Journal of Racial and Ethnic Health Disparities

, Volume 3, Issue 4, pp 608–624 | Cite as

Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives

  • Sheila FleischhackerEmail author
  • Erica Roberts
  • Ricky Camplain
  • Kelly R. Evenson
  • Joel Gittelsohn


Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.


American Indians Alaskan Natives Active living Physical activity Exercise Obesity 



Verma Walker was of great assistance to us on developing our systematic search process. Support for preliminary data gathering and analysis for this review was provided in part by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation (RWJF) (ID #66958); National Institutes of Health (NIH) University of North Carolina Interdisciplinary Obesity Training Grant (T 32 MH75854-03); and Kate B. Reynolds Charitable Trust (KBR).

Compliance with Ethical Standards

Conflicts of Interest

The authors declare no conflicts of interest. The content is solely the responsibility of the authors and does not necessarily represent the official views of the RWJF, NIH, or KBR.


  1. 1.
    Schell L, Gallo M. Overweight and obesity among North American Indian infants, children, and youth. Am J Hum Biol. 2012;24:302–13.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Lindberg S, Adams A, Prince R. Early predictors of obesity and cardiovascular risk among American Indian children. Matern Child Health J. 2012;16(9):1879–86.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Anderson S, Whitaker R. Prevalence of obesity among US preschool children in different racial and ethnic groups. Arch Pediatr Adolesc Med. 2009;163(4):344–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Teufel-Shone N, Fitzgerald C, Teufel-Shone L, Gamber M. Systematic review of physical activity interventions implemented with American Indian and Alaska Native populations in the United States and Canada. Am J Health Promot. 2009;23(6):S8–S32.CrossRefPubMedGoogle Scholar
  5. 5.
    Bauer U, Plescia M. Addressing disparities in the health of American Indian and Alaska Native people: the importance of improved public health data. Am J Public Health. 2014;104(S3):S255–7.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Foulds H, Warburton D, Dredin S. A systematic review of physical activity levels in Native American populations in Canada and the United States in the last 50 years. Obes Rev. 2013;14:593–603.CrossRefPubMedGoogle Scholar
  7. 7.
    Khan L, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. MMWR Recomm Rep. 2009;58(RR-7):1–26.PubMedGoogle Scholar
  8. 8.
    Bunnell R, O’Neil D, Soler R, Payne R, Giles WH, Collins J, Bauer U, Communities Putting Prevention to Work Program Group. Fifty communities putting prevention to work: accelerating chronic disease prevention through policy, systems and environmental change. J Community Health. 2012;37(5):1081–90.CrossRefPubMedGoogle Scholar
  9. 9.
    Abercrombie L, Sallies J, Conway T, Frank L, Saelens B, Chapman J. Income and racial disparities in access to public parks and private recreation facilities. Am J Prev Med. 2008;34(1):9–15.CrossRefPubMedGoogle Scholar
  10. 10.
    Sallis J, Cervero R, Ascher W, Henderson K, Kraft M, Kerr J. An ecological approach to creating active living communities. Ann Rev Public Health. 2005;27(14):1–14.Google Scholar
  11. 11.
