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Spurr S, Burles M, Hyslop S, Bally J, Bullin C, Froehlich Chow A, Tootoosis H, Oosman S. Preventing type 2 diabetes among Indigenous youth: A systematic review of community-based interventions. Int J Circumpolar Health 2024; 83:2320449. [PMID: 38412067 PMCID: PMC10901188 DOI: 10.1080/22423982.2024.2320449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024] Open
Abstract
A systematic review was conducted to assess evidence on effectiveness of community-based interventions promoting wellbeing and prevention of type 2 diabetes (T2D) among Indigenous youth. A convergent, segregated, mixed methods approach was used, with six databases and four grey literature sites searched from inception to May 2022. Articles selected for inclusion were about community-based interventions related to T2D prevention with Indigenous youth that evaluated effectiveness or youth experience published in English. Reference lists were also searched for relevant sources. Seven quantitative research articles met the inclusion and quality assessment criteria. No qualitative articles were identified. The results were synthesised through narrative analysis, while meta-analysis was not possible due to heterogenous study designs. Common foci across interventions included promoting physical wellness, improving physical activity and healthy eating patterns, enhancing knowledge, and psychosocial wellness. Interventions deemed effective addressed multiple areas, were school-based, and operated for at least a year. Findings support multi-strategy, community-based interventions implemented over longer periods of time. However, gaps in research and reporting included the extent to which interventions are culturally informed and based on community-driven priorities. Future research should include Indigenous, mixed and qualitative methods and Indigenous-driven measures of success to better understand effectiveness in alignment with Indigenous worldviews.
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Affiliation(s)
- Shelley Spurr
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Meridith Burles
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Shannon Hyslop
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jill Bally
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Carol Bullin
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Amanda Froehlich Chow
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Helen Tootoosis
- Indigenous Liaison Advisor for Saskatchewan, Statistics Canada, Saskatchewan, Canada
| | - Sarah Oosman
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Gachupin FC, Caston E, Chavez C, Bernal J, Cager P, Harris D, John T, Remitera J, Garcia CA, Romero VM, Gchachu KE, Gchachu CR, Garcia K, Gchachu V, Gchachu BM, Rens E, Slowtalker J, Blew R, Tracy K, Figueroa T, Thomson CA, Ranjbar N, Hingle M, O’Connor T, Roe DJ, Grant V, Swick S, Joe JR. Primary Disease Prevention for Southwest American Indian Families During the COVID-19 Pandemic: Camp in a Box. FRONTIERS IN SOCIOLOGY 2021; 6:611972. [PMID: 33869562 PMCID: PMC8022461 DOI: 10.3389/fsoc.2021.611972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
The goal of the American Indian Youth Wellness Camp in a Box was to engage, educate and empower families to improve their health and overall well-being during the COVID-19 pandemic. Camp in a Box was a 9-week program, inclusive of a 1-week intensive camp component followed by an 8-week booster component with content focused on nutrition, mental health and physical activity education. The Camp in a Box is a Tribal/Urban Indian-University partnership, and materials were developed to replace an existing weeklong residential camp and to comply with social distancing guidelines. Fourteen American Indian families from Tribal/Urban Indian communities in the southwestern United States participated (36 children aged 2-18 years; 32 adults). The intensive camp week included daily materials for families to complete together, Monday through Friday. Materials were provided for approximately 4 h of activities per day. The booster sessions began after camp week and included approximately 4 h of supplementary activities designed to be completed at any time most convenient for the family over the course of the week. Activities were designed to encourage interaction among family members with materials and supplies for parents and youth to participate. Self-reported outcomes suggested that families changed their eating habits to include more vegetables, less sweets and junk food. Parents reported an increase in family physical activity and that the activities brought the family closer together. Our Camp in a Box program was feasible and well-received until school began. During camp week, 100% of recruited families participated; at Booster Week 8, ten families (71%) remained enrolled and active. Camp in a Box is a feasible alternative to residential camps for promotion of health behaviors associated with metabolic disease prevention among American Indian families. In contrast to residential camps for youth, Camp in a Box offers an opportunity to engage the entire family in health promotion activities.
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Affiliation(s)
- Francine C. Gachupin
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
- University of Arizona Cancer Center, Tucson, AZ, United States
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Evelyn Rens
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Jacquanette Slowtalker
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
- University of Arizona Cancer Center, Tucson, AZ, United States
| | - Robert Blew
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Keyauni Tracy
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
- University of Arizona Cancer Center, Tucson, AZ, United States
| | - Ty Figueroa
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Cynthia A. Thomson
- University of Arizona Cancer Center, Tucson, AZ, United States
- Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Noshene Ranjbar
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Melanie Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Teresia O’Connor
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Denise J. Roe
- University of Arizona Cancer Center, Tucson, AZ, United States
- Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Vernon Grant
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, United States
| | - Shayna Swick
- University of Arizona, Tucson, AZ, United States
| | - Jennie R. Joe
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
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Ducharme-Smith K, Chambers R, Garcia-Larsen V, Larzelere F, Kenney A, Reid R, Nelson L, Richards J, Begay M, Barlow A, Rosenstock S. Native Youth Participating in the Together on Diabetes 12-Month Home-Visiting Program Reported Improvements in Alternative Healthy Eating Index-2010 Diet Quality Domains Likely to Be Associated With Blood Pressure and Glycemic Control. J Acad Nutr Diet 2021; 121:1125-1135. [PMID: 33547030 DOI: 10.1016/j.jand.2020.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 12/08/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Together on Diabetes (TOD) intervention was a home-visiting diabetes prevention and management program for Native youth. OBJECTIVES (1) Examine the impact of the TOD program on diet quality using the Alternative Healthy Eating Index (AHEI-2010); (2) determine association between diet quality and cardiometabolic health. DESIGN The TOD program was conducted from October 2012 to June 2014 and was evaluated using a pretest-posttest study design from baseline to 12 months. Dietary intake was assessed using a food frequency questionnaire. PARTICIPANTS/SETTING There were 240 participants between 10 and 19 years of age from 4 reservation-based, rural tribal communities in the southwestern United States that had been diagnosed with T2DM or prediabetes or were identified as at risk based on body mass index and a qualifying laboratory test. INTERVENTION Youth were taught a 12-lesson curriculum on goal setting, nutrition, and life skills education. MAIN OUTCOME MEASURES Behavioral and physiologic outcomes related to diabetes. STATISTICAL ANALYSIS Changes in AHEI-2010 score and associations with cardiometabolic measures were tested, over time, using adjusted longitudinal linear mixed-effects models. RESULTS The study sample reported an average energy intake of 2016 kcal/d (±1260) and AHEI-2010 score of 47.4 (±7.4) (range: 0-110, higher = better diet quality), indicating low diet quality at baseline. At 12 months' follow-up, there was a reduction in kilocalories (mean = -346 kcal/d; P < .001), sugar-sweetened beverages (mean = -2 fluid oz/d; P = .032), red/processed meat (mean = -1.5 oz/d; P = .008), and sodium (mean = -650 mg/d; P < .001) but no change in AHEI-2010 score (P = .600). The change in systolic blood pressure from baseline to 12 months for participants within the highest AHEI-2010 quartile group was significantly larger than the change in participants within the lowest quartile group (mean = -5.90 mm Hg; P = .036). CONCLUSIONS Despite stable AHEI-2010 scores during follow-up, there were improvements in diet quality domains likely to be associated with cardiometabolic health. Home-visiting programs like TOD are promising interventions for decreasing dietary intake of poor-quality foods.
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