Key DFM Personnel

Alex Adams, MD, PhD – Principal Investigator
Jamie Scott, MS – Project Staff

Funding

Morgridge Center for Public Service

Summary

For American Indian communities, the problem of obesity is a growing concern. Since 2000, the Department of Family Medicine has partnered with three Wisconsin tribes. Research with Great Lakes Inter-Tribal Council (GLITC), and the Bad River, Lac du Flambeau, and Menominee Tribes, showed that 26% of children aged of 5 – 7 years were obese, over 75% of their mothers and fathers were overweight or obese, and cardiovascular risk factors were found even in young children.

Based on this data, a community based participatory research (CBPR) project was designed in collaboration with the communities, and funded by the National Institutes of Health for 2006 – 2011. The project contains two components: Healthy Children Strong Families (HCSF), a home visiting intervention to improve healthy lifestyles in families with children ages 2 – 5 and Supportive Communities, which looks at environmental factors that support healthy lifestyles. The aims of both components are to collaboratively reduce the burden of obesity and chronic disease, support community goals and enhance healthy lifestyle choices. The mission of Supportive Communities is to establish a Community Advisory Board (CAB) in each community to assess, plan, and act on the environmental barriers that impede the community’s ability to make healthy lifestyle choices. Sustaining the CABs’ current and future interventions is a long-term project goal which will be achieved by their inclusion in tribal legislative policy and strategic plans.

Goal

The primary objectives of this project are: 1. Enhance CABs’ work at 3 tribal sites to increase their sustainability, organizational effectiveness, and to enhance their ability to support policy/environmental changes at each community; 2. Promote student learning through UW Landscape Architecture Senior Capstone projects and Native American Research Centers for Health research internship opportunities for American Indian students; 3. Support and develop research practices and projects that allow UW students to work in partnership with underserved communities and contribute to their well-being; 4) Evaluate the impact of this UW/community collaboration on community change.

Methodology

Methodology encompasses the CBPR principles of working with multiple tribal leaders and community members to accomplish mutual goals, community organization and outreach efforts in supporting the CABs, and both quantitative and qualitative assessments of outcomes. CAB meetings involve Tribal members representing Tribal planning, nutrition programs, health and wellness, recreation, transportation, commerce, elders, education, law enforcement, housing and community members living in specific community villages. The CABs hold brainstorming sessions to enumerate key environmental barriers and supports which inhibit or increase healthy nutrition and physical activity. Environmental supports, factors which enable the community to live a healthy lifestyle, have included: Tribal employer policies, such as offering 30 minutes paid time for exercise during the work day; a supportive community atmosphere; family encouragement; agency programs; access to tribal health coverage; strong cultural identity and pride; a strong and trusting partnership with the University; and natural resources. Barriers have included: the lack of a supermarket or poor availability of fresh fruits and produce; poverty; lack of food preparation knowledge; loose or dangerous dogs that pose a threat to families or children; unlit paths; no sidewalks; lack of safe playgrounds for children; and long distances between homes and sources of healthy food. The ultimate goal is to create interventions that change the barriers to community supports. CAB meetings are held every 4 – 6 weeks and typically attract 15 – 25 participants.