Physical inactivity is an ongoing public health challenge in the U.S., especially among ethnic minorities, and is related to four leading causes of death: heart disease, stroke, diabetes, and cancer. American Indian and Alaska Native (AIAN) older adults (OAs) are among the least physically active ethnic minority groups and experience pronounced health disparities. Recent attempts to increase physical activity (PA) among OAs have emphasized walking as a key therapeutic modality based on its health benefits, and intergenerational programs have shown promising results to increase walking among diverse OAs. However, little is known about walking among rural AIAN OAs, and although intergenerational interaction is a valued social practice among AIAN communities, research to evaluate the acceptability and feasibility of this strategy to promote OA health is absent from the literature. This mentored research project is aligned with best practices for research with AIAN populations. A participatory research approach will be used to identify key ecologic and life course influences on walking among rural AIAN OAs, and to evaluate the acceptability of an intergenerational intervention to increase routine PA. This project will build on an ongoing, NIH-funded development award under the AIAN Clinical and Translational Research Program (U54GM115371) which establishes PA research infrastructure in rural AIAN communities.
Aim 1 features qualitative interviews with AIAN OAs (n=20) to advance knowledge on ecologic and life course influences on walking behavior. This data will provide critical information for the development of meaningful and targeted behavioral interventions among this population.
Aim 1 will also inform Aim 2 in the adaptation and development of a culturally responsive intergenerational walking intervention. This is a non-controlled, multi-dose intervention (4-weeks, 30-minute sessions 1x/week) to evaluate acceptability and feasibility of intervention content and methods, featuring paired intergenerational walking and dialogue (n=10 AIAN OAs, n=10 AIAN youth). Outcome measures include acceptability, feasibility, and routine PA among the OA participants. Post-test focus groups (one for OA participants, one for youth) will provide in-depth information on intervention evaluation and improvement for future testing. The candidate?s research experience combined with the proposed high-quality mentoring, training, and research project will extend her knowledge and skills in mixed methods and health disparities research. It will ensure the achievement of her short-term goal of attaining the knowledge and skills of the scientific process to conduct ethical, high-impact research using CBPR and mixed methods in the fields of gerontology and implementation science. The trainee?s long-term goal is to become an independent, externally funded researcher with a program of inquiry aimed at developing and implementing sustainable interventions to promote health equity among AIAN populations. Results from the proposed research project will inform future efforts to prevent disease and disability, and best practices for public health research in partnership with AIAN communities.
This study will inform future physical activity interventions for rural American Indian and Alaska Native older adults. This population experiences disproportionately high rates of chronic disease and disability compared with other racial/ethnic groups, and reports among the lowest physical activity levels. Results will support culturally responsive, theory-driven strategies to prevent chronic disease and disability, reduce health disparities, and improve wellbeing.
