Targeting risk factors for type 2 diabetes in American Indian youth: the Tribal Turning Point pilot study

K. A. Sauder, D. Dabelea, R. Bailey-Callahan, S. Kanott Lambert, J. Powell, R. James, C. Percy, B. F. Jenks, L. Testaverde, J. M. Thomas, R. Barber, J. Smiley, C. W. Hockett, V. W. Zhong, L. Letourneau, K. Moore, A. M. Delamater, E. Mayer-Davis

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: American Indian (AI) youth are at high risk for type 2 diabetes. Objectives: To partner with Eastern Band of Cherokee Indians and Navajo Nation to develop a culturally sensitive behavioural intervention for youth (Tribal Turning Point; TTP) and assess feasibility in an 8-month randomized pilot study. Methods: We enrolled 62 overweight/obese AI children (7–10 years) who participated with ≥1 parent/primary caregiver. Intervention participants (n = 29) attended 12 group classes and five individual sessions. Control participants (n = 33) attended three health and safety group sessions. We analysed group differences for changes in anthropometrics (BMI, BMI z-score, waist circumference), cardiometabolic (insulin, glucose, blood pressure) and behavioural (physical activity and dietary self-efficacy) outcomes. Results: Study retention was 97%, and intervention group attendance averaged 84%. We observed significant treatment effects (p = 0.02) for BMI and BMI z-score: BMI increased in control (+1.0 kg m−2, p < 0.001) but not intervention participants (+0.3 kg m−2, p = 0.13); BMI z-score decreased in intervention (−0.17, p = 0.004) but not control participants (0.01, p = 0.82). There were no treatment effects for cardiometabolic or behavioural outcomes. Conclusions: We demonstrated that a behavioural intervention is feasible to deliver and improved obesity measures in AI youth. Future work should evaluate TTP for effectiveness, sustainability and long-term impact in expanded tribal settings.

Original languageEnglish (US)
Pages (from-to)321-329
Number of pages9
JournalPediatric Obesity
Issue number5
StatePublished - May 2018


  • American Indian
  • Native
  • behavioural research
  • obesity
  • paediatrics
  • prevention

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Health Policy
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health


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