    O’Connell M, Buchwald D, Duncan G. Food access and cost in American Indian communities in Washington state. J Am Diet Assoc. 2011;111:1375–9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Fleischhacker S, Rodriguez D, Evenson K, et al. Evidence for validity of five secondary data sources for enumerating retail food outlets in seven communities in North Carolina. Int J Behav Nutr Phys Act. 2012;9:137.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Wallerstein N, Duran B, Aguilar J, et al. Jemez pueblo: built and social-cultural environments and health within a rural American Indian community in the southwest. Am J Public Health. 2003;93(9):1517–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    King A, Castro C, Wilcox S, Eyler A, Sallis J, Brownson R. Personal and environmental factors associated with physical inactivity among different racial-ethnic groups of the U.S. middle-aged and older-aged women. Health Psychol. 2000;19:354–64.CrossRefPubMedGoogle Scholar
  15. 15.
    Coble J, Rhodes R. Physical activity and Native Americans: a review. Am J Prev Med. 2006;31(1):36–46.CrossRefPubMedGoogle Scholar
  16. 16.
    Teufel-Shone N Promising strategies for obesity prevention and treatment within American Indian communities. J Transcult Nurs. 2006;17:224.CrossRefPubMedGoogle Scholar
  17. 17.
    Fleischhacker S, Byrd R, Ramachandran G, et al. Tools for healthy tribes: improving access to healthy foods in Indian country. Am J Prev Med. 2012;43(3 Suppl 2):S123–9.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Adams A, Scott J, Prince R, Williamson A. Using community advisory boards to reduce environmental barriers to health in American Indian communities, Wisconsin, 2007–2012. Prev Chronic Dis. 2014;11(E160):1–11.Google Scholar
  19. 19.
    Huhman M, Berkowitz J, Wong F, et al. The VERB™ campaign’s strategy for reaching African-American, Hispanic, Asian, and American Indian children and parents. Am J Prev Med. 2008;34(6S):S194–209.CrossRefPubMedGoogle Scholar
  20. 20.
    Davis S, Sanders S, Fitzgerald C, Keane P, Canaca G, Volker-Rector R. CHILE: an evidence-based preschool intervention for obesity prevention in Head Start. J Sch Health. 2013;83(3):223–9.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Sussman A, Davis S. Integrating formative assessment and participatory research: building healthier communities in the CHILE Project. Am J Health Educ. 2010;41(4):244–9.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Cruz T, Davis S, FitzGerald C, Canaca G, Keane P. Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children. J Primary Prevent. 2014;35:135–49.CrossRefGoogle Scholar
  23. 23.
    Cunningham-Sabo L, Bauer M, Pareo S, Phillips-Benally S, Roanhorse J, Garcia L. Qualitative investigation of factors contributing to effective nutrition education for Navajo families. Matern Child Health J. 2008;12:S68–75.CrossRefGoogle Scholar
  24. 24.
    Kimes C, Golden S, Maynor R, Spangler J, Bell R. Lessons learned in community research through The Native Proverbs 31 Health Project. Prev Chronic Dis. 2014;11:130256.CrossRefGoogle Scholar
  25. 25.
    Adams A, LaRowe T, Cronin K, et al. The Healthy Children, Strong Families intervention: design and community participation. J Primary Prevent. 2012;33:175–85.CrossRefGoogle Scholar
  26. 26.
    Adams A Understanding community and family barriers and supports to physical activity in American Indian children. J Public Health Manag Pract. 2010;16(5):401–3.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Adams A, Prince R. Correlates of physical activity in young American Indian children: lessons learned from the Wisconsin Nutrition and Growth Study. J Public Health Manag Pract. 2010;16(5):394–400.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Adams A, Harvey H, Brown D. Constructs of health and environment inform child obesity prevention in American Indian communities. Obesity. 2008;16:311–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Adams A, Quinn R, Prince R. Low recognition of childhood overweight and disease risk among Native-American caregivers. Obes Res. 2005;13(1):146–52.CrossRefPubMedGoogle Scholar
