{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:30:43Z","timestamp":1773163843791,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,6,21]],"date-time":"2017-06-21T00:00:00Z","timestamp":1498003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30DK092923"],"award-info":[{"award-number":["P30DK092923"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30DK56350"],"award-info":[{"award-number":["P30DK56350"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R34DK096403"],"award-info":[{"award-number":["R34DK096403"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["T32DK07658"],"award-info":[{"award-number":["T32DK07658"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32DK07658"],"award-info":[{"award-number":["T32DK07658"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30DK092923"],"award-info":[{"award-number":["P30DK092923"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30DK56350"],"award-info":[{"award-number":["P30DK56350"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R34DK096403"],"award-info":[{"award-number":["R34DK096403"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Obesity"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>American Indian (AI) youth are at high risk for type 2 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To partner with Eastern Band of Cherokee Indians and Navajo Nation to develop a culturally sensitive behavioural intervention for youth (Tribal Turning Point; TTP) and assess feasibility in an 8\u2010month randomized pilot study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 62 overweight\/obese AI children (7\u201310\u00a0years) who participated with \u22651 parent\/primary caregiver. Intervention participants (<jats:italic>n<\/jats:italic>\u00a0=\u00a029) attended 12 group classes and five individual sessions. Control participants (<jats:italic>n<\/jats:italic>\u00a0=\u00a033) attended three health and safety group sessions. We analysed group differences for changes in anthropometrics (BMI, BMI <jats:italic>z<\/jats:italic>\u2010score, waist circumference), cardiometabolic (insulin, glucose, blood pressure) and behavioural (physical activity and dietary self\u2010efficacy) outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Study retention was 97%, and intervention group attendance averaged 84%. We observed significant treatment effects (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02) for BMI and BMI <jats:italic>z<\/jats:italic>\u2010score: BMI increased in control (+1.0\u00a0kg\u00a0m<jats:sup>\u22122<\/jats:sup>, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) but not intervention participants (+0.3\u00a0kg\u00a0m<jats:sup>\u22122<\/jats:sup>, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.13); BMI <jats:italic>z<\/jats:italic>\u2010score decreased in intervention (\u22120.17, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) but not control participants (0.01, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.82). There were no treatment effects for cardiometabolic or behavioural outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We demonstrated that a behavioural intervention is feasible to deliver and improved obesity measures in AI youth. Future work should evaluate TTP for effectiveness, sustainability and long\u2010term impact in expanded tribal settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijpo.12223","type":"journal-article","created":{"date-parts":[[2017,6,21]],"date-time":"2017-06-21T05:22:41Z","timestamp":1498022561000},"page":"321-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Targeting risk factors for type 2 diabetes in American Indian youth: the Tribal Turning Point pilot study"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8473-8015","authenticated-orcid":false,"given":"K. A.","family":"Sauder","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Colorado School of Medicine  Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Dabelea","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado School of Medicine  Aurora CO USA"},{"name":"Department of Epidemiology Colorado School of Public Health  Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Bailey\u2010Callahan","sequence":"additional","affiliation":[{"name":"Eastern Band of Cherokee Indians  Cherokee NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Kanott Lambert","sequence":"additional","affiliation":[{"name":"Eastern Band of Cherokee Indians  Cherokee NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Community Health, Shiprock Service Unit Navajo Area Indian Health Service  NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"James","sequence":"additional","affiliation":[{"name":"Eastern Band of Cherokee Indians  Cherokee NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Percy","sequence":"additional","affiliation":[{"name":"Northern Navajo Medical Center Diabetes Research  NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. F.","family":"Jenks","sequence":"additional","affiliation":[{"name":"Department of Nutrition University of North Carolina  Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Testaverde","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Colorado School of Public Health  Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Nutrition University of North Carolina  Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Barber","sequence":"additional","affiliation":[{"name":"Northern Navajo Medical Center Diabetes Research  NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Smiley","sequence":"additional","affiliation":[{"name":"Northern Navajo Medical Center Diabetes Research  NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. W.","family":"Hockett","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Colorado School of Public Health  Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. W.","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Nutrition University of North Carolina  Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Letourneau","sequence":"additional","affiliation":[{"name":"Kovler Diabetes Center University of Chicago  Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Moore","sequence":"additional","affiliation":[{"name":"Centers for American Indian and Alaskan Native Health Colorado School of Public Health  Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. M.","family":"Delamater","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Miami  Miami FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Mayer\u2010Davis","sequence":"additional","affiliation":[{"name":"Department of Nutrition University of North Carolina  Chapel Hill NC USA"},{"name":"Department of Medicine University of North Carolina  Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0b013e3181e887ae"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.732"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3201"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.301968"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012512"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1250"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.5.1030"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/135.10.2392"},{"key":"e_1_2_6_10_1","article-title":"Using a participatory research approach in a school\u2010based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002\u20132006","volume":"11","author":"Teufel\u2010Shone NI","year":"2014","journal-title":"Prev Chronic Dis"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992289803700211"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2012.89"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0745"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12072"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2621"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.425"},{"key":"e_1_2_6_17_1","first-page":"A103","article-title":"Cherokee Choices: a diabetes prevention program for American Indians","volume":"3","author":"Bachar JJ","year":"2006","journal-title":"Prev Chronic Dis"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2780E"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2007.61"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.10762"},{"key":"e_1_2_6_21_1","volume-title":"Motivational Interviewing in Health Care: Helping Patients Change Behavior","author":"Rollnick S","year":"2008"},{"key":"e_1_2_6_22_1","first-page":"462","volume-title":"Health Behavior and Health Education: Theory, Research, and Practice","author":"Sallis J","year":"2008"},{"key":"e_1_2_6_23_1","unstructured":"Centers for Disease Control and Prevention.Modified z\u2010scores in the CDC growth charts.2011Ed."},{"key":"e_1_2_6_24_1","doi-asserted-by":"crossref","unstructured":"VijayakumarP WheelockKM KobesS et al.Secular changes in physical growth and obesity among southwestern American Indian children over four decades.Pediatr Obes.2016.","DOI":"10.1111\/ijpo.12199"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640418808729800"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/69.4.773S"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2329D"},{"key":"e_1_2_6_28_1","first-page":"44","article-title":"Effects of nutrition education and exercise in obese children: the Ho\u2010Chunk Youth Fitness Program","volume":"104","author":"Carrel A","year":"2005","journal-title":"WMJ"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-7435(02)00015-4"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.165340"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.3.557"}],"container-title":["Pediatric Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fijpo.12223","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijpo.12223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T07:31:29Z","timestamp":1695540689000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijpo.12223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,21]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1111\/ijpo.12223"],"URL":"https:\/\/doi.org\/10.1111\/ijpo.12223","archive":["Portico"],"relation":{},"ISSN":["2047-6302","2047-6310"],"issn-type":[{"value":"2047-6302","type":"print"},{"value":"2047-6310","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,21]]},"assertion":[{"value":"2016-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}