@article{2ea4391083b74c849a7582bbebca60cf,
title = "Targeting risk factors for type 2 diabetes in American Indian youth: the Tribal Turning Point pilot study",
abstract = "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.",
keywords = "American Indian, Native, behavioural research, obesity, paediatrics, prevention",
author = "Sauder, {K. A.} and D. Dabelea and R. Bailey-Callahan and {Kanott Lambert}, S. and J. Powell and R. James and C. Percy and Jenks, {B. F.} and L. Testaverde and Thomas, {J. M.} and R. Barber and J. Smiley and Hockett, {C. W.} and Zhong, {V. W.} and L. Letourneau and K. Moore and Delamater, {A. M.} and E. Mayer-Davis",
note = "Funding Information: The authors thank the participants, staff and members of Eastern Band Cherokee and Navajo Nation for their dedicated contribution to this work. The authors also thank Drs. William Knowler, Madhumita Sinha and Sayuko Kobes for their assistance in interpreting the results. This work was supported by the NIH (R34DK096403, P30DK56350, P30DK092923). K.A.S. was supported by an NIH post-doctoral institutional training grant to the University of Colorado (T32DK07658). V.W.Z. was supported by the Sanofi Global Nutrition Scholars program at UNC Gillings School of Public Health. Contents are the authors{\textquoteright} sole responsibility and do not necessarily represent official NIH views. The funders had no role in the design, conduct or reporting of this work. D.D. and E.M.D. designed the research. R.B.C., S.K.L., J.P., R.J., C.P., B.F.J., L.T., J.M.T., R.B., J.S., C.W.H., L. L., K.M. and A.M.D. contributed to the study design and implementation. K.A.S. and V.W.Z. analysed the data. K.A.S. drafted the first version of the manuscript. All authors interpreted the results, were involved in writing the paper and had final approval of the submitted and published versions. Funding Information: The authors thank the participants, staff and members of Eastern Band Cherokee and Navajo Nation for their dedicated contribution to this work. The authors also thank Drs. William Knowler, Madhumita Sinha and Sayuko Kobes for their assistance in interpreting the results. This work was supported by the NIH (R34DK096403, P30DK56350, P30DK092923). K.A.S. was supported by an NIH post-doctoral institutional training grant to the University of Colorado (T32DK07658). V.W.Z. was supported by the Sanofi Global Nutrition Scholars program at UNC Gillings School of Public Health. Contents are the authors' sole responsibility and do not necessarily represent official NIH views. The funders had no role in the design, conduct or reporting of this work. D.D. and E.M.D. designed the research. R.B.C., S.K.L., J.P., R.J., C.P., B.F.J., L.T., J.M.T., R.B., J.S., C.W.H., L.L., K.M. and A.M.D. contributed to the study design and implementation. K.A.S. and V.W.Z. analysed the data. K.A.S. drafted the first version of the manuscript. All authors interpreted the results, were involved in writing the paper and had final approval of the submitted and published versions.",
year = "2018",
month = may,
doi = "10.1111/ijpo.12223",
language = "English (US)",
volume = "13",
pages = "321--329",
journal = "Pediatric obesity",
issn = "2047-6302",
publisher = "Wiley-Blackwell for the International Association for the Study of Obesity",
number = "5",
}