Gittelsohn Joel, Jock Brittany, Redmond Leslie, Fleischhacker Sheila, Eckmann Thomas, Bleich Sara N, Loh Hong, Ogburn Elizabeth, Gadhoke Preety, Swartz Jacqueline, Pardilla Marla, Caballero Benjamin
Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
National Institute of Diabetes, Digestive and Kidney Diseases Office of Nutrition Research, Bethesda, USA.
BMC Public Health. 2017 Jan 23;17(1):105. doi: 10.1186/s12889-017-4018-0.
Obesity and other nutrition-related chronic disease rates are high in American Indian (AI) populations, and an urgent need exists to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component (MLMC) interventions are needed, but there are significant knowledge gaps on how to deliver these types of interventions in low-income rural AI communities.
OPREVENT2 is a MLMC intervention targeting AI adults living in six rural reservations in New Mexico and Wisconsin. Aiming to prevent and reduce obesity in adults by working at multiple levels of the food and physical activity (PA) environments, OPREVENT2 focuses on evidence-based strategies known to increase access to, demand for, and consumption of healthier foods and beverages, and increase worksite and home-based opportunities for PA. OPREVENT2 works to create systems-level change by partnering with tribal stakeholders, multiple levels of the food and PA environment (food stores, worksites, schools), and the social environment (children as change agents, families, social media). Extensive evaluation will be conducted at each level of the intervention to assess effectiveness via process and impact measures.
Novel aspects of OPREVENT2 include: active engagement with stakeholders at many levels (policy, institutional, and at multiple levels of the food and PA system); use of community-based strategies to engage policymakers and other key stakeholders (community workshops, action committees); emphasis on both the built environment (intervening with retail food sources) and the social environment. This paper describes the design of the intervention and the evaluation plan of the OPREVENT2.
Clinical Trial Registration: NCT02803853 (June 10, 2016).
美国印第安人群中肥胖及其他与营养相关的慢性病发病率很高，因此迫切需要确定基于证据的预防和治疗策略。需要采取多层次、多成分（MLMC）干预措施，但在如何在低收入农村美国印第安社区实施这类干预措施方面存在重大知识空白。
OPREVENT2是一项针对居住在新墨西哥州和威斯康星州六个农村保留地的美国印第安成年人的MLMC干预措施。OPREVENT2旨在通过在食物和身体活动（PA）环境的多个层面开展工作来预防和减少成年人肥胖，重点关注已知能增加健康食品和饮料的获取、需求及消费，并增加工作场所和家庭PA机会的循证策略。OPREVENT2通过与部落利益相关者、食物和PA环境的多个层面（食品店、工作场所、学校）以及社会环境（儿童作为变革推动者、家庭、社交媒体）合作，努力实现系统层面的变革。将在干预的每个层面进行广泛评估，以通过过程和影响指标评估有效性。
OPREVENT2的新颖之处包括：在多个层面（政策、机构以及食物和PA系统的多个层面）积极与利益相关者互动；使用基于社区的策略来吸引政策制定者和其他关键利益相关者（社区研讨会、行动委员会）；强调建筑环境（干预零售食品来源）和社会环境。本文描述了OPREVENT2的干预设计和评估计划。
临床试验注册：NCT02803853（2016年6月10日）。
