Wakaya Program for Childhood Obesity
(Wakaya Trial)
Recruiting in Palo Alto (17 mi)
+2 other locations
Age: < 65
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Washington
Disqualifiers: Opioid use, Methamphetamine use, Allergies, Disability, Aggressive behavior, others
No Placebo Group
Trial Summary
What is the purpose of this trial?Investigators will conduct a two-group randomized waitlist-control trial to assess the efficacy of the Wakaya: Rising Up for Choctaw Youth Health program on improving physical activity, reducing sedentary behaviors and improving healthful eating habits as well as delaying or reducing alcohol, tobacco and other drug use. Wakaya is an experiential, outdoor, nature-based program grounded in Choctaw values. It is a multi-level intervention that increases individual motivation and leadership skills to make healthy behavioral choices for behavior and exercise.
Do I need to stop taking my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the Wakaya Program for Childhood Obesity treatment?
The Wakaya Program for Childhood Obesity treatment may be effective as it incorporates culturally relevant strategies, similar to other successful programs like the Sandy Lake school-based intervention and the Culture-Based Talking Circle Intervention, which improved diet, self-efficacy, and cultural identity among Native American youth.
12345Is the Wakaya Program for Childhood Obesity safe for children?
The available research does not provide specific safety data for the Wakaya Program for Childhood Obesity or its related names. However, similar programs focusing on nutrition education and physical activity for children have generally been considered safe, with positive health changes reported in some cases.
12367What makes the Wakaya Program for Childhood Obesity treatment unique?
The Wakaya Program for Childhood Obesity is unique because it is a culturally tailored curriculum specifically designed for Choctaw youth, focusing on community involvement and cultural acceptance to promote healthy lifestyles, unlike standard treatments that may not consider cultural contexts.
23789Eligibility Criteria
The Wakaya trial is for high school students living in the Choctaw Nation of Oklahoma region who have unhealthy diets or sedentary lifestyles, and are not highly active outdoors. It's not for those with severe allergies, certain disabilities, a history of aggressive behavior, inability to follow directions, or recent opioid/methamphetamine use.Inclusion Criteria
Be enrolled in Choctaw Nation of Oklahoma (CNO)
Live within CNO tribal region for 12 months
YES to one of the following: Consumed sweetened beverages or processed/fast food 2x or more per week; Engaged in excessive sitting or lying around (>540 min/day) or engage in small screen recreation (>2 hours/day); Physical activity - spend <60 minutes/day outdoors or <2.5 hrs per week in moderate or vigorous physical activity OR spend <60 minutes a day in moderate or vigorous intensity aerobic activity; Engage in any T.V., small screen/video game recreation (> 2 hours/day)
Exclusion Criteria
Opioid/methamphetamine drug use (2 times or more in past month)
Allergic reactions to food (e.g. peanuts), plant (poison oak or ivy) or insects (e.g. bees, fire ants) that caused difficulty in breathing or necessitated hospitalization or caused an anaphylactic reaction
Aggressive, violent, combative or inappropriate behaviors
+3 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
1 visit (in-person or phone)
Baseline Assessment
Participants complete a physical health assessment and a computer-assisted behavioral health survey
1 week
1 visit (in-person)
Intervention
Participants engage in group sessions on Choctaw history, traditions, and health beliefs, including outdoor activities and motivational interviewing sessions
3 months
Up to 20 group sessions, 3 individual sessions
Follow-up
Participants are monitored for changes in physical activity, sedentary behaviors, and health habits
6 months
3 follow-up surveys
Post-intervention
Ripple Effect Mapping focus groups to assess community impact
1 month
Focus groups with selected participants
Participant Groups
This study tests the 'Wakaya: Rising Up for Choctaw Youth Health' program which aims to boost physical activity and healthy eating while reducing drug use among youth through outdoor activities and leadership skills development based on Choctaw values.
2Treatment groups
Experimental Treatment
Group I: Wakaya (Immediate Group)Experimental Treatment1 Intervention
Participants in the immediate group will be randomly assigned to start the intervention immediately in the Spring.
Group II: Wait List ControlExperimental Treatment1 Intervention
Participants in the Wait List group will be randomly assigned to start the intervention 3 months later in the Summer.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Choctaw Nation of OklahomaDurant, OK
Choctaw Nation of OklahomaTalihina, OK
University of Washington, IWRI, School of Social WorkSeattle, WA
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Who Is Running the Clinical Trial?
