1 Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
2 Choctaw Nation of Oklahoma, Durant, OK, USA.
Clin Trials. 2019 Aug;16(4):391-398. doi: 10.1177/1740774519839066. Epub 2019 Apr 3.
The prevalence and socioeconomic burden of childhood obesity and diabetes has increased rapidly in the United States in the last 30 years. American Indians have the highest prevalence of type 2 diabetes among newly diagnosed youth in the country. Contributing factors include environmental, behavioral, and genetic components. Some American Indian tribal communities have explored innovative ways to combat this epidemic including collaborations with academic centers on community-based research.
From 2012 to 2017, the University of Oklahoma Health Science Center and the Choctaw Nation of Oklahoma partnered on a National Institutes of Health-funded project to determine if financial incentives would elicit an increase in physical activity in Native youth. This was a community-based behavioral intervention for overweight or obese American Indian youth ages 11-20 living in a rural community at risk for developing diabetes.
Tribal leaders and staff identified culturally appropriate strategies to aid implementation of the trial in their community. Their identified implementation strategies helped standardize the study in order to maintain study integrity. The mutually agreed strategies included co-review of the study by tribal and University research review boards (but designation of the Choctaw Nation review board as the "Board of Record"), training of community-based staff on research ethics and literacy, standardization of the informed consent process by videotaping all study information, creation of a viable and culturally appropriate timeline for study implementation, adapting tribal wellness center operations to accommodate youth, and development of effective two-way communication through training sessions, on-site coordination, and bi-monthly conference calls.
In an effort to partner collectively on a randomized clinical research trial to combat childhood diabetes, tribal leaders and staff implemented strategies that resulted in a culturally appropriate and organized community-based behavioral intervention research project.
在过去的 30 年里，美国儿童肥胖症和糖尿病的患病率和社会经济负担迅速增加。在美国，新诊断的青少年中，美洲印第安人 2 型糖尿病的患病率最高。促成因素包括环境、行为和遗传因素。一些美洲印第安部落社区探索了创新的方法来对抗这一流行病，包括与学术中心合作进行基于社区的研究。
从 2012 年到 2017 年，俄克拉荷马大学健康科学中心和 Choctaw 族的俄克拉荷马州合作开展了一项由美国国立卫生研究院资助的项目，以确定经济激励是否会增加美国印第安青年的体育活动。这是一项针对居住在农村社区、有患糖尿病风险的超重或肥胖的美洲印第安青年的基于社区的行为干预措施。
部落领导人及工作人员确定了文化上适当的策略，以帮助在其社区实施试验。他们确定的实施策略有助于规范研究，以保持研究的完整性。双方同意的策略包括由部落和大学研究审查委员会共同审查研究（但指定 Choctaw 族审查委员会为“记录委员会”）、对社区工作人员进行研究伦理和读写能力培训、通过录制所有研究信息使知情同意过程标准化、制定可行且文化上适当的研究实施时间表、调整部落健康中心的运作以适应青年、并通过培训课程、现场协调和双月电话会议进行有效的双向沟通。
为了在一项针对儿童糖尿病的随机临床试验中合作，部落领导人和工作人员实施了策略，从而开展了一项文化上适当和有组织的基于社区的行为干预研究项目。
