AI/AN Review

The articles listed in the table below are from a review of literature inclusive of AI/AN populations or sample sizes for studies looking at policy, system or environmental change policies related to obesity prevention. A total of ten articles were found that included AI/AN in sample size. Links to the articles are included in the table.

Obesity Prevention and Control: Intervention in Community Settings

Community Guide Recommended Strategy: Worksite Programs

(Recommended by Community Guide February 2007)
**No articles from the Community Guide review discussed AI/AN**
Additional Articles Found by Experts in AAIP Review
Thompson, J L (2002). "Environmental, policy, and cultural factors related to physical activity in sedentary American Indian women".Women & health (0363-0242), 36 (2), p. 59
Study Design Study Site Study Information Conclusions
Focus Group Analysis Worksites and Community

Enablers
i. Support from family, coworkers, and participation in traditional community events

Barriers
i. Inadequate support for childcare and household responsibilities
ii. Difficulties balancing home and societal expectations with physical activity
iii. Little support from worksites and communities
iv. Environmental barriersv. Socio-cultural barriers

Intervention suggestions
i. Compatible with role expectations of family and community
ii. Emphasis from community on physical activity
iii. Incorporate needs of larger women and their families
iv. Acceptance and encouragement to be active from family, community, worksite, and Tribal leaders. 
Wynd, C. A., & Ryan-Wenger, N. A. (2004). Factors predicting health behaviors among Army Reserve, active duty Army, and civilian hospital employees. Military Medicine, 169(12), 942-947.
Study Design Study Site Study Information Study Conclusions
Comparedactive duty, reserve, and civilian personnel Employees of hospitals  Included AI/AN (1%) but did not discuss results specifically for AI/AN   Organizational workplace cultures were inconsistent predictors of health Self-motivation and social support were important indicators of adopting health-promoting behaviors 
Lusk, P., & Holst, P. (2001). Occupational health nursing with Navajo workers: providing culturally competent care. AAOHN Journal, 49(1), 27-34.
Review article on occupational health nursing, not a research article

Obesity Prevention and Control: Intervention in Community Settings

Community Guide Recommended Strategy: Multi-component coaching or counseling interventions

(Recommended by Community Guide June 2009)

Articles Included in the Community Guide review
Bond, G. E., Burr, R., Wolf, F. M., Price, M., McCurry, S. M. & Teri, L. (2007) The effects of a web-based intervention on the physical outcomes associated with diabetes among adults age 60 and older: a randomized trial. Diabetes Technol Ther, 9, 52-9.
Study Design Study Site Study Information Conclusions
Randomized control Trial Washington State Included American Indians but did not discuss in text. Randomized controlled trial testing a web-based intervention plus usual care v. usual care alone among adults 60 years and older with diabetes  Intervention group had significant reductions in diabetes indicators than usual care group.  
Additional Articles Found by Experts in AAIP Review
Henderson, J. A., Chubak, J., O'Connell, J., Ramos, M. C., Jensen, J., Jobe, J. B., et al. (2012). Design of a randomized controlled trial of a web-based intervention to reduce cardiovascular disease risk factors among remote reservation-dwelling American Indian adults with type 2 diabetes. [Randomized Controlled Trial Research Support, N.I.H., Extramural]. Journal of Primary Prevention, 33(4), 209-222.
Study Design Study Site Study Information Study Conclusions
Randomized Control Trial  Lakota Oyate Wicozani Pi Kte (LOWPK) Trial   Included reservation-dwelling adult AI men and women with type 2 diabetes and high risk for cardiovascular disease. Web-based diabetes and nutritional intervention and risk factors related to cardiovascular diseasewere important indicators of adopting health-promoting behaviors  This article discusses the design and methods of the trial, no results to date. 
Mah, S. S. (2011). A Case Study of Telehealth Usage in Three First Nation Communities: Understanding the Role of Technology Users in Health Care Practice. Unpublished Ph.D., University of Calgary (Canada), Ann Arbor.
Study Design Study Site Study Information Study Conclusions
 Doctoral thesis  First Nations Communities in Canada Focuses on use of tele-health in 3 First Nations communities in Canada  In general, there were several factors associated with a negative perception of tele-health, including negative human factors, space, and technology
Bantum, E., Layi, G., Albright, C., Berenberg, J., & Vogel, C. (2009). Formative study using multi-ethnic health care providers and cancer survivors to determine interest and viability of an online intervention to modify lifestyle factors. [Conference Abstract]. Psycho-Oncology, 18, S38-S39.
Study Design Study Site Study Information Study Conclusions
Focus group analysis  Hawaii 4% AI/AN, set in Hawaii Focus group analysis for interest in an online health behavior change intervention for cancer survivors and health care professionals Diet, exercise and coping with stress were common health behavior topics that survivors and health care providers preferred in a web-based program. 

