Obesity is one of the most daunting health challenges facing American Indian children today and has serious implications for the development of serious chronic diseases, including type-2 diabetes. Early prevention of inappropriate weight gain in childhood is critical. The proposed study, targeting kindergarten and 1st grade American Indian children on the Pine Ridge and Rosebud reservations, will develop and test the efficacy of a school environmental intervention, augmented with a family household environmental intervention, to reduce excessive weight gain by increasing physical activity and healthy dietary practices. The focus of the intervention, Ohiyu lyojanjan - Bright Start Program, is to create dietary and physical activity environmental change at school and home. The intervention has three primary goals: increase physical activity at school to 60 min/day; modify school meals and snacks, and classroom food practices; and involve families in making behavioral and environmental changes at home. The efficacy of the intervention will be tested in a group-randomized controlled trial with 14 schools randomized to two conditions (intervention or control). Two cohorts of kindergarten children will be followed through the end of 1st grade. The major hypothesis is that by the end of the 16-month intervention, children in the intervention schools, relative to children in the control schools, will have significantly lower body mass index (BMI) and percent body fat after adjustment for baseline values. The primary outcome measures in children are BMI and percent body fat. Secondary measures include child's total daily physical activity, nutrient and food-group analysis of school meals and snacks, and assessment of classroom food and physical activity practices. Child measures will occur at the beginning of kindergarten (baseline), at the end of kindergarten (BMI only), and at the end of the 1st grade. Parents will be surveyed at baseline, and when their child is at the end of the 1st grade. Parent assessments will include measures of household food availability, parent reports of their own and child eating and physical activity behaviors. The study will advance our knowledge of how best to prevent obesity in American Indians, a population at extreme risk, and in doing so will help address health disparities. The proposed intervention has potential for school policy change that would be generalizable and sustainable in schools nationwide. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL078846-03
Application #
7158575
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Jobe, Jared B
Project Start
2005-01-16
Project End
2009-12-31
Budget Start
2007-01-01
Budget End
2007-12-31
Support Year
3
Fiscal Year
2007
Total Cost
$708,744
Indirect Cost
Name
University of Minnesota Twin Cities
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
555917996
City
Minneapolis
State
MN
Country
United States
Zip Code
55455
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Arcan, Chrisa; Hannan, Peter J; Fulkerson, Jayne A et al. (2013) Associations of home food availability, dietary intake, screen time and physical activity with BMI in young American-Indian children. Public Health Nutr 16:146-55
Story, Mary; Hannan, Peter J; Fulkerson, Jayne A et al. (2012) Bright Start: Description and main outcomes from a group-randomized obesity prevention trial in American Indian children. Obesity (Silver Spring) 20:2241-9
Bauer, Katherine W; Widome, Rachel; Himes, John H et al. (2012) High food insecurity and its correlates among families living on a rural American Indian Reservation. Am J Public Health 102:1346-52
Arcan, Chrisa; Hannan, Peter J; Himes, John H et al. (2012) American Indian parents' assessment of and concern about their kindergarten child's weight status, South Dakota, 2005-2006. Prev Chronic Dis 9:E56
Zhang, Jianduan; Himes, John H; Hannan, Peter J et al. (2011) Summer effects on body mass index (BMI) gain and growth patterns of American Indian children from kindergarten to first grade: a prospective study. BMC Public Health 11:951
Barr-Anderson, Daheia J; Fulkerson, Jayne A; Smyth, Mary et al. (2011) Associations of American Indian children's screen-time behavior with parental television behavior, parental perceptions of children's screen time, and media-related resources in the home. Prev Chronic Dis 8:A105