Developing and piloting the Journey to Native Youth Health program in Northern Plains Indian communities.

PURPOSE: The purpose of this study was to develop a lifestyle change program for Native American youth by modifying the Diabetes Prevention Program (DPP) and assess implementation indicators and short term behavioral and physiological outcomes of the intervention among a small pilot sample. METHODS: Community members and project staff modified the original DPP to be developmentally and culturally appropriate for youth targeting healthy weight maintenance, lowering fat intake, and increasing physical activity. Modifications included incorporating cultural aspects and delivering the program in small groups led by community members. Sixty-four Native American youth, aged 10-14 years old were recruited from 2 Montana Indian reservations to participate in the project, titled "Journey to Native Youth Health." Participants were randomized to the Journey DPP or a health-oriented comparison condition. Pretest and posttest measures included body mass index (BMI), dietary intake, physical activity (PA), and nutrition knowledge, attitudes and beliefs (KAB). RESULTS: The target number of participants was recruited and 84% completed the program and final measures. Changes favoring the Journey DPP group were observed on measures of PA, KAB, and kilocalories from fat consumed. As expected given the short (3-month) duration of treatment, there was no overall effect on BMI at end of treatment. Among youth who were overweight or obese at baseline, however, the Journey DPP had lower BMI growth. CONCLUSIONS: Results suggest the Journey DPP is feasible to implement and has the potential to impact behaviors and weight gain associated with risk for type-2 diabetes in Native American youth.

Parental influence on obesity in Northern Plains American Indian youth.

Little is known regarding American Indian (AI) parental influence on children's diet and physical activity (PA), or if this influence is associated with childhood weight. We compared AI parents' diet, PA, and support for these behaviors with the child's body mass index. Scores for parental support of positive PA and diet were higher among parents of overweight/obese children. Parent PA and nutrition behaviors were in a similar, but not significant, direction with respect to child body mass index. Findings suggest that future research is needed to determine what parental, societal, or community variables influence AI children to engage in healthy eating and PA, especially if they are overweight or obese, and the age at which these variables would have the most impact on these behaviors.

Acanthosis nigricans among Northern Plains American Indian children.

The purpose of this study is to present cross-sectional and prospective data on acanthosis nigricans (AN) prevalence in the context of other risk factors for diabetes including high body mass index (BMI), abnormal blood pressure (BP), physical inactivity and family history of diabetes among Northern Plains American Indian (AI) children. Standardized health measures were collected in 2,520 K-12th-grade AI students for AN, BMI, and BP. Data were also collected on family history of diabetes and physical activity. Approximately, 9.7% of the participants were positive for AN. AN was associated with high BMI, abnormal BP, and diabetes family history. Sports participation was inversely associated with AN. Among children measured the prior year, relative risk (and 95% confidence interval [CI]) for obesity and incident AN was 9.8 (4.2-23.0) compared to normal weight. These findings suggest there is utility in measuring this marker of insulin resistance in this at-risk population.