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Principal Investigator: BERT Brandon BOYER
Organization: OREGON HEALTH & SCIENCE UNIVERSITY
Fiscal Year: 2024
Award: $748,455
Funding agency: National Heart Lung and Blood Institute
Project Summary/Abstract
Heart disease is the leading cause of death for Alaska Native men and the second leading cause of death
(after cancer) among women and Alaska Native people overall. The overarching goal of the proposed
multilevel, multicomponent intervention, Diet and Active Lifestyle - Yuuyaraq (DAiLY), is to reduce
consumption of highly processed store-bought foods while promoting intake of subsistence foods, healthy
store-bought foods, and a more active lifestyle to reduce heart disease risk. The Yup'ik word Yuuyaraq means
`the Yup'ik way of life' and encompasses a worldview in which living in harmony with the environment, as well
as sharing of subsistence foods and traditional knowledge is central. The proposed DAiLY intervention is
grounded in the Yup'ik worldview and Indigenous Food Sovereignty, and supported by a foundation of trust
resulting from 22 years of continuous Community Based Participatory Research on heart disease risk and
protective factors with Yup'ik communities. DAiLY is a direct response to the intervention research requests of
community partners and input from Yup'ik Community Research Associates and a Yup'ik Community Planning
Group during the formative research and community engagement process shaping this proposal. The
proposed intervention, based on the Warnecke model of health disparities and social cognitive theory, includes
three components: 1) home-based workshops, framed in the Yupik worldview, led by Community Research
Associates to facilitate interactive discussions with community members about healthy market foods, as well
as the health benefits of locally harvested traditional foods and increased physical activity; 2) local food store
interventions to increase access to, and help build demand for, healthy food options; and 3) traditional
community activities, including Yuraq (Yup'ik traditional dance), Native sports events, and berry festivals, that
provide opportunities to increase physical activity. The three components will be supported and reinforced via
community media, including Facebook, text messaging and visual materials. A continuous metabolic
syndrome score will be used as the primary outcome to assess changes in heart disease risk, and objective
stable isotope biomarkers of diet and a validated food frequency questionnaire will be used to measure intake
of traditional and market foods. We will test the DAiLY intervention in four Yupik communities, randomized to
immediate and delayed intervention. Aim 1, will determine the effectiveness of the DAiLY intervention on heart
disease risk by measuring change in a continuous metabolic syndrome risk score (primary outcome). Aim 2,
will assess implementation of the DAiLY intervention using a mixed methods process evaluation to determine
fidelity, dose, and reach, as well as barriers and facilitators to implementation of program activities and
participant satisfaction and engagement. Aim 3, will determine the impact of the DAiLY intervention on
community-level outcomes, including access to, and sales of, healthy foods in local stores, as well as
opportunities for physical activity at community venues.
Terms: <21+ years old><ACRP30 protein><Accelerometer><Adult><Adult Human><Alaska Indian><Alaska Native><Alaska Native group><Alaska Native individual><Alaska Native people><Alaska Native population><Alaskan American><Alaskan Indian><Alaskan Native><Alaskan Native American><Assess implementation><BP reduction><Behavioral><Berry><Beverages><Biological Markers><Body Weight><Cancers><Carbon Isotopes><Cardiac Diseases><Cardiac Disorders><Cardiac health><Cardiometabolic Disease><Cardiometabolic Disorder><Cause of Death><Communities><Community Education><Community Health Education><Consumption><Cross Sectional Analysis><Cross-Sectional Analyses><Cross-Sectional Studies><Cross-Sectional Survey><Dancing><Diet><Dietary Practices><Disease Frequency Surveys><Dose><Educational workshop><Environment><Event><Facebook><Festival><Fishes><Food><Food Access><Foundations><Frequencies><Goals><Grain><Harvest><Health><Health Benefit><Health Food><Healthy diet><Heart><Heart Diseases><Heart health><Home><Implementation assessment><Improve Access><Indigenous><Individual><Intake><Intervention><Intervention Strategies><Intervention Studies><Knowledge><Life><Link><Lipids><Malignant Neoplasms><Malignant Tumor><Mammalia><Mammals><Measures><Metabolic syndrome><Methods><Modeling><Na element><Native American community><Nitrogen Isotopes><Outcome><Participant><Persons><Physical activity><Plants><Postdoc><Postdoctoral Fellow><Process><Production><Questionnaires><Race><Races><Randomized><Research><Research Associate><Research Training><Risk><Risk Factors><Risk Reduction><Sales><Schools><Sedentary behavior><Sedentary life-style><Self Efficacy><Shapes><Sodium><Sports><System><Testing><Text Messaging><Time><Tribes><Trust><VIT D><Visual><Vitamin D><Woman><Workshop><Yup'ik><Yupik><accelerometry><active life style><active lifestyle><active living><activity monitor><activity tracker><adipocyte complement-related protein 30-kDa><adipocyte, C1q and collagen domain containing protein><adiponectin><adulthood><apM-1 protein><apM1 (adipose-specific) protein><assess effectiveness><balanced diet><bio-markers><biologic marker><biomarker><blood pressure reduction><cardiac disease risk><cardiac disorder risk><cardioprotectant><cardioprotection><cardioprotective><community based participatory research><community engagement process><community intervention><community led intervention><community led research><community level intervention><community participatory research><community partnered participatory research><community partners><community planning><community research><community-based intervention><community-based partners><community-driven intervention><design><designing><determine effectiveness><dietary><dietary pattern><diets><disease risk><disorder risk><disparity in health><effectiveness assessment><effectiveness evaluation><evaluate effectiveness><evaluate implementation><evaluation of implementation><examine effectiveness><experience><facilitators to implementation><food ads><food advertising><food environment><food marketing><good diet><health disparity><healthy food><heart disease risk><heart disorder><heart disorder risk><homes><implementation evaluation><implementation facilitators><improved><intervention research><interventional research><interventional strategy><interventional study><interventions research><lower BP><lower blood pressure><lowers blood pressure><malignancy><marine><marine environment><member><men><mortality><multi-component intervention><multi-faceted intervention><multi-modal intervention><multicomponent intervention><multifaceted intervention><multimodal intervention><neoplasm/cancer><participatory action research><post intervention><post-doc><post-doctoral><post-doctoral trainee><primary outcome><process evaluation><programs><protective factors><psychosocial><racial><racial background><racial origin><randomisation><randomization><randomly assigned><reduce BP><reduce blood pressure><reduce risk><reduce risks><reduce that risk><reduce the risk><reduce these risks><reduces risk><reduces the risk><reducing risk><reducing the risk><reduction in BP><reduction in blood pressure><research associates><response><risk-reducing><satisfaction><saturated dietary fat><saturated dietary lipid><saturated fat><saturated lipid><secondary outcome><sedentary lifestyle><short message service><social><social cognitive theory><social learning theory><stable isotope><sugar><systemic inflammation><systemic inflammatory response><texting><wild bird>