallel government and healthcare service systems are in place for tribal and non-tribal residents. However, this does not necessarily translate to improved available resources to residents or integration of services. Reducing the prevalence of childhood obesity in this rural setting which has a mix of Native and non-Native children and dual service systems requires novel approaches based on an in-depth understanding of the community, social, familial, political, behavioral and economic influences upon childhood obesity. This project will capitalize on the dual government and health care services systems that exist on the Flathead Indian Reservation and build capacity to develop partnerships that promote sustainable childhood obesity reduction via shared vision, community outreach and education with the goal of developing and testing culturally- appropriate intervention strategies. The project aims to use a community-based participatory approach to develop partnerships that establish memoranda of understandings between Flathead Tribal Health, Salish Kootenai College, The University of Montana and at least two community organizations for the purpose of developing research projects, negotiating IRB protocols, developing culture review protocols and submitting research applications. Additional aims will determine a collaborative agenda that identifies community needs and priorities in preventing childhood obesity through an iterative process; educate the public about national guidelines and behavior change strategies for preventing childhood obesity through evidence-based health education and health promotion activities; and evaluate the reach, adoption, implementation and maintenance of the project by collecting social network analyses data. In addition, survey data, attendance, and review of timeline and procedures by an Advisory Board will be used to evaluate the project.
Obesity in children is the result of physical inactivity and (or) consuming excess calories, which are influenced synergistically by individual, community and societal level factors. Native American populations have the highest prevalence of obesity among North American youth. This project aims to capitalize on dual government and health care service systems that exist on the Flathead Indian Reservation to develop partnerships and interventions that promote sustainable childhood obesity reduction via shared vision and community outreach.