  30. 30.
    Adams A, Harvey H, Prince R. Association of maternal smoking with overweight at age 3 y in American Indian children. Am J Clin Nutr. 2005;82:393–8.PubMedGoogle Scholar
  31. 31.
    LaRowe T, Adams A, Jobe J, Cronin K, Vannatter S, Prince R. Dietary intakes and physical activity among preschool-aged children living in rural American Indian communities before a family-based healthy lifestyle intervention. J Am Diet Assoc. 2010;110:1049–57.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    LaRowe T, Wubben D, Cronin K, Vannater S, Adams A. Development of a culturally appropriate, home-based nutrition and physical activity curriculum for Wisconsin American Indian families. Prev Chronic Dis. 2007;4(4):1–8.Google Scholar
  33. 33.
    Walters K, LaMarr J, Levy R, et al. Project heli?dxw/Healthy Hearts Across Generations: development and evaluation design of a tribally based cardiovascular disease prevention intervention for American Indian families. J Prim Prev. 2012;33:197–207.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Harvey-Berino J, Rourke J. Obesity prevention in preschool Native American children: a pilot study using home visiting. Obes Res. 2003;11(5):606–11.CrossRefPubMedGoogle Scholar
  35. 35.
    Karanja N, Aickin M, Lutz T, et al. A community-based intervention to prevent obesity beginning at birth among American Indian children: study design and rationale for the PTOTS study. J Prim Prev. 2012;33:161–74.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Fisher P, Ball T. The Indian FAMILY WELLNESS Project: an application of the tribal participatory model. Prev Sci. 2002;3(3):235–40.CrossRefPubMedGoogle Scholar
  37. 37.
    Fisher P, Ball T. Tribal participatory research: mechanisms of a collaborative model. Am J Comm Psychol. 2003;32(3/4):207–16.CrossRefGoogle Scholar
  38. 38.
    Karanja N, Lutz T, Ritenbaugh C, et al. The TOTS community intervention to prevent overweight in American Indian toddlers beginning at birth: a feasibility and efficacy study. J Community Health. 2010;35:667–75.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Story M, Hannan P, Fulkerson J, et al. Bright Start: description and main outcomes from a group-randomized obesity prevention trial in American Indian children. Obesity (Sliver Spring). 2012;20(11):2241–9.CrossRefGoogle Scholar
  40. 40.
    Arcan C, Hannan P, Fulkerson J, et al. Associations of home food availability, dietary intake, screen time and physical activity with BMI in young American-Indian children. Public Health Nutr. 2013;16(1):146–55.CrossRefPubMedGoogle Scholar
  41. 41.
    Arcan C, Hannan P, Himes J, et al. Intervention effects on kindergarten and first-grade teachers’ classroom food practices and food-related beliefs in American Indian reservation schools. J Acad Nutr Diet. 2013;113:1076–83.CrossRefPubMedGoogle Scholar
  42. 42.
    Arcan C, Hannan P, Himes J, et al. American Indian parents’ assessment of and concern about their kindergarten child’s weight status, South Dakota, 2005–2006. Prev Chronic Dis. 2012;9:E56.PubMedPubMedCentralGoogle Scholar
  43. 43.
    Barr-Anderson D, Fulkerson J, Smyth M, et al. Association of American Indian children’s screen time behavior with parental television behavior, parental perceptions of children’s screen time, and media-related resources in the home. Prev Chronic Dis. 2011;8(5):A105.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Bauer K, Widome R, Himes J, et al. High food insecurity and its correlates among families living on a rural American Indian reservation. Am J Public Health. 2012;102:1346–52.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Zhang J, Himes J, Hannan P, et al. Summer effects on body mass index (BMI) gain and growth patterns of American Indian children from kindergarten to first grade: a prospective study. BMC Public Health. 2011;11:951.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Bachar J, Lefler L, Reed L, McCoy T, Bailey R, Bell R. Cherokee Choices: a diabetes prevention program for American Indians. Prev Chronic Dis. 2006;3(3):1–9.Google Scholar
