Project Leader:  Dr. Vernon Grant | Blackfeet Community College

Abstract

Obesity is a major public health concern in American Indian (AI) children. In addition to physical inactivity, sleep disorders and screen time are risk factors for obesity. However, there is a paucity of literature on how physical activity (PA), sleep, and screen time impact obesity risk in AI populations. 

Specific Aims

  1. Assess the association between PA, sleep, screen time, and obesity in AI children. 
  2. Determine AI children and adult perspectives on PA, sleep, screen time, and obesity. 

We hypothesize that PA and sleep will have an inverse relationship with BMI percentile and screen time will have a positive relationship with BMI percentile. We expect that among AI children and adults, themes will be identified such as poor access to healthy food and/or safe places to for kids to play.

The study population will include children in grades 6 – 8 (n=311 Middle School 7th and 8th grade; n = 131 Napi elementary 6th grade) living on the Blackfeet Indian Reservation in Browning, Mont.  Using a cross-sectional/mixed-methods assessment data will be collected from children attending Browning Middle School and Napi Elementary. We anticipate sampling at least 50 percent of all students (n = 210). Height and weight will be measured and then children will be administered a demographic and screen time survey. Children will be issued an Actical accelerometer, which objectively measures PA and sleep, to wear 24 hours per day for 7-days. A sub-sample of children (n = 36) and adults (n = 24) within the community will be recruited to participate in focus group discussions (3 for children and 2 for adults) about behaviors related to risk of obesity in children on the Blackfeet Indian reservation. 

Multivariate linear regression techniques will be used to explore predictors of obesity. A line-by-line analysis of the focus group transcripts will identify themes for risk factors for obesity, and behavioral strategies to reduce risk of obesity in AI children. 

Anticipated Results 

Physical activity and sleep will have negative coefficients with BMI percentile and screen time will have positive coefficients with BMI percentile. Focus group themes will show AI children engage in low amounts of PA and sleep and high amounts of screen time. We also anticipate that many of the behavioral strategies identified in the focus groups will include building capacity and securing resources for future programs and activities to reduce risk of obesity in AI children. 

Public Health Impact

This study will be the first to objectively measure PA and sleep concurrently in AI children living on a rural AI reservation, and asses this relationship to child BMI. The mixed-methods approach will generate a rich description of the need that exists in the community and will help to determine community-identified approaches to reducing risk of obesity in AI children.