University of WashingtonLead Sponsor
National Institute on Drug Abuse (NIDA)Collaborator
References
A pilot school-based healthy eating and physical activity intervention improves diet, food knowledge, and self-efficacy for native Canadian children. [2023]The Sandy Lake school-based diabetes prevention program is a culturally appropriate intervention for Ojibway-Cree students in the 3rd, 4th, and 5th grades. This paper reports the results of the program in changing dietary intake behaviors and related psychosocial factors. Physical activity results are not included. The study was a pretest/post-test, single-sample design conducted during the 1998-1999 school year. A total of 122 students completed all 4 measurements (anthropometry, 24-h dietary recall, and 2 questionnaires), at baseline and follow-up. There were significant increases (P
Qualitative investigation of factors contributing to effective nutrition education for Navajo families. [2021]Obesity rates in American Indian and Alaskan Native children are a major health threat, yet effective ways to address this remain elusive. Building on an earlier dietary assessment of Navajo Head Start families which indicated a gap in parental nutrition awareness despite a strong program emphasis, the aim of this project was to identify culturally relevant nutrition education strategies for Navajo parents and educators of young children.
Childhood obesity in American Indians. [2010]American Indian youth are affected disproportionately by the epidemic of obesity and its comorbidities compared with other ethnic groups in the United States. Before 10 years of age, 40% to 50% of Indian children of many communities are classified as either overweight or obese by modern definitions in contrast to data from a century ago in which Caucasian and Lakota children were equivalent in weight and body mass index. Multiple etiologies must be addressed to build programs to decrease the prevalence of childhood obesity. While awaiting definitive results from prevention and treatment trials, common-sense approaches such as encouraging healthy diets and increased activity are appropriate. A long-term approach to the community is necessary to improve the health of Indian children: short-term programs that come and go along with varying personnel may not be accepted by the community. We have achieved acceptance in Native American communities, utilizing telecommunications to introduce a family directed program that is then modified and administered by members of the community to ensure that it is culturally acceptable.
Ethnic issues in the epidemiology of childhood obesity. [2022]Childhood obesity may be seen as a marker for high-risk dietary and physical inactivity practices. Recent increases in the prevalence of overweight and obesity among American children are not limited to one age, gender, or ethnic group, which suggests that unique behaviors of the members of various racial or ethnic subgroups of the population are unlikely to be the major contributing factors. Rather, it seems that environmental changes promoting increased energy intake and decreased energy output are occurring and have widespread impact on children from various backgrounds. Although no ethnic group is immune from the current shift in energy balance, differential rates of overweight seem to exist among ethnic groups. National probability samples of African-American, Hispanic, and white children in the United States provide clear evidence that white children are at lower risk for childhood overweight than are African-American or Hispanic children. Of concern is the lack of national data on the prevalence of overweight and obesity for Native-American and Asian-American groups. Also of concern is the aggregation of racial and ethnic subgroups, which may render prevalence rates meaningless. This possibility is clearly true with some surveys of weight status that combine diverse populations, such as Asians and Pacific Islanders, into one group. The high rates of obesity in African-American, Hispanic, and Native-American children are of concern. Although parental SES is associated inversely with childhood obesity among whites, higher SES does not seem to protect African-American and Hispanic children against obesity. In these groups, childhood obesity does not seem to be associated significantly with parental income and education. Health consequences of childhood obesity include a higher prevalence of type 2 diabetes and an increased risk for adverse levels of lipids, lipoproteins, and blood pressure. The effects of recently reported unprecedented levels of childhood overweight on subsequent risk for obesity in middle age are not known until future longitudinal data can be collected. It seems likely, however, that future health consequences of current early and severe childhood obesity will be staggering. Funding for adult follow-up of longitudinal studies of high-risk African American, Hispanic, and Native-American children is needed urgently to provide information on the long-term effects of childhood obesity. Halting the obesity epidemic is a formidable task, but the success in recent decades of drastically reducing childhood undernutrition offers hope and should spur similar action and leadership efforts. Promotion of efforts to reduce excess caloric intake with efforts to increase energy expenditure should receive paramount attention in the design of health programs. Given the relatively few published obesity-prevention and treatment studies that are designed to address specific cultural issues, it is important to promote the development of culturally appropriate intervention strategies that are shown to be effective among youth of diverse backgrounds. Although the dietary and activity goals will be similar, parental, family, and community messages and techniques grounded in cultural traditions and norms will be different for each ethnic group. This approach is crucial in the United States, a country with an increasingly diverse population.
A Culture-Based Talking Circle Intervention for Native American Youth at Risk for Obesity. [2018]This community-based study explored the effectiveness of an after-school cultural-based intervention for Native American youth at risk for obesity. A standard health education after-school program served as the comparison control condition. Cherokee self-reliance (cultural identity), perceived stress, and obesity knowledge and related behaviors were the three outcome measures evaluated at baseline and immediate post-intervention. Findings revealed that participants who completed the cultural-based intervention had better results on the three outcome measures in comparison to the standard health education program.
