{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T07:41:29Z","timestamp":1762414889959,"version":"build-2065373602"},"reference-count":50,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"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":["R01DK115434","P30DK092923","K99DK136503"],"award-info":[{"award-number":["R01DK115434","P30DK092923","K99DK136503"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Obesity"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>American Indian youth experience a high risk of overweight\/obesity and type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the effect of a behavioural intervention on diabetes risk factors among American Indian youth with overweight\/obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Between 2018 and 2023, youth (7\u201310\u2009years) were randomised to the tribal turning point (TTP) intervention (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200987) or control arm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200995). Community coaches delivered the core intervention in the first 6\u2009months (10 group classes, 4 individual sessions with motivational interviewing) followed by the booster intervention in the second 6\u2009months (2 group classes, 3 individual sessions). The control arm received 4 health\/safety classes over 12\u2009months. Data were collected at baseline, 6, and 12\u2009months. Co\u2010primary outcomes were 12\u2010month change in BMI and fasting insulin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were no significant differences by randomization for either primary outcome at 12\u2009months. Among youth who completed 6\u2010month assessments before the COVID\u201019 pandemic, the TTP intervention, compared to the control arm, was associated with significantly decreased change values for age\/sex\u2010adjusted BMI z\u2010scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028) and waist circumference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040) at 6\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this trial among American Indian youth spanning the COVID\u201019 pandemic, the TTP intervention yielded short\u2010term improvements on obesity measures but only in the subset who participated before the pandemic.<\/jats:p>\n                  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