Pathways: a school-based program for the primary prevention of obesity in american indian children

Abstract

This report describes the proposed intervention and outcome measurement procedures for the Pathways study. Pathways is a multicenter school-based study aimed at reducing the alanning increase in the prevalence of obesity in American Indian children. It is designed as a randomized clinical trial, involving approximately 2,00 third grade children in 40 schools in seven diferent American Indian communities. During a 3-year feasibility phase, which was just completed, the major components of the intervention (school food service, classroom curriculum, physical education program, and family involvement) were developed and pilot-tested. The measurement instruments for body composition; physical activity; dietary intake; and knowledge, attitudes, and behavior were also developed and validated. Comprehensive process evaluation procedures also were defined. As of this writing, thefull-scale intervention program is being initiated and is scheduled to be completed in the spring of 200. The primary aim of the Pathways intervention is to reduce average percent body fat in intervention-school children by at least 3% compared with control-school children by the end of the 3-year intervention. This goal is to be achieved primarily by an increase in physical activity and a reduction in the perceni of dietary fat intake. The program does not seek to reduce dietary energy intake. Rather, it is based on the assumption that a healthier; lower-fat diet, combined with an increase in energy expenditure by increased physical activity, will result in fewer excess calories deposited as body fat.

Does the Metabolically Healthy Obese Phenotype Protect Adults with Class III Obesity from Biochemical Alterations Related to Bone Metabolism?

“…Anthropometric, clinical, and biochemical parameters were evaluated to characterize the sample and analyze the association among the markers of bone metabolism (regardless they are nutrients or not) with metabolic and bodily variables, according to MHO and MUHO classification. The anthropometric evaluation included the measurement of weight (using a Welmy ® electronic platform scale with maximum weighing capacity of 300 kg, São Paulo, Brazil) and height (using a Sany ® stadiometer, São Paulo, Brazil) for BMI calculation according to the World Health Organization (WHO) [18]; waist circumference (WC) was measured based on Lohman et al [19] with cutoff points according to the NCEP ATP III [14], and the visceral adiposity index (VAI) was calculated according to Amato et al [20]. All measurements were performed in duplicate by a single trained observer, variations up to 0.5 cm were accepted, and the mean was calculated.…”

Cultural adaptation of health interventions including a nutrition component in Indigenous peoples: a systematic scoping review

“…The majority of interventions were conducted in the USA among Native American ( n = 27 ) [ 28 , 32 , 33 , 37 , 38 , 42 , 43 , 46 , 48 , 50 , 52 , 56 – 58 , 61 – 63 , 65 , 70 , 72 – 74 , 82 , 83 , 87 , 89 , 92 ], Alaskan ( n = 4 ) [ 47 , 64 , 75 , 93 ] & Hawaiian ( n = 2 ) [ 54 , 71 ] populations. Together with Australian Aboriginal and/or Torres Strait Islander ( n = 14 ) [ 27 , 29 – 31 , 40 , 44 , 51 , 68 , 78 , 80 , 85 , 86 , 88 , 91 ] and Canadian First Nations People ( n = 11 ) [ 35 , 36 , 41 , 45 , 49 , 55 , 67 , 69 , 76 , 84 , 90 ] these three groups accounted for 85% of the literature included in this review.…”

“…Most interventions were designed for adults ( n = 29 ) [ 27 , 28 , 36 , 39 , 40 , 42 , 46 , 51 – 54 , 58 , 60 – 63 , 66 , 71 , 74 – 77 , 80 , 81 , 83 , 85 – 87 , 91 ], with less than a third ( n = 19 ) [ 29 – 31 , 34 , 35 , 38 , 44 , 47 , 48 , 50 , 59 , 65 , 68 , 69 , 73 , 78 , 79 , 88 , 90 ] designed for both adults and children. Most interventions aimed to change health outcomes for diabetes prevention ( n = 19 ) [ 27 , 28 , 36 , 38 , 44 , 55 , 56 , 60 , 62 , 67 , 69 , 70 , 79 , 81 , 82 , 88 , 89 , 92 , 93 ], obesity prevention or treatment ( n = 11 ) [ 32 , 34 , 42 , 50 , 57 , 59 , ...…”

“…Two studies each employed community only [ 43 , 90 ], system only [ 35 , 57 ] and individual plus system [ 39 , 91 ] level interventions. Seven interventions aimed to influence all three levels [ 30 – 32 , 45 , 69 , 81 , 89 ]. Most interventions ( n = 56) [ 28 , 30 – 39 , 41 – 50 , 52 – 59 , 61 , 63 – 69 , 77 , 80 , 81 , 83 – 87 , 90 – 92 ] cited formative research.…”

A Pragmatic Review to Assist Planning and Practice in Delivering Nutrition Education to Indigenous Youth

“…Moreover, the guides (and associated programs) mainly target canteen provisions, dedicating only a small proportion of their information to nutrition education. Such educational programs have been developed as part of trials of obesity prevention with American Indian children in the US as part of a multi-faceted interventions, with the investigators emphasising Indigenous learning modes that included learning through observation and practice, learning from storytelling, learning metaphorically, holistic learning, learning by trial and error, learning through play, learning cooperatively, and learning through reflection [73].…”