  47. 47.
    Going S, Thompson J, Cano S, et al. The effects of the Pathways Obesity Prevention Program on physical activity in American Indian children. Prev Med. 2003;37:S62–9.CrossRefPubMedGoogle Scholar
  48. 48.
    Caballero B, Clay T, Davis S, et al. Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren. Am J Clin Nutr. 2003;78:1030–8.PubMedPubMedCentralGoogle Scholar
  49. 49.
    Gittelsohn J, Evans M, Helitzer D, et al. Formative research in a school-based obesity prevention program for Native American school children (Pathways). Health Educ Res. 1998;13(2):251–65.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Steckler A, Ethelbah B, Jane Martin C, et al. Pathways process evaluation results: a school-based prevention trial to promote healthful diet and physical activity in American Indian third, fourth, and fifth grade students. Prev Med. 2003;37:S80–90.CrossRefPubMedGoogle Scholar
  51. 51.
    Gittelsohn J, Davis S, Steckler A, et al. Pathways: lessons learned and future directions for school-based interventions among American Indians. Prev Med. 2003;27:S107–12.CrossRefGoogle Scholar
  52. 52.
    Caballero B, Himes J, Lohman T, et al. Body composition and overweight prevalence in 1704 schoolchildren from 7 American Indian communities. Am J Clin Nutr. 2003;78:308–12.PubMedPubMedCentralGoogle Scholar
  53. 53.
    Gittelsohn J, Merkle S, Story M, et al. School climate and implementation of the Pathways study. Prev Med. 2003;37:S97–S106.CrossRefPubMedGoogle Scholar
  54. 54.
    Going S Physical activity measurements: lessons learned from the Pathways Study. J Public Health Manag Pract. 2010;16(5):420–5.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Koehler K, Cunningham-Sabo L, Lambert L, McCalman R, Skipper B, Davis S. Assessing food selection in a health promotion program: validation of a brief instrument for American Indian children in the Southwest United States. J Am Diet Assoc. 2000;100:205–11.CrossRefPubMedGoogle Scholar
  56. 56.
    Lytle L, Dixon L, Cunningham-Sabo L, et al. Dietary intake of Native American children: findings from the Pathways Feasibility Study. J Am Diet Assoc. 2002;102(4):557–8.CrossRefGoogle Scholar
  57. 57.
    Stevens J, Cornell C, Story M, et al. Development of a questionnaire to assess knowledge, attitudes, and behaviors in American Indian children. Am J Clin Nutr. 1999;69(Suppl):773S–81S.PubMedGoogle Scholar
  58. 58.
    Himes J, Ring K, Gittelsohn J, et al. Impact of the Pathways intervention on dietary intakes of American Indian schoolchildren. Prev Med. 2003;37(6 Pt 2):S55–61.CrossRefPubMedGoogle Scholar
  59. 59.
    Davis S, Going S, Helitzer D, et al. Pathways: a culturally appropriate obesity-prevention program for American Indian schoolchildren. Am J Clin Nutr. 1999;69(Suppl):796S–802S.PubMedPubMedCentralGoogle Scholar
  60. 60.
    Davis C, Hunsberger S, Murray D, et al. Design and statistical analysis for the Pathways study. Am J Clin Nutr. 1999;69(Suppl):760S–3S.PubMedGoogle Scholar
  61. 61.
    Davis S Introduction. Prev Med. 2003;37:S1–2.CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Davis S, Clay T, Smyth M, et al. Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren. Prev Med. 2003;37:S24–34.CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Gittelsohn J, Evans M, Story MD, Davis SM, Metcalfe L, Helitzer D, Clay T. Multisite formative assessment for the Pathways study to prevent obesity in American Indian schoolchildren. Am J Clin Nutr. 1999;69(Suppl):767S–72S.PubMedPubMedCentralGoogle Scholar