Increasing Physical Activity: Environmental and Policy Approaches to Promote Physical Activity

Community Guide Recommended Strategy: Community-Scale and Land Use Policies

(Recommended by Community Guide June 2004)
**No articles from the Community Guide review discussed AI/AN**
Additional Articles Found by Experts in AAIP Review
No Articles were found relating to Community-Scale and Land Use Policies with AI/AN communities as participants

Increasing Physical Activity: Environmental and Policy Approaches to Promote Physical Activity

Community Guide Recommended Strategy - Creation of enhanced Access to Places for Physical Activity Combined with Informational Outreach Activities

**No articles from The Community Guide review discussed AI/AN**
Additional Articles Found by Experts in AAIP Review
Davis, S. M., Lambert, L. C., Gomez, Y., & Skipper, B. (1995). Southwest Cardiovascular Curriculum Project: Study Findings for American Indian Elementary Students. Journal of Health Education, 26(sup2), S72-S81
Study Design Study Site Study Information Conclusions
School-based health program  Navajo and Pueblo Reservations in New Mexico 

11 elementary schools on or near reservations, rural

Intervention was curriculum that focused on increasing knowledge and health behavior change related to cardiovascular health. It included the cardiovascular system, exercise, nutrition, obesity, tobacco use, habit change, and social influence

Improvements among children in curriculum group for diet (salt, butter), smoking, smokeless tobacco, increased exercise 
Mobley, L. R., Root, E. D., Finkelstein, E. A., Khavjou, O., Farris, R. P., & Will, J. C. (2006). Environment, obesity, and cardiovascular disease risk in low-income women. Am J Prev Med, 30(4), 327-332.
Study Design Study Site Study Information Conclusions
Survey  CDC 

Women enrolled in the WISEWOMAN

Assessed whether aspects of the built environment are associated with obesity or coronary heart disease risk among uninsured low-income women

 Living in a more racially segregated neighborhood was positively associated with CHD risk in AI women 

Increasing Physical Activity: Environmental and Policy Approaches to Promote Physical Activity

Street Scale Urban Design Land Use Policies

(Recommended by Community Guide June 2004)
**No articles from the Community Guide review discussed AI/AN**
Additional Articles Found by Experts in AAIP Review
No Articles were found relating to Community-Scale and Land Use Policies with AI/AN communities as participants

Increasing Physical Activity: Environmental and Policy Approaches to Promote Physical Activity

Transportation and Travel Policies and Practices

(Recommended by Community Guide June 2004)

**No articles from the Community Guide review discussed AI/AN**
Additional Articles Found by Experts in AAIP Review
Sanchez, T. W., Stolz, R., & Ma, J. S. (2003). Moving to Equity: Addressing Inequitable Effects of Transportation Policies on Minorities. Cambridge, MA: The Civil Rights Project of Harvard University.
Study Design Study Site Study Information Study Conclusions
Review Discussion  Examples of how transportation decisions can affect minority communities Example in AI/AN – road construction threatens a sacred site outside of Albuquerque, NM 

Increasing Physical Activity: Environmental and Policy Approaches to Promote Physical Activity

Point-of-Decision Prompts to Encourage Use of Stairs

(Recommended by Community Guide June 2004)
**No articles from the Community Guide review discussed AI/AN**
Additional Articles Found by Experts in AAIP Review
No Articles were found with AI/AN communities as participants
Review article on occupational health nursing, not a research article

Increasing Physical Activity: Environmental and Policy Approaches to Promote Physical Activity

Community Wide Campaigns to Increase Physical Activity

(Recommended by Community Guide June 2004)
**No articles from the Community Guide review discussed AI/AN**
Additional Articles Found by Experts in AAIP Review
Pigford, A. A., Willows, N. D., Holt, N. L., Newton, A. S., & Ball, G. D. (2012). Using first nations children's perceptions of food and activity to inform an obesity prevention strategy. Qualitative Health Research, 22(7), 986-996.
Study Design Study Site Study Information Study Conclusions
Focus Group interviews of 4th and 5th graders First Nation’s community  Children preferred foods and activities from both Western and traditional cultures, family members were primary source of health information, they had gaps in their level of health education   Next steps are developing an obesity program for First Nations children. 
Henderson, K. A., & Ainsworth, B. E. (2000). Enablers and constraints to walking for older African American and American Indian women: the Cultural Activity Participation Study. Res Q Exerc Sport, 71(4), 313-321.
Study Design Study Site Study Information Study Conclusions
    Purpose to determine factors that prevented African Americans and American Indians from walking, along with what conditions enabled walking in this group. Themes that emerged were the context of walking, how walking was enabled, and constraints to walking more or achieving greater satisfaction with walking as a physical activity