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A Family-based Intervention to Promote Healthy Lifestyles in an Aboriginal Community in Canada

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Abstract

Context

Obesity is a major public health problem in North America, particularly in Aboriginal people.

Objective

To determine if a household-based lifestyle intervention is effective at reducing energy intake and increasing physical activity among Aboriginal families after 6 months.

Design, Participants, and Intervention

Randomized, open trial of 57 Aboriginal households recruited between May 2004 and April 2005 from the Six Nations Reserve in Ohsweken, Canada. Aboriginal Health Counsellors made regular home visits to assist families in setting dietary and physical activity goals. Additional interventions included provision of filtered water, a physical activity program for children, and educational events about healthy lifestyles.

Results

57 households involving 174 individuals were randomized to intervention or usual care. Intervention households decreased consumption of fats, oils and sweets compared to usual care households (-4.9 servings per day vs. -3 servings/day, p=0.006), and this was associated with a reduction in trans fatty acids (-0.2 vs. +0.6 grams/day, p=0.02). Water consumption increased (+0.3 vs. -0.1 servings/day, p<0.04) and soda pop consumption decreased (-0.3 vs. -0.1 servings/day, p=0.02) in intervention households compared to usual care. A trend toward increased knowledge about healthy dietary practices in children, increased leisure-time activity and decreased sedentary behaviours was observed, although these differences were not statistically significant.

Conclusion

A household-based intervention is associated with some positive changes in dietary practices and activity patterns. A larger and longer-term intervention which addresses both individual change and structural barriers in the community is needed.

Résumé

Contexte

L’obésité est un problème de santé publique majeur en Amérique du Nord, particulièrement chez les Autochtones.

Objectif

Déterminer si une intervention de modification du mode de vie centrée sur les ménages parvient à réduire l’apport énergétique et à accroître l’activité physique dans des familles autochtones au bout de six mois.

Méthode, participants et intervention

Essai ouvert aléatoire auprès de 57 ménages autochtones recrutés entre mai 2004 et avril 2005 dans la réserve des Six-Nations à Ohsweken (Ontario), au Canada. Des conseillers en santé autochtone ont fait des visites à domicile périodiques pour aider les familles à se fixer des objectifs de saine alimentation et d’activité physique. D’autres mesures ont aussi été instaurées: on a fourni de l’eau filtrée aux ménages, offert un programme d’activité physique aux enfants et organisé des activités de sensibilisation aux modes de vie sains.

Résultats

Les 57 ménages (174 personnes) ont été répartis aléatoirement en deux groupes, l’un recevant les mesures d’intervention et l’autre, les soins habituels. Les ménages recevant les mesures d’intervention ont diminué leur consommation de matières grasses, d’huile et de sucreries par rapport aux ménages recevant les soins habituels (-4,9 portions/jour contre -3 portions/jour, p=0,006), et cette diminution était associée à une baisse de la consommation d’acides gras trans (-0,2 contre +0,6 g/jour, p=0,02). Par ailleurs, leur consommation d’eau a augmenté (+0,3 contre -0,1 portion/jour, p<0,04), et leur consommation de boissons gazeuses a diminué (-0,3 contre -0,1 portion/jour, p=0,02). Nous avons aussi observé une amélioration des connaissances des enfants sur la saine alimentation, une augmentation de l’activité pendant les temps libres et une diminution des comportements sédentaires, mais ces changements n’étaient pas significatifs.

Conclusion

Une intervention centrée sur les ménages est associée à certains changements positifs dans l’alimentation et l’activité physique. Il faudrait élargir et prolonger l’initiative, en tenant compte à la fois des changements individuels et des obstacles structurels dans la communauté.

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Authors and Affiliations

  1. Department of Medicine, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, 237 Barton Street East, 4 EAST Rm. 441, Hamilton, ON, L8L 2X2, Canada

    Sonia S. Anand MD, PhD, FRCPC (Study Team Investigator), Stephanie Atkinson PhD (Study Team Investigator), Cameron Blimkie BA, BPHE, MA, PhD (Study Team Investigator), Melissa Brouwers PhD (Study Team Investigator), Katherine Morrison MD, FRCPC (Study Team Investigator), Hertzel Gerstein MD, MSc, FRCPC (Study Team Investigator) & Salim Yusuf MBBS, DPhil, FRCPC, FRSC (Study Team Investigator)

  2. Population Health Research Institute, Hamilton Health Sciences and McMaster University, Canada

    Sonia S. Anand MD, PhD, FRCPC (Study Team Investigator), Rashid Ahmed BSc (Study Team Investigator), Changchun Xie PhD (Study Team Investigator), Larry de Koning BSc, MSc & Salim Yusuf MBBS, DPhil, FRCPC, FRSC (Study Team Investigator)

  3. Six Nations Health Services, Ohsweken, Canada

    A. Darlene Davis RN (Study Team Investigator), Ruby Jacobs RN, BA (Study Team Investigator), Amber Hill & Joon Sowden

Authors
  1. Sonia S. Anand MD, PhD, FRCPC
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  2. A. Darlene Davis RN
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  6. Amber Hill
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  7. Joon Sowden
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  8. Stephanie Atkinson PhD
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  9. Cameron Blimkie BA, BPHE, MA, PhD
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  11. Katherine Morrison MD, FRCPC
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  12. Larry de Koning BSc, MSc
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  13. Hertzel Gerstein MD, MSc, FRCPC
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  14. Salim Yusuf MBBS, DPhil, FRCPC, FRSC
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behalf of the SHARE-AP ACTION Investigators

Corresponding author

Correspondence to Sonia S. Anand MD, PhD, FRCPC.

Additional information

Funding: Canadian Institutes of Health Research (CIHR) Grant number: MCT 64076.

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Anand, S.S., Davis, A.D., Ahmed, R. et al. A Family-based Intervention to Promote Healthy Lifestyles in an Aboriginal Community in Canada. Can J Public Health 98, 447–452 (2007). https://doi.org/10.1007/BF03405436

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  • DOI: https://doi.org/10.1007/BF03405436

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