There are few studies focusing on the patterns of food use among American Indian populations, and even fewer evaluating nutrition education interventions among this population. This project will build on the findings from a previous study of the dietary habits of California Indians to design a culturally sensitive intervention utilizing the talking circle (Nutritional Circle). The intervention will focus on reinforcing positive foods habits and modifying nutritionally detrimental ones, to reduce the risk of cancer and other chronic diseases. Increased use of traditional foods will be emphasized as appropriate. The American Indian family is the target population. Four urban and four rural Indian sites will be randomly assigned to intervention and control clinics. Fifty homemakers per site (n=400) will be followed and evaluated. Process evaluation also will be conducted, and will provide information on the cultural adaptation of the intervention. Phase I consists of instrument development and design of educational materials. During Phase II, homemakers in the intervention sites will participate in a series of 12 Nutritional Circle sessions. Pre- and post- testing of the groups will be conducted. In Phase III, outcome and process measures will be analyzed and evaluated. Studying the efficacy of a culturally acceptable and sensitive intervention has far-reaching significance not only to California's Indian population, but potentially to American Indians nation-wide. Improving dietary behavior in a unique population such as our First Americans has the potential to lower the risk of cancer as well as other chronic diseases as diabetes, hypertension, and heart disease. A successful urban/rural Indian intervention model may have generalizability to the larger Indian population across the nation.
