Reaching urban American Indian and Alaskan Natives for obesity prevention

Purpose: In the United States, studies over the last 10 years show that AIAN of all age groups are disproportionately overweight or obese. AIAN also suffer disproportionately from the consequences of obesity. For example, according to a study of 2000-2006 BRFSS data 12.4% of AIAN had diabetes compared to the national rate of 6%. Yet, obesity prevention is complicated given little knowledge of this small population. Study Design: AIAN elders, adults and youth participated in focus groups to discuss beliefs, behaviors and obesity prevention messaging. As part of this study, an Audience Response Survey (ARS) was used to anonymously collect survey data to augment qualitative data. Results: Urban AIAN participants came from a wide range of tribes and localities. Although knowledge about health eating was generally good (75% got most answers correct), reported behaviors lagged behind intentions. Respondents reported eating few fruits and vegetables and having high levels of sugared drinks and fast food. Adolescents, in particular, had alarmingly poor diets. Conclusions: In order to effectively address obesity prevention for AIAN groups, health education must be sensitive to unique factors of AIAN cultures, especially for youth. AIAN messaging may need to include family and local “regular” people in messaging and avoiding “selfish” motivations. Further, some tribes have symbols that are positive yet the same symbol is negative others hence no “one size fits all” exists for graphics. Many from reservations have English as their second language complicating messaging. Communication channels cannot depend on internet and high technology options.