Back to Basics: Addressing Childhood Obesity Through Traditional Foods in Alaska

Back to Basics is a mixed-methods intervention trial to reduce the prevalence of obese Alaska Native children by increasing the proportion of nutrient-dense traditional and non-traditional foods consumed, and decreasing consumption of sugar-sweetened beverages (SSBs). This 5-year intervention trial targeting 0-5 year olds is conducted in partnership with Rural Community Action Program, Inc. (RCAP) Head Start (HS), Early Head Start (EHS), and Parents as Teachers (PAT) programs in 12 rural Alaskan communities in the Yukon-Kuskokwim (YK) region, where each site is assigned to either a 9-month nutritional education and meal program intervention or a standard education and meal program repeating annually.

This intervention trial aims to increase consumption of local traditional foods and nutrient-dense non-traditional foods, decrease SSB consumption, and decrease prevalence of obesity in children 3-5 years old by: (1) adjusting the nutritional content of existing meal services provided by RCAP to children ages 3-5 years; (2) providing culturally relevant nutrition education to families of children 0-5 years; (3) developing local and community driven initiatives that provide knowledge and skills and engage families in the gathering and preparing of local traditional foods; and (4) incorporating available and emerging resources (e.g. Fish/Farm-to- Schools) to increase integration of traditional foods into the diet.

Phase 1 involves the collection and analysis of formative and baseline data to help guide the intervention in Phase 2.

Phase 1 includes:

1. Gathering baseline height/weight and food/SSB consumption data previously collected on children ages 0-5 years enrolled in YK RCAP programs.
2. Conducting formative studies in the 12 YK communities to better understand attitudes towards childhood obesity and barriers/enablers to traditional foods consumption
3. Creating/integrating a traditional foods-focused nutrition curriculum into RCAP menu programs in YK communities.

5. Work to expand the "Fish to Schools" and "Farm to Preschool" programs into YK RCAP HS programs.

Phase 2 includes implementing:

1. A physical activity curriculum in HS programs in all communities
2. A traditional food in HS menu program in intervention communities
3. A home-based nutrition program in intervention communities
4. A mechanism to document traditional foods important to each community

Study Overview

• Status: Unknown
• Conditions: Obesity
• Intervention / Treatment: Other: Traditional food

• Study Type: Interventional
• Enrollment (Anticipated): 804
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Timothy K Thomas, MD; Phone Number: 907 729 3095; Email: tkthomas@anthc.org
• Study Contact Backup: Name: Kathy Koller, PhD; Phone Number: 907 729 3644; Email: kkoller@anthc.org

Study Locations

• United States
  • Alaska
    • Anchorage, Alaska, United States, 99508
      • Recruiting
      • Alaska Native Tribal Health Consortium
      • Contact: Kathy Koller, PhD; Phone Number: 907-729-3644

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• for the Focus Group Discussions: Consenting Alaska Native residents of the 12 communities involved in the study, aged 18 and over.
• for the intervention study: Upon parental or guardian consent, Alaska Native residents of the 12 communities involved in the study, aged 0-5 years and enrolled in the RurAL CAP Head start, Early Head start, or Parents as Teachers, programs

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Traditional food arm; Traditional food-focused menu	Other: Traditional food; Increasing traditional food consumption through Head start programs in Alaska
No Intervention: Non-intervention arm; Standard RurAL CAP menu

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Body Mass Index (BMI)	Change in Proportion of AN children 3-5 years old with a BMI greater than or equal to the 95th percentile	Measured annually over 4 years of intervention
Traditional food content	Change in Percentage of total calories derived from traditional foods	Measured annually over 4 years of intervention

Collaborators and Investigators

• Sponsor: Alaska Native Tribal Health Consortium
• Collaborators: University of Alaska Fairbanks; University of Alaska Anchorage; Yukon Kuskokwim Health Corporation; Rural Alaska Community Action Program, Inc. (RurAL CAP)
• Investigators: Principal Investigator: Timothy K Thomas, MD, Alaska Native Tribal Health Consortium; Study Director: Kathy Koller, PhD, Alaska Native Tribal Health Consortium

Publications and helpful links

General Publications

• Koller KR, Flanagan CA, Nu J, Lee FR, Desnoyers C, Walch A, Alexie L, Bersamin A, Thomas TK. Storekeeper perspectives on improving dietary intake in 12 rural remote western Alaska communities: the "Got Neqpiaq?" project. Int J Circumpolar Health. 2021 Jan 1;80(1):1961393. doi: 10.1080/22423982.2021.1961393.

Study record dates

Study Major Dates

• Study Start (Actual): May 14, 2018
• Primary Completion (Anticipated): April 30, 2022
• Study Completion (Anticipated): July 31, 2022

Study Registration Dates

• First Submitted: June 14, 2018
• First Submitted That Met QC Criteria: July 24, 2018
• First Posted (Actual): July 26, 2018

Study Record Updates

• Last Update Posted (Actual): July 14, 2020
• Last Update Submitted That Met QC Criteria: July 10, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity; Pediatric Obesity
• Other Study ID Numbers: 5RO1NRO15417-02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No