Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives.
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.
Office of Nutrition Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Two Democracy Plaza, Room 635, 6707 Democracy Boulevard MSC 5461, Bethesda, MD, 20892-5461, USA. sheila.fleischhacker@nih.gov.
Sheila
S
Fleischhacker
Department of Behavioral and Community Health, University of Maryland School of Public Health, 2242 Valley Dr., College Park, MD, 20742, USA.
Erica
E
Roberts
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 137 East Franklin Street, Suite 303A, Chapel Hill, NC, 27514, USA.
Ricky
R
Camplain
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 137 E Franklin Street, Suite 306, Chapel Hill, NC, 27514, USA.
Kelly R
KR
Evenson
Bloomberg School of Public Health, Department of International Health, Johns Hopkins University, Center for Human Nutrition 615 N. Wolfe Street, Rm W2041, Baltimore, MD, 21205, USA.
Joel
J
Gittelsohn
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002652:Child Behavior; D055812:Community-Based Participatory Research; D015444:Exercise; D006801:Humans; D007198:Indians, North American; D008913:Minority Groups
Active living; Alaskan Natives; American Indians; Exercise; Obesity; Physical activity