title: OPREVENT2: Design of a multi-institutional intervention for obesity control and prevention for American Indian adults.
abstract: Obesity and other nutrition-related chronic disease rates are high in American Indian (AI) populations, and an urgent need exists to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component (MLMC) interventions are needed, but there are significant knowledge gaps on how to deliver these types of interventions in low-income rural AI communities.
  
  
  
  OPREVENT2 is a MLMC intervention targeting AI adults living in six rural reservations in New Mexico and Wisconsin. Aiming to prevent and reduce obesity in adults by working at multiple levels of the food and physical activity (PA) environments, OPREVENT2 focuses on evidence-based strategies known to increase access to, demand for, and consumption of healthier foods and beverages, and increase worksite and home-based opportunities for PA. OPREVENT2 works to create systems-level change by partnering with tribal stakeholders, multiple levels of the food and PA environment (food stores, worksites, schools), and the social environment (children as change agents, families, social media). Extensive evaluation will be conducted at each level of the intervention to assess effectiveness via process and impact measures.
  
  
  
  Novel aspects of OPREVENT2 include: active engagement with stakeholders at many levels (policy, institutional, and at multiple levels of the food and PA system); use of community-based strategies to engage policymakers and other key stakeholders (community workshops, action committees); emphasis on both the built environment (intervening with retail food sources) and the social environment. This paper describes the design of the intervention and the evaluation plan of the OPREVENT2.
  
  
  
  Clinical Trial Registration: NCT02803853 (June 10, 2016).
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA. jgittel1@jhu.edu.
authors.forename: Joel
authors.identifier: 0000-0003-2761-3280
authors.initials: J
authors.lastname: Gittelsohn
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Brittany
authors.initials: B
authors.lastname: Jock
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Redmond
authors.affiliation: National Institute of Diabetes, Digestive and Kidney Diseases Office of Nutrition Research, Bethesda, USA.
authors.forename: Sheila
authors.initials: S
authors.lastname: Fleischhacker
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Eckmann
authors.affiliation: Harvard T.H. Chan School of Public Health, Boston, USA.
authors.forename: Sara N
authors.initials: SN
authors.lastname: Bleich
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Loh
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ogburn
authors.affiliation: St. John's University, Queens, NY, USA.
authors.forename: Preety
authors.initials: P
authors.lastname: Gadhoke
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Swartz
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Marla
authors.initials: M
authors.lastname: Pardilla
authors.affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Caballero
mesh_terms: D001628:Beverages; D002648:Child; D002985:Clinical Protocols; D004032:Diet / Q000379:methods; D004777:Environment; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007198:Indians, North American; D009516:New Mexico; D009765:Obesity / Q000517:prevention & control*; D011203:Poverty; D012424:Rural Population; D012574:Schools; D012931:Social Environment; D014922:Wisconsin
keywords: Adults; American Indian; Multi-level interventions; Obesity; Policy; Rural; Study design