Redmond Leslie C, Jock Brittany, Gadhoke Preety, Chiu Dorothy T, Christiansen Karina, Pardilla Marla, Swartz Jacqueline, Platero Harrison, Caulfield Laura E, Gittelsohn Joel
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
University of Alaska Anchorage, School of Allied Health, Dietetics and Nutrition Department, Anchorage, AK.
Curr Dev Nutr. 2019 Feb 13;3(Suppl 2):81-93. doi: 10.1093/cdn/nzz009. eCollection 2019 Aug.
Obesity prevalence is high in Native American (NA) adults, and there is a critical need to establish and implement evidence-based social, behavioral, and policy interventions that are theoretically informed. The use of multilevel, multicomponent (MLMC) interventions has been shown to be an effective strategy for comprehensive health behavior change; however, there is little guidance available in the literature to facilitate implementation in this underserved and understudied population. To decrease obesity and related comorbidities in NA adults, an MLMC intervention called OPREVENT (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans) was implemented in 5 rural NA communities to modify the food-purchasing environment, improve diet, and increase physical activity (PA). Five NA communities across the Upper Midwest and Southwest United States were randomly assigned to Immediate ( = 3) or Delayed ( = 2) Intervention. OPREVENT was implemented in Immediate Intervention community food stores, worksites, schools, and media over 1 y. A community-randomized controlled trial was used to evaluate intervention impact in adults at the individual and institutional levels, with individual-level data being collected on diet, PA, and psychosocial variables at baseline and follow-up; and institutional-level data being collected on food stores, worksites, and schools, media, and process measures. The OPREVENT intervention was one of the first MLMC obesity interventions in this population and provides evidence-based practices for future program development. The purpose of this article is to describe the design, implementation, and evaluation of OPREVENT. This trial was registered at isrctn.com as ISRCTN76144389.
美国原住民（NA）成年人的肥胖患病率很高，因此迫切需要建立并实施基于证据的、有理论依据的社会、行为和政策干预措施。多层次、多成分（MLMC）干预措施已被证明是促进全面健康行为改变的有效策略；然而，文献中几乎没有可用的指导来促进在这个服务不足且研究较少的人群中实施此类干预。为了降低NA成年人的肥胖率及相关合并症，一项名为OPREVENT（北美原住民肥胖预防与干预效果评估）的MLMC干预措施在5个农村NA社区实施，以改变食品购买环境、改善饮食并增加身体活动（PA）。美国中西部上游和西南部的5个NA社区被随机分配到立即干预组（n = 3）或延迟干预组（n = 2）。OPREVENT在立即干预社区的食品商店、工作场所、学校和媒体中实施了1年。采用社区随机对照试验在个体和机构层面评估干预效果，在基线和随访时收集个体层面的饮食、PA和心理社会变量数据；并收集食品商店、工作场所、学校、媒体和过程指标的机构层面数据。OPREVENT干预是该人群中首批MLMC肥胖干预措施之一，为未来项目开发提供了循证实践。本文旨在描述OPREVENT的设计、实施和评估。该试验在isrctn.com上注册为ISRCTN76144389。
