Yappalli - The Road to Choctaw Health

Summary

This is an obesity and alcohol, tobacco, and other drug (ATOD) use risk prevention and health leadership program. This project will include 150 at-risk adult Native women across 5 communities (30 women from each community) in the Choctaw Nation of Oklahoma. The intervention targets individual behavioral change relative to ATOD and obesity prevention and simultaneously provides behavioral skills for health promotion leadership.

Investigators will conduct a longitudinal study using a cluster randomized stepped-wedge design to evaluate the intervention impact on ATOD and obesity prevention primary aims of: (1) substance use harm reduction and ATOD use and intentions to use; and (2) reduction in weight/body mass index (BMI) and increase in leisure-time physical activity/physical activity (LTPA/PA) and healthful food habits. Specifically, investigators will ask participants to participate in up to eight group sessions (based on a curriculum drawing on cultural teachings around health and behavioral change); attend up to three Motivational Interviewing individual sessions (to identify individual behavioral change goals); attend a two-day overnight culture and Trail prep camp; participate in camping and walking for up to 10 days on the Trail; and attend up to six post-walk meetings (to develop community health events). All five communities will also be asked to complete a baseline health assessment as well as three follow up assessments over the course of the year. Additionally, communities 2-5 will participate in three pre-intervention health assessments. This intervention integrates components of motivational interviewing, information-motivation-behavior, and a leadership development framework for adults. It targets individual behavioral change relative to ATOD and obesity prevention and simultaneously provides behavioral skills for health promotion leadership within their respective communities.The project addresses a critical public health issue among a group experiencing considerable health disparities and strengthens the research infrastructure in partnership with the Tribe. If efficacious, it has the potential for widespread dissemination and could be generalizable to other chronic co-occurring mental health and physical health conditions.

Conditions

• Obesity
• Substance Abuse

Interventions

BEHAVIORAL

Yappalli

Month 1-3: Up to 8 group sessions on Choctaw history, traditions, cultural systems, \& women's roles. Up to 3 individual Motivational Interviewing (MI) sessions to identify community leadership \& personal change goals on the main outcome. Month 2: Overnight Culture Camp to strengthen group cohesion \& synthesize goals. Month 3: Walk for a week on the Choctaw Trail of Tears, upon completion make a commitment to conduct a community-wide event based on personal \& leadership goals \& experience on the Trail. Months 3-12: Up to 6 group meetings to plan community leadership events related to ATOD \& obesity prevention. Includes: digital storytelling training to create a story related to ATOD \& obesity prevention \& an individual MI booster session to revise their personal \& community leadership goals. Month 12: Share digital stories \& community event experiences \& undergo a ceremony to transition to health leaders within their communities.

Sponsors & Collaborators

• National Institute on Drug Abuse (NIDA)

  collaborator NIH

• University of Washington

  lead OTHER

Principal Investigators

• Karina L Walters, PhD · University of Washington

• Kristie Brooks · Choctaw Nation of Oklahoma

• Michelle Johnson-Jennings, PhD · University of Washington

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2015-03-31

Primary Completion

2022-05-30

Completion

2022-05-30

Countries

• United States

Study Locations