  64. 64.
    Helitzer D, Davis S, Gittelsohn J, et al. Process evaluation in a multisite, primary obesity-prevention trial in American Indian school children. Am J Clin Nutr. 1999;69(Suppl):816S–24S.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Lohman T, Thompson J, Going S, et al. Indices of change in adiposity in American Indian children. Prev Med. 2003;37(Suppl):S91–6.CrossRefPubMedGoogle Scholar
  66. 66.
    Snyder P, Anliker J, Cunningham-Sabo L, Dixon L, et al. The Pathways study: a model for lowering the fat in school meals. Am J Clin Nutr. 1999;69(Suppl):810S–5S.PubMedPubMedCentralGoogle Scholar
  67. 67.
    Stevens J, Story M, Becenti A, et al. Weight-related attitudes and behaviors in fourth grade American Indian children. Obes Res. 1999;7(1):34–42.CrossRefPubMedGoogle Scholar
  68. 68.
    Stevens J, Suchindran C, Ring K, et al. Physical activity as a predictor of body composition in American Indian children. Obes Res. 2004;12(12):1974–80.CrossRefPubMedGoogle Scholar
  69. 69.
    Stevens J, Story M, Ring K, et al. The impact of the Pathways intervention on psychosocial variables related to diet and physical activity in American Indian schoolchildren. Prev Med. 2003;37:S70–9.CrossRefPubMedGoogle Scholar
  70. 70.
    Stone E, Norman J, Davis S, et al. Design, implementation, and quality control in the Pathways American-Indian multicenter trial. Prev Med. 2003;37:S13–23.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Story M, Snyder P, Anliker J, et al. Nutrient content of school meals in elementary schools on American Indian reservations. J Am Diet Assoc. 2002;102(2):253–6.CrossRefPubMedGoogle Scholar
  72. 72.
    Story M, Snyder P, Anliker J, et al. Changes in the nutrient content of school lunches: results from the Pathways study. Prev Med. 2003;37:S35–45.CrossRefPubMedGoogle Scholar
  73. 73.
    Story M, Stevens J, Evans M, et al. Weight loss attempts and attitudes toward body size, eating, and physical activity in American Indian children: relationship to weight status and gender. Obes Res. 2001;9(6):356–63.CrossRefPubMedGoogle Scholar
  74. 74.
    Teufel N, Perry C, Story M, et al. Pathways family intervention for third-grade American Indian children. Am J Clin Nutr. 1999;69(Suppl):803S–9S.PubMedPubMedCentralGoogle Scholar
  75. 75.
    Thompson J, Allen P, Cunningham-Sabo L, Yazzie D, Curtis M, Davis S. Environmental, policy and cultural factors related to physical activity in sedentary American Indian women. Women Health. 2002;36(2):59–74.CrossRefPubMedGoogle Scholar
  76. 76.
    Thompson J, Davis S, Gittelsohn J, et al. Patterns of physical activity among American Indian children: an assessment of barriers and support. J Community Health. 2001;26(6):423–45.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Weber J, Cunningham-Sabo L, Skipper B, et al. Portion-size estimation training in second- and third-grade American Indian children. Am J Clin Nutr. 1999;69(Suppl):782S–7S.PubMedGoogle Scholar
  78. 78.
    Weber J, Lytle L, Gittelsohn J, et al. Validity of self-reported dietary intake at school meals by American Indian children: the Pathways study. J Am Diet Assoc. 2004;104:746–52.CrossRefPubMedGoogle Scholar
  79. 79.
    Cunningham-Sabo L, Snyder P, Anliker J, et al. Impact of the Pathways food service intervention on breakfast served in American-Indian schools. Prev Med. 2003;37:S46–54.CrossRefPubMedGoogle Scholar
  80. 80.
