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Preventing CVD in Native Populations: The Traditional Living Challenge [NHLBI]

Cheryl Ritenbaugh, PhD, MPH

American Indians and Alaska Natives AIANs suffer the highest rates of health disparities, such as CVD, where lifestyle is a key risk factor. Behavior change interventions attempted to date with AIANs have incorporated native cultural components in hopes of somehow making it culturally relevant, as opposed to starting with native culture and indigenous wisdom as the community strength and foundation upon which to stimulate the motivation for and design of an intervention. The project proposed here develops from a CBPR-based masters thesis that identified an immersion experience in traditional culture and life-ways – the Traditional Living Challenge (TLC) -- as a mechanism for community revitalization around wellness.  This project is a collaboration between the University of Arizona and Salish Kootenai College (SKC) to design and implement a community-based CVD risk reduction intervention using the TLC as the basis for motivation and commitment to wellness.  This project has the following goals:  build capacity for NIH-funded research at SKC; develop collaborations among the tribal health department, cultural leaders, tribal council, and other relevant tribal units; identify the most appropriate age-gender and risk factor target population segment, choose and evaluate relevant outcome measures and potential effect size; evaluate the feasibility of the project through a full pilot process including all aspects of intervention and data collection; and design a full-scale study for submission as an R01.  The planning process and subsequent study is guided by internal and external advisory boards, with the external board assuring scientific integrity and relevance for dissemination to other tribal communities.