1Johns Hopkins University, Baltimore, MD, USA.
Health Educ Behav. 2013 Oct;40(5):592-602. doi: 10.1177/1090198112467793. Epub 2012 Dec 13.
Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention-Healthy Foods North-was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two comparison communities) in Nunavut and the Northwest Territories, Canada, in 2008. The 12-month program was developed from theory (social cognitive theory and social ecological models), formative research, and a community participatory process. It included an environmental component to increase healthy food availability in local stores and activities consisting of community-wide and point-of-purchase interactive educational taste tests and cooking demonstrations, media (e.g., radio ads, posters, shelf labels), and events held in multiple venues, including recreation centers and schools. The intervention was evaluated using pre- and postassessments with 246 adults from intervention and 133 from comparison communities (311 women, 68 men; mean age 42.4 years; 78.3% retention rate). Outcomes included psychosocial constructs (healthy eating knowledge, self-efficacy, and behavioral intentions), frequency of healthy and unhealthy food acquisition, healthiness of commonly used food preparation methods, and body mass index (kg/m(2)). After adjustment for demographic, socioeconomic status, and body mass index variables, respondents living in intervention communities showed significant improvements in food-related self-efficacy (β = 0.15, p = .003) and intentions (β = 0.16, p = .001) compared with comparison communities. More improvements from the intervention were seen in overweight, obese, and high socioeconomic status respondents. A community-based, multilevel intervention is an effective strategy to improve psychosocial factors for healthy nutritional behavior change to reduce chronic disease in indigenous Arctic populations.
在加拿大北极地区的土著人群中，与饮食相关的慢性病发病率很高。为了改善因纽特人和因努伊特人在食物相关的心理社会因素和行为，2008 年在加拿大努纳武特地区和西北地区的四个干预社区（有两个对照社区）实施了一项以社区为基础、多机构的营养和生活方式干预措施，即“健康食物北极项目”。该 12 个月的项目是从理论（社会认知理论和社会生态模型）、形成性研究和社区参与过程中发展而来的。它包括一个环境组成部分，旨在增加当地商店中健康食品的供应，以及开展社区范围和购买点的互动式教育品尝测试和烹饪示范、媒体（如广播广告、海报、货架标签）以及在多个场所（包括娱乐中心和学校）举办的活动。该干预措施通过对干预社区的 246 名成年人和对照社区的 133 名成年人进行了预评估和后评估，其中包括 311 名女性和 68 名男性，平均年龄为 42.4 岁，保留率为 78.3%。结果包括心理社会结构（健康饮食知识、自我效能和行为意向）、健康和不健康食品的获取频率、常用食品制备方法的健康程度以及体重指数（kg/m(2)）。在调整了人口统计学、社会经济地位和体重指数变量后，与对照社区相比，生活在干预社区的受访者在与食物相关的自我效能（β=0.15，p=0.003）和意向（β=0.16，p=0.001）方面有显著改善。在超重、肥胖和高社会经济地位的受访者中，干预措施的效果更为明显。基于社区的多层次干预措施是改善健康营养行为改变的心理社会因素，以减少土著北极人口慢性病的有效策略。