    Going S, Levin S, Harrell J, et al. Physical activity assessment in American Indian schoolchildren in the Pathways study. Am J Clin Nutr. 1999;69(Suppl):788S–95S.PubMedGoogle Scholar
  81. 81.
    Lohman T, Caballero B, Himes J, et al. Body composition assessment in American Indian children. Am J Clin Nutr. 1999;69(Suppl):764S–6S.PubMedGoogle Scholar
  82. 82.
    Cook V, Hurley J. Prevention of type 2 diabetes in childhood. Clin Pediatr. 1998;37:123–30.CrossRefGoogle Scholar
  83. 83.
    Harris M, Davis S, Ford V, Tso H. The Checkerboard Cardiovascular Curriculum: a culturally oriented program. J Sch Health. 1988;58(3):104–7.CrossRefPubMedGoogle Scholar
  84. 84.
    Davis S, Gomez Y, Lambert L, Skipper B. Primary prevention of obesity in American Indian children. Ann N Y Acad Sci. 1993;699:167–80.CrossRefPubMedGoogle Scholar
  85. 85.
    Davis S, Gomez Y. The Southwestern Cardiovascular Curriculum Project. Ann N Y Acad Sci. 1993;699:265–6.CrossRefPubMedGoogle Scholar
  86. 86.
    Teufel-Shone N, Gamber M, Watahornigie H, Siyuja T, Crozier L, Irwin S. Using a participatory research approach in a school-based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002–2006. Prev Chronic Dis. 2014;11(E166):1–11.Google Scholar
  87. 87.
    Teufel-Shone N, Siyuja T, Watahomigie H, Irwin S. Community-based participatory research: conducting a formative assessment of factors that influence youth wellness in the Hualapai community. Am J Public Health. 2006;96(9):1623–8.CrossRefPubMedPubMedCentralGoogle Scholar
  88. 88.
    Ritenbaugh C, Teufel-Shone N, JR AMJ, et al. A lifestyle intervention improves plasma insulin levels among Native American high school youth. Prev Med. 2003;36:309–19.CrossRefPubMedGoogle Scholar
  89. 89.
    Teufel N, Ritenbaugh C. Development of a primary prevention program: insight gained in the Zuni Diabetes Prevention Program. Clin Pediatr. 1998;37:131–41.CrossRefGoogle Scholar
  90. 90.
    Weaver H Healthy Living In Two Worlds: testing a wellness curriculum for urban Native youth. Child Adolesc Social Work J. 2010;27(3):231–44.CrossRefPubMedPubMedCentralGoogle Scholar
  91. 91.
    Brown B, Noonan C, Harris K, et al. Developing and piloting the Journey to Native Youth Health Program in Northern Plains Indian communities. Diabetes Educ. 2013;39(1):109–18.CrossRefPubMedGoogle Scholar
  92. 92.
    Brown B, Harris K, Harris J, Parker M, Ricci C, Noonan C. Translating the Diabetes Prevention Program for Northern Plains Indian youth through community-based participatory research methods. Diabetes Educ. 2010;36(6):924–35.CrossRefPubMedPubMedCentralGoogle Scholar
  93. 93.
    Carrel A, Meinen A, Garry C, Storandt R. Effects of nutrition education and exercise in obese children: the Ho-Chunk Youth Fitness Program. WMJ. 2005;104(5):44–7.PubMedGoogle Scholar
  94. 94.
    Marlow E, D’Eramo G, Bosma A. STOP Diabetes! An educational model for Native American adolescents in the prevention of diabetes. Diabetes Educ. 1998;24(4):441–3 446-450.CrossRefPubMedGoogle Scholar
  95. 95.
    Deacon Z, Pendley J, Hinson W, Hinson J. Chokka-Chaffa’ Kilimpi’ Chikashshiyaakni’ Kilimpi’: Strong Family, Strong Nation. Am Indian Alsk Native Ment Health Res. 2011;18(2):41–63.CrossRefPubMedGoogle Scholar
  96. 96.
    Jernigan V, Brokenleg I, Burkhart M, Magdalena C, Sibley C, Yepa K. The implementation of a participatory manuscript development process with Native American tribal awardees as part of the CDC Communities Putting Prevention to Work initiative: challenges and opportunities. Prev Med. 2014;67:S51–7.CrossRefGoogle Scholar
  97. 97.
    Perry C, Hoffman B. Assessing tribal youth physical activity and programming using a community-based participatory research approach. Public Health Nurs. 2010;27(2):104–14.CrossRefPubMedPubMedCentralGoogle Scholar
