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APHA Scientific Session and Event Listing

Tam D. Lutz, MPH, MHA, TOTS Project, Northwest Portland Area Indian Health Board, 527 SW Hall St, Ste 300, Portland, OR 97008, 503 416 3271, tlutz@npaihb.org, Njeri Karanja, PhD, RD, Kaiser Permanente Center for Health Research, 3800 N Interstate Ave, Portland, OR 97227, and Cheryl Ritenbaugh, PhD, MPH, Department of Family and Community Medicine, University of Arizona, 1450 Cherry Ave, Tucson, AZ 85719.

Background: Currently AI/AN youth experience the highest prevalence of childhood obesity of any U.S. population. Obesity is a major risk factor for type 2 diabetes, which is being diagnosed at increasingly younger ages among AI/ANs. Few studies have been conducted to assess the burden of overweight in very young AI/AN children. TOTS was a partnership with northwest tribes and researchers to develop family-based interventions to reduce Toddler overweight and Tooth Decay. Formative research indicated that not only mothers raised children but also grandmothers, aunties and extended family.

Methods: TOTS Community Health Advocates (CHA), implemented family-based interventions aimed to Increase family members support, provide health education to mothers, family members and caregivers, help families set family goals to achieve behavior change and provide other types of support and referral as locally appropriate. Recumbent length, weight, and dental measures were made according to study protocol; gender and birth date were recorded from parental records. Home visit intervention delivery was recorded in case management forms that tracked health topics discussed, breastfeeding status, resources needed and provided. Family goal setting and action plans to change behavior were reviewed. Final evaluations were conducted during last home visit.

Results: Intervention sites had a significantly lower post-intervention mean weight-for length percentile than control sites. Acceptability and appropriateness of the program was assessed through study family exit interviews.

Public Health Implications. Study shows effectiveness of utilizing CHAs and provides guidance for reducing the burden of overweight in other communities.

Learning Objectives:

• Describe the burden of overweight seen among northwest AI/AN toddlers compared to the general population. Articulate the need for early family-based interventions to prevent obesity in AI/AN communities. Demonstrate methods Community Health Advocates used to document and evaluate the impact of their interventions.

Keywords: Maternal and Child Health, Community Health Advisor

Related Web page: www.npaihb.org

Presenting author's disclosure statement:

Any relevant financial relationships? No