R01DA056416

Wakaya: Rising Up for Choctaw Youth Health is an experiential, outdoor, nature-based program grounded in Choctaw values. It aims to address the vulnerability of American Indian youth to ill health, which is influenced by adverse socio-demographic indices, little physical activity, sedentary behaviors, and inadequate nutrition. These factors, along with behavioral risk factors such as alcohol, tobacco, and other drug use (ATOD), form a toxic triangle of risk. If current patterns persist, by 2050, one out of three youth from the Choctaw Nation of Oklahoma, the third largest AI tribe, will be living with type 2 diabetes, and 70% of the nation will be obese.

Wakaya: Rising Up for Choctaw Youth Health is a multi-level intervention that integrates components of motivational interviewing, the information-motivation-behavioral skills model, the positive youth leadership development framework, and the NIMHD multilevel socio-ecological research framework. The program will be evaluated using a prospective two-group randomized waitlist-control trial design among 176 at-risk Choctaw youth aged 14-18 years. The primary outcomes to be assessed include physical activity, sedentary behavior, and healthful food habits. Secondary outcomes include weight/BMI and ATOD. Additionally, guided by the NIMHD multilevel socioecological framework, the study will examine the potential mechanisms of change by analyzing how pathway variables, such as nature connectedness, mediate intervention effects.

Furthermore, the study will explore the community-level impact of Wakaya through topic modeling of qualitative interview data and ripple effect mapping via youth participant and tribal leader focus groups (N=64). This will involve creating a visual map representing the interconnected ripple effects of the intervention into the community. The program, supported by promising preliminary data on this approach among adults and acceptability data from youth, involves a 3-month outdoor intervention. It includes four individual sessions, weekly group sessions, two overnight culture immersion camps (7 days total), and a 4-day Choctaw Trail of Tears walk. The intervention also aims to build youth health leadership and community organizing skills.

The research team comprises experts in American Indian health from academia, as well as the Choctaw Nation and collaborative efforts among two tribal departments - Historic Preservation and Behavioral Health. Findings from the study will be disseminated scientifically and shared with the tribe for programmatic implementation. If efficacious, this intervention will provide evidence for interventions that promote physical activity and nutrition programs targeting green spaces, community gardens, natural/nature trails, and built environments.

The proposed study provides significant and practical information in several areas, including the feasibility of delivering interventions in nature-based settings across multilevel stakeholders. Should it be efficacious, the program has the potential for widespread adaptation and dissemination to other tribal communities. It could also be generalizable to other chronic co-occurring physical activity and food habit-related conditions.

University Of Washington

NOT APPLICABLE

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

Seattle, Washington 981951016 United States

Single Zip Code

Intervention Research to Improve Native American Health (R01 Clinical Trial Optional) (PAR-20-238)

Amendment Since initial award the total obligations have increased 369% from $682,798 to $3,200,771.