title: Cardiovascular Disease Risk Factors and Health Outcomes Among American Indians in Oklahoma: the THRIVE Study.
abstract: BACKGROUND
  Limited available data document higher prevalences of cardiovascular disease (CVD) risk factors and health outcomes among American Indians (AIs) compared to other racial/ethnic groups.
  
  
  METHODS
  As part of a randomized control trial to improve tribal food and physical activity environments, our tribal-academic partnership surveyed a cross-sectional sample of American Indian adults (n = 513) to assess the prevalence of type 2 diabetes, obesity, hypertension, tobacco use, physical activity, and vegetable and fruit intake. Surveys were collected from April through May 2015. We used logistic regression to examine the association between CVD-related risk factors and health outcomes.
  
  
  RESULTS
  The prevalence of CVD-related outcomes was high, ranging from 25% for diabetes to 75% for low vegetable intake. The prevalence of diabetes, obesity, and hypertension tended to be higher among participants with any tobacco use compared to no tobacco use, but findings were not statistically significant. The prevalence of diabetes (prevalence ratio 2.1, 95% CI 1.4-3.2) and obesity (prevalence ratio 1.5, 95% CI 1.2-1.8) was higher among participants with low physical activity levels compared to recommended physical activity levels.
  
  
  CONCLUSIONS
  CVD risk factors and health outcomes persist among American Indians even as some risks (e.g., smoking) appear to be stabilizing or even declining in the general US population. Efforts to include American Indians in national health surveys, implement broad reaching environmental and policy interventions, and address the social determinants of health are critical to the elimination of these disparities.
authors.affiliation: College of Public Health, University of Oklahoma Health Sciences Center, 4502 E 41st St., Tulsa, OK, 74105, USA. Valarie-Jernigan@ouhsc.edu.
authors.forename: Valarie Blue Bird
authors.initials: VBB
authors.lastname: Jernigan
authors.affiliation: College of Public Health, University of Oklahoma Health Sciences Center, 4502 E 41st St., Tulsa, OK, 74105, USA.
authors.forename: Marianna
authors.initials: M
authors.lastname: Wetherill
authors.affiliation: College of Public Health, University of Oklahoma Health Sciences Center, 4502 E 41st St., Tulsa, OK, 74105, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Hearod
authors.affiliation: College of Public Health, University of Oklahoma Health Sciences Center, 4502 E 41st St., Tulsa, OK, 74105, USA.
authors.forename: Tvli
authors.initials: T
authors.lastname: Jacob
authors.affiliation: College of Public Health, University of Oklahoma Health Sciences Center, 4502 E 41st St., Tulsa, OK, 74105, USA.
authors.forename: Alicia L
authors.initials: AL
authors.lastname: Salvatore
authors.affiliation: Choctaw Nation of Oklahoma Health Services Authority, One Choctaw Way, Talihina, OK, 74571, USA.
authors.forename: Tamela
authors.initials: T
authors.lastname: Cannady
authors.affiliation: Choctaw Nation of Oklahoma Health Services Authority, One Choctaw Way, Talihina, OK, 74571, USA.
authors.forename: Mandy
authors.initials: M
authors.lastname: Grammar
authors.affiliation: Chickasaw Nation Nutrition Services Department, 518 E. Arlington, Ada, OK, 74820, USA.
authors.forename: Joy
authors.initials: J
authors.lastname: Standridge
authors.affiliation: Chickasaw Nation Nutrition Services Department, 518 E. Arlington, Ada, OK, 74820, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Fox
authors.affiliation: Chickasaw Nation Nutrition Services Department, 518 E. Arlington, Ada, OK, 74820, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Spiegel
authors.affiliation: Chickasaw Nation Nutrition Services Department, 518 E. Arlington, Ada, OK, 74820, USA.
authors.forename: AnDina
authors.initials: A
authors.lastname: Wiley
authors.affiliation: Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Noonan
authors.affiliation: Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA.
authors.forename: Dedra
authors.initials: D
authors.lastname: Buchwald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009825:Oklahoma / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: American Indian; Cardiovascular disease; Community-based participatory research; Diabetes; Native American; Obesity; Vegetable and fruit intake