  98. 98.
    Pargee D, Lara-Albers E, Puckett K. Building on tradition: promoting physical activity with American Indian community coalitions. J Health Educ. 1999;30(2):S37–43.CrossRefGoogle Scholar
  99. 99.
    Peercy M, Gray J, Thurman P, Plested B. Community readiness: an effective model for tribal engagement in prevention of cardiovascular disease. Fam Community Health. 2010;33(3):238–47.CrossRefPubMedGoogle Scholar
  100. 100.
    Davis S, Cruz T, Korzoll R. Health impact assessment, physical activity and Federal lands trail policy. Health Behav Policy Rev. 2014;1(1):82–95.CrossRefPubMedPubMedCentralGoogle Scholar
  101. 101.
    Fleischhacker S, Vu M, Ries A, McPhail A. Engaging tribal leaders in an American Indian Healthy Eating Project through Modified Talking Circles. Fam Community Health. 2011;34(3):202–10.CrossRefPubMedGoogle Scholar
  102. 102.
    Page-Reeves J, Davis S, Romero C, Chrisp E. Understanding “agency” in the translation of a health promotion program. Prev Sci. 2015;16(1):11–20.CrossRefPubMedPubMedCentralGoogle Scholar
  103. 103.
    Lardon C, Soule S, Kernak D, Luple H. Using strategic planning and organizational development principles for health promotion in an Alaska Native community. J Prev Interv Community. 2011;39(1):65–76.CrossRefPubMedPubMedCentralGoogle Scholar
  104. 104.
    Parker S, Hunter T, Briley C, et al. Formative assessment using social marketing principles to identify health and nutrition perspectives of Native American women living within the Chickasaw Nation Boundaries in Oklahoma. J Nutr Educ Behav. 2011;43:55–62.CrossRefPubMedGoogle Scholar
  105. 105.
    Nichols P, Ussery-Hall A, Griffin-Blake S, Easton A. The evolution of the Steps Program, 2003–2010: transforming the Federal Public Health Practice of Chronic Disease Prevention. Prev Chronic Dis. 2012;9:E50.PubMedPubMedCentralGoogle Scholar
  106. 106.
    MacDonald G, Garcia D, Zaza S, et al. Steps to a HealthierUS Cooperative Agreement Program: foundational elements for program evaluation planning, implementation, and use of findings. Prev Chronic Dis. 2006;3(1):1–11.Google Scholar
  107. 107.
    Edgerly C, Laing S, Day A, et al. Steps to a Healthier Anishinaabe, Michigan: strategies for implementing health promotion programs in multiple American Indian communities. Health Promot Pract. 2009;10(2):109S–17S.CrossRefPubMedGoogle Scholar
  108. 108.
    Jernigan V, Salvatore A, Styne D, Winkleby M. Addressing food security in a Native American reservation using community-based participatory research. Health Educ Res. 2012;27(4):645–55.CrossRefPubMedGoogle Scholar
  109. 109.
    Bock C, Jarczok M, Litaker D. Community-based efforts to promote physical activity: a systematic review of interventions considering mode of delivery, study quality and population subgroups. J Sci Med Sport. 2014;17(3):276–82.CrossRefPubMedGoogle Scholar
  110. 110.
    Sallis J Measuring physical activity: practical approaches for program evaluation in Native American communities. J Public Health Manag Pract. 2010;16(5):404–10.CrossRefPubMedPubMedCentralGoogle Scholar
  111. 111.
    Benyshek D, Martin J, Johnston C. A reconsideration of the origins of the type 2 diabetes epidemic among Native Americans and the implications for intervention policy. Med Anthro. 2001;20:25–64.CrossRefGoogle Scholar
  112. 112.
    Hodge F, Weinmann S, Roubideaux Y. Recruitment of American Indians and Alaska Natives into clinical trials. Ann Epidemiol. 2000;10(8 Suppl):S41–8.CrossRefPubMedGoogle Scholar
  113. 113.
    Branscum P, Sharma M. A systematic analysis of childhood obesity interventions targeting Hispanic children: lessons learned from the previous decade. Obes Rev. 2011;12(5):e151–8.CrossRefPubMedGoogle Scholar
