TY - JOUR
T1 - Promoting physical activity among native american youth
T2 - A systematic review of the methodology and current evidence of physical activity interventions and community-wide initiatives
AU - Fleischhacker, Sheila
AU - Roberts, Erica
AU - Camplain, Ricky
AU - Evenson, Kelly R.
AU - Gittelsohn, Joel
N1 - Funding Information:
Verma Walker was of great assistance to us on developing our systematic search process. Support for preliminary data gathering and analysis for this review was provided in part by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation (RWJF) (ID #66958); National Institutes of Health (NIH) University of North Carolina Interdisciplinary Obesity Training Grant (T 32 MH75854-03); and Kate B. Reynolds Charitable Trust (KBR).
Funding Information:
Specialized funding from government and non-government sources plays a critical role in supporting culturally appropriate research and evaluation of physical activity interventions and community-wide initiatives targeting Native youth. The National Institutes of Health (NIH) was the primary support for 15 interventions (75 %) [, , , –, , , , , , , , ]. Three of the remaining interventions acknowledged the Centers for Disease Control and Prevention (CDC) [], the Health Resources and Services Administration (HRSA) [], and the American Medical Association []. About half of the community-wide initiatives were supported by the CDC (n = 6; 46 %) [, , , , , ]; other funding sources acknowledged included the Indian Health Service (IHS) [], the NIH [, ], the US Department of Agriculture (USDA) [], state governmental agencies [, ], and foundations [, , ]. Future funding initiatives could focus on developing the next generation of American Indian and Alaska Native researchers and practitioners, ensuring strong skills in conducting community-based participatory research or tribally driven research models. Another potential funding area that could be stimulated and strengthened is multi-level, multi-sector interventions to promote physical activity among Native youth. A call for data on the cost-effectiveness of implementing and sustaining interventions and community-wide initiatives targeting physical activity among Native youth will be instrumental in encouraging tribal leaders to explore these types of strategies and in advancing our understanding of how to bring effective approaches to scale in Indian Country. Similarly, more work with tribal leaders will help advance our understanding of how to encourage them to use environmental, policy, and systems approaches to promote physical activity and address any specific data needs they have to make informed decisions on these matters.
Publisher Copyright:
© W. Montague Cobb-NMA Health Institute 2015.
PY - 2016/12
Y1 - 2016/12
N2 - Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.
AB - Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.
KW - Active living
KW - Alaskan Natives
KW - American Indians
KW - Exercise
KW - Obesity
KW - Physical activity
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U2 - 10.1007/s40615-015-0180-1
DO - 10.1007/s40615-015-0180-1
M3 - Article
C2 - 27294756
AN - SCOPUS:85019349651
SN - 2197-3792
VL - 3
SP - 608
EP - 624
JO - Journal of racial and ethnic health disparities
JF - Journal of racial and ethnic health disparities
IS - 4
ER -