This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this project is to evaluate the effectiveness of a school-based intervention program to reduce the risk of Type 2 diabetes mellitus (DM) among American Indian (AI) children of the Five Civilized Tribes of Oklahoma. We propose to examine the effectiveness of a school and family-based intervention for reducing the disproportionate prevalence of obesity, inactivity, dyslipidemia and hyperinsulinemia in AI children by a) improving the school food service, physical education program, and health curriculum, b) inducing potentially sustainable behavioral changes in AI children that will lead to healthier lifestyles, and c) enhancing the capacity of AI health professionals to conduct research to address the health disparity of the emerging epidemic of Type 2 DM in their children and adolescents. The study will have three phases.
The specific aims of each phase are listed below. Phase I: Formative Assessment and Collection of Baseline Data (Year 1) Based on recommendations of an Inter-Tribal Advisory Council, design and implement a formative assessment to: a. determine the kinds of foods available in the schools, homes and communities; b. determine the facilities and resources available for physical activity in the schools, homes and communities; c. obtain information on health curricula and educational programs available in the schools and communities; d. identify potential barriers and opportunities that might impede or facilitate success of the intervention; e. collect baseline data on height, weight, body mass index, waist and hip circumference, percent body fat, fasting blood glucose, insulin, leptin, plasma lipids, activity recall, 24-hour dietary recall, family medical history, and diabetes risk factor knowledge in 250 children in intervention and control schools. Phase II: Intervention Based on results of the formative assessment and advice from the Inter-Tribal Advisory Council, design and implement an age and culturally appropriate school and family-based intervention program, in five randomly allocated intervention schools, to teach children and their families how to increase physical activity and choose a healthy diet. We hypothesize that the school and family-based intervention will result in a significant decrease in the proportion of American Indian children with physiologic measures or behaviors that increase risk for Type 2 DM, compared with baseline data. In addition, we hypothesize that the magnitude of the decrease among children in intervention schools will be greater than the magnitude of any decrease observed in children in five randomly allocated control schools. Phase III: Evaluation Perform a post-intervention assessment of the same measures as a baseline in the 250 children, evaluate and compare the intervention and control groups, and analyze results to determine whether the: a. intervention increases the percentage of AI children who make healthy food choices; b. intervention increases the amount and quality of regular aerobic physical activity in AI children; c. intervention increases the knowledge of diabetes risk factors and healthy behaviors in AI children; d. intervention decreases the proportion of AI children with risk factors for Type 2 DM e. capacity of tribal co-investigators and health professionals to organize and conduct research to address the epidemic of Type 2 DM in their children is improved as a result of the intervention; f. trust of research among AI communities and people is improved as a result of the intervention
Showing the most recent 10 out of 209 publications