  114. 114.
    Conn V, Chan K, Banks J, Ruppar T, Scharff J. Cultural relevance of physical activity intervention research with underrepresented populations. Int Q Community Health Educ. 2013;34(4):391–414.CrossRefPubMedPubMedCentralGoogle Scholar
  115. 115.
    Brownson R, Housemann R, Brown D, et al. Promoting physical activity in rural communities: walking trail access, use, and effects. Am J Prev Med. 2000;18(3):235–41.CrossRefPubMedGoogle Scholar
  116. 116.
    LaVeaux D, Christoper S. Contextualizing CBPR: key principles of CBPR meet the indigenous research context. J Aboriginal Indigenous Comm Health. 2009;7(1):1–25.Google Scholar
  117. 117.
    Mariella P, Brown E, Carter M, Verri V. Tribally-driven participatory research: state of the practice and potential strategies for the future. J Health Disparities Res Pract. 2009;3(2):41–58.Google Scholar
  118. 118.
    Narayan K, Hoskin M, Kozak A, et al. Randomized clinical trial of lifestyle interventions in Pima Indians: a pilot study. Diabet Med. 1998;15(1):66–72.CrossRefPubMedGoogle Scholar
  119. 119.
    Welch V, Casper M, Rith-Najarian S. Correlates of hypertension among Chippewa and Menominee Indians, the Inter-Tribal Heart Project. Ethn Dis. 2002;12(3):398–402.PubMedGoogle Scholar
  120. 120.
    Roshanaei-Moghaddam B, Katon W, Russo J. The longitudinal effects of depression on physical activity. General Hospital Psychiatry. 2009;31:306–15.CrossRefPubMedGoogle Scholar
  121. 121.
    Dickerson D, Johnson C. Design of a behavioral health program for urban American Indian/Alaska Native youths: a community informed approach. J Psychoactive Drugs. 2011;43(4):337–42.CrossRefPubMedGoogle Scholar
  122. 122.
    Komro K, Wagenaar A, Boyd M, et al. Prevention trial in the Cherokee Nation: design of a randomized community trial. Prev Sci. 2015;16:291–300.CrossRefPubMedGoogle Scholar
  123. 123.
    Goldston D, Molock S, Whitbeck L, Murakami J, Zayas L, Nagayama HG. Cultural considerations in adolescent suicide prevention and psychosocial treatment. Am Psychol. 2008;63(1):14–31.CrossRefPubMedPubMedCentralGoogle Scholar
  124. 124.
    Trickett E, Beehler S. The ecology of multilevel interventions to reduce social inequalities in health. Am Behav Sci. 2013;57:1227.CrossRefGoogle Scholar
  125. 125.
    Bjork A, Holman R, Callinan L, Hennessy T, Cheek J, McQuiston J. Dog bite injuries among American Indian and Alaska Native children. J Pediatr. 2013;162:1270–5.CrossRefPubMedGoogle Scholar
  126. 126.
    The Indian Health Service Special Diabetes Program for Indians. 2011 Report to Congress: Making Progress Toward a Healthier Future. Accessed April 15, 2015.
  127. 127.
    Legaspi A, Orr E. Disseminating research on community health and well-being: a collaboration between Alaska Native villages and academe. Am Indian Alsk Native Ment Health Res. 2007;14(1):24–43.CrossRefPubMedGoogle Scholar

Copyright information

© W. Montague Cobb-NMA Health Institute 2015

Authors and Affiliations

  • Sheila Fleischhacker
    • 1
    Email author
  • Erica Roberts
    • 2
  • Ricky Camplain
    • 3
  • Kelly R. Evenson
    • 4
  • Joel Gittelsohn
    • 5
  1. 1.Office of Nutrition Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthDepartment of Health and Human ServicesBethesdaUSA
  2. 2.Department of Behavioral and Community HealthUniversity of Maryland School of Public HealthCollege ParkUSA
  3. 3.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  4. 4.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  5. 5.Bloomberg School of Public Health, Department of International HealthJohns Hopkins UniversityBaltimoreUSA

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