Pathways: A school-based program for the primary prevention of obesity in American Indian children

Area of Science:

• Childhood obesity intervention
• Public health research
• Preventive medicine

Background:

• Rising obesity rates in American Indian children present a significant public health concern.
• Existing interventions require adaptation for cultural relevance and school-based settings.

Purpose of the Study:

• To describe the intervention and outcome measurement procedures for the "Pathways" study.
• To reduce the prevalence of obesity among American Indian children through a school-based randomized clinical trial.

Main Methods:

• A multicenter, randomized clinical trial involving approximately 2,000 third-grade children across 40 schools in seven American Indian communities.
• Development and pilot testing of intervention components: school food service, classroom curriculum, physical education, and family involvement.
• Validated measurement instruments for body composition, physical activity, dietary intake, and knowledge, attitudes, and behaviors.

Main Results:

• The primary aim is to decrease average body fat percentage by at least 3% in intervention schools compared to control schools over 3 years.
• Intervention strategies focus on increasing physical activity and reducing dietary fat intake, not overall calorie reduction.
• The study assumes a healthier, lower-fat diet combined with increased physical activity will reduce excess calorie deposition as body fat.

Conclusions:

• The "Pathways" study outlines a comprehensive, culturally tailored approach to combat childhood obesity in American Indian communities.
• Validated methods and intervention components are established for a full-scale trial.
• The intervention's success hinges on synergistic effects of diet modification and increased physical activity.