Aboriginal and Torres Strait Islander children with obesity: A review of programmes for children and young people aged 5-17 years. [2023]A literature review of overweight and obesity prevention and management programmes for Australian Aboriginal and Torres Strait Islander children 5-17 years to inform a co-design weight management intervention in an urban Aboriginal community. Systematic searching of PubMed, Science Direct, Lowitja LitSearch and hand-searching of references, government and Aboriginal websites. Programmes were categorised as including nutrition and food literacy, cooking skills, health education and cultural components. Quality was assessed against the CREATE QAT Tool. Eight programmes, including two evaluations and six programme descriptions, were identified. Interventions ranged in duration from 1 day to 10 weeks involving nutrition education, health information, cooking skills, exercise and cultural content. There were no significant reductions in weight outcomes, although there were reported positive health changes to the children including a reduction in waist circumference and an increase in exercise levels. Insights for future research include effective co-design with community and the delivery of flexible content through an Aboriginal-led, multifaceted programme. There is limited evidence for the prevention and management of weight in Aboriginal children with overweight and obesity. Future research efforts should include more time-intensive, multifaceted, community-run programmes that are supported by medical, advocacy and evaluation expertise from health services.
Tools for Iina (Life): the journey of the Iina curriculum to the glittering world. [2018]This article presents the participatory curriculum development process and foundational Diné (Navajo) concepts that inform the Tools for Iina (Life) curriculum, designed for grades 4-6 by a group of Diné educators to strengthen resiliency by addressing children's health, relationships, identity, and sense of the future, utilizing core concepts from Diné oral tradition. Rather than develop a curriculum relying only on experts, and rather than utilize existing American Indian curricula addressing specific risk behaviors or diseases, we facilitated a dialogue with a range of community members to identify core concepts from Diné oral tradition that could provide young people with a perspective on life and its conflicts and challenges, tools for building respectful and supportive relationships, and stories to inform their sense of themselves, the Diné People, and their shared future. The Ways of Life: Iina Project will make the curriculum available in 2012. We offer reflections for other tribes interested in adopting a similar curriculum development process.
Development of a culturally appropriate, home-based nutrition and physical activity curriculum for Wisconsin American Indian families. [2022]We designed an obesity prevention intervention for American Indian families called Healthy Children, Strong Families using a participatory approach involving three Wisconsin tribes. Healthy Children, Strong Families promotes healthy eating and physical activity for preschool children and their caregivers while respecting each community's cultural and structural framework. Academic researchers, tribal wellness staff, and American Indian community mentors participated in development of the Healthy Children, Strong Families educational curriculum. The curriculum is based on social cognitive and family systems theories as well as on community eating and activity patterns with adaptation to American Indian cultural values. The curricular materials, which were delivered through a home-based mentoring model, have been successfully received and are being modified so that they can be tailored to individual family needs. The curriculum can serve as a nutrition and physical activity model for health educators that can be adapted for other American Indian preschool children and their families or as a model for development of a culturally specific curriculum.
"We were always doing something outside. … I had a wonderful, wonderful life": U.S. Indigenous peoples' subsistence, physical activity, and the natural world. [2023]Obesity tends to be higher, whereas physical activity (PA) tends to be lower for U.S. Indigenous peoples, which drives chronic health problems and mortality. Historical oppression and nutritional colonialism have disrupted Indigenous peoples' subsistence and concomitant PA. The purpose of this research is to use the framework of historical oppression, resilience, and transcendence (FHORT) with 31 participants in a critical ethnography identifying past and present forms of PA. By examining universal themes across two tribal contexts-a Southeast reservation tribal context and an urban Northwestern context-important knowledge about promising forms of PA can inform culturally relevant and effective interventions to promote health and prevent obesity and chronic health problems. Reconstructive thematic qualitative analysis resulted in the following themes: (a) Family-Centered Physical Activity: "The Kids Would … Follow Along, Dropping Seeds and Covering it … the Seeds Grew"; (b) Staying Active in the Natural World: "When I Would Go Home [from boarding school] in the Summertime, That's When … We'll Be Back Being an Indian"; (c) Staying Active through Culture: "The Traditional Dancing … [is] a Form of Exercise"; (d) Mental Wellness in Nature: "It Seemed Like Just Sitting Out There Makes You Feel Better"; and (e) Sports and Competitions Fostering PA: "A lot … Prefer Playing Softball, Basketball, Volleyball, Nowadays". Results highlighted how participants preferred and participated in subsistence and PA growing up, how this had evolved over time, and how being outside in nature contributed to a sense of wellness and overall health.