The Pathways Project is a comprehensive, school-based intervention designed to help reduce obesity in Native American children. Grades 3,4, and 5 in forty schools from six American Indian nations are involved: Gila River tribal preference) Tohono O'odham, Navajo, White Mountain Apache, Oglala lakota, and Sicangu Lakota. The intervention is implemented through representatives of the six nations and four cooperating universities; The Johns Hopkins University, the University of New Mexico, the University of Arizona, and the University of Minnesota with a fifth institution, the University of north Carolina, serving as the Coordinating Center. The design of Pathways is a randomized, controlled trial with the following components: physical activity, food service, classroom curriculum, and family involvement. The NHLBI funded a three-year feasibility study, whose results are summarized in the proposal, and now the PI's have received funding to begin the full-scale study, to be carried out over a five-year period. The purpose of this study is to develop a comprehensive program that is school-based to promote healthy eating behaviors and increased physical activity in American indian children. The major outcome variable is percent body fat after three years of intervention. The investigators have documented that American Indians have a higher prevalence of obesity. In addition, when examining the NHANES II and HHANES-MA national reference sets, American indian children have significantly higher BMIs for nearly every age and sex group. By defining overweight as exceeding the 85th percentile of the reference population, American Indian children have 39% compared with the NHANES-2 population and 26.6% compared with the HHANES-MA population. The investigators selected the strategy of intervening in school children. They have selected grades 3,4 and 5 since developmental age appears to be critical for learning health knowledge and skill. They refer to other studies which have tried programs in older children and adolescents with a very low rate of success.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZHL1-CSR-G (O1))
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of New Mexico
Schools of Medicine
United States
Zip Code
Page-Reeves, Janet; Davis, Sally; Romero, Camilla et al. (2015) Understanding ""agency"" in the translation of a health promotion program. Prev Sci 16:11-20
Going, Scott B (2010) Physical activity measurements: lessons learned from the pathways study. J Public Health Manag Pract 16:420-5
Stevens, June; Suchindran, Chirayath; Ring, Kim et al. (2004) Physical activity as a predictor of body composition in American Indian children. Obes Res 12:1974-80
Gittelsohn, Joel; Davis, Sally M; Steckler, Allan et al. (2003) Pathways: lessons learned and future directions for school-based interventions among American Indians. Prev Med 37:S107-12
Cunningham-Sabo, Leslie; Snyder, M Patricia; Anliker, Jean et al. (2003) Impact of the Pathways food service intervention on breakfast served in American-Indian schools. Prev Med 37:S46-54
Himes, John H; Ring, Kim; Gittelsohn, Joel et al. (2003) Impact of the Pathways intervention on dietary intakes of American Indian schoolchildren. Prev Med 37:S55-61
Steckler, Allan; Ethelbah, Becky; Martin, Catherine Jane et al. (2003) Pathways process evaluation results: a school-based prevention trial to promote healthful diet and physical activity in American Indian third, fourth, and fifth grade students. Prev Med 37:S80-90
Caballero, Benjamin; Clay, Theresa; Davis, Sally M et al. (2003) Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren. Am J Clin Nutr 78:1030-8
Story, Mary; Stevens, June; Himes, John et al. (2003) Obesity in American-Indian children: prevalence, consequences, and prevention. Prev Med 37:S3-12
Going, Scott; Thompson, Janice; Cano, Stephanie et al. (2003) The effects of the Pathways Obesity Prevention Program on physical activity in American Indian children. Prev Med 37:S62-9

Showing the most recent 10 out of 35 publications