Study of Health Assessment and Risk Evaluation in Aboriginal Peoples Action Toward Obesity Prevention (SHARE-AP Action)
Condition: Obesity
MeSH terms: Obesity
Study type: Interventional

Summary: 
      The purpose of this study is to develop an effective intervention strategy to prevent &
      reduce obesity among a high risk cohort of Aboriginal families.
    

Detailed description: 
      Obesity is a major public health problem in North America. The most recent estimates indicate
      that over 35% of men and 27% of women over the age of 18 are obese (body mass index (BMI)
      ≥30), and the prevalence of obesity among children and adolescents has increased over the
      last two decades to about 13%. Obesity leads to a number of chronic health problems including
      diabetes, hypertension, cardiovascular disease (CVD), and some cancers. Throughout the world,
      Aboriginal people suffer a high prevalence of overweight and obesity. This is likely due to
      their transition from a lifestyle of modest energy intake and high levels of physical
      activity, to a lifestyle of high energy intake and low levels of physical activity. This in
      turn has led to extraordinarily high rates of overweight, obesity, and type 2 diabetes.

      There is an urgent need to test interventions to reduce or prevent obesity among Aboriginal
      people. Obesity has been resistant to traditional public health education strategies and
      novel approaches at multiple levels to develop effective strategies are required. SHARE-AP
      ACTION is a randomized controlled trial testing if a household-based intervention to improve
      change dietary and physical activity patterns has the potential to succeed where individual,
      school based and community interventions have not. Our project frees individuals from being
      alone in making subtle lifestyle changes, and uses the strength of the family unit to make
      changes toward healthy lifestyles. The family structure proposed in this project builds on
      the strengths of the family unit in Aboriginal culture, invokes role-modelling within the
      households and outside the household via the health counsellor, and facilitates opportunities
      to engage in regular group activities in a community where there is a paucity of physical
      activity.

      This randomized controlled trial will test the feasibility of a culturally-sensitive
      household-based intervention, will determine the effect of the intervention on body weight,
      abdominal fat, blood pressure, glucose, and lipids, and will provide unique evaluation on
      intensive behavioural, and lifestyle modification program in a high-risk Aboriginal
      community.

      Eligible families are randomized to intervention or control at baseline and are followed-up
      for 6-months. The intervention consists of: weekly home visits by trained health counsellors
      who provide information, advice and support on improving dietary habits and increasing
      physical activity; weekly home delivery of bottled water to supplant sugared drinks; and a
      variety of afterschool/work physical activity programs and nutritional workshops. Control
      families receive written material, including Canada's Food Guide to Healthy Eating and
      Canada's Physical Activity Guide to Healthy Active Living, which outlines suggestions for
      healthy living, and none of the interventions.
    

Intervention name(s): Health messaging at weekly home visits by health counsellor; Weekly home delivery of bottled spring water; Weekly afterschool physical activity program for 5-18y.o.; Cooking classes and grocery store tours with dietician; Pedometers to track/increase weekly physical activity
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: obesity; physical activity; daily energy intake; nutrition; healthy lifestyle; Aboriginal; body fat; exercise; education; family; body mass index; knowledge; randomized controlled trial; community; intervention; Six Nations Indian Reserve; household; health counselling