Physical Activity Interventions Among American Indian and Alaska Native Persons: A Systematic Review

Abstract

Objective The purpose of this review was to identify and describe physical activity (PA) interventions that have been implemented with American Indian and Alaska Natives (AIANs) in the U.S. and Canada since 2006. Data Source Searches were conducted in 8 databases plus grey literature sources. Study Inclusion and Exclusion Criteria Eligible studies: (a) described an intervention designed to increase PA; (b) targeted AIANs residing in the U.S. or Canada, or if a multiethnic population, contained an AIAN subanalysis; (c) were published in 2006 or later; and (d) reported a PA outcome. Data Extraction Two reviewers independently extracted data, with conflicts resolved through discussion. Data Synthesis Data were synthesized by participant characteristics, intervention strategies, PA outcomes, and impact. Results We identified 25 eligible studies, most targeting children and youth. Intergenerational, environmental policy, cultural adaptation, and curriculum-based approaches were used. Twenty studies used self-reported PA measures. 80% of studies used an element of cultural adaptation, mostly considering cultural needs in design, not program or outcome evaluation. Sedentary behavior and leisure-time PA were rarely assessed. Significant changes in PA outcomes were achieved post-intervention in 13 studies (52%). Conclusion Future interventions should target AIAN adults to evaluate sedentary behavior and leisure-time PA. Interventions should incorporate psychometrically tested objective measures and prioritize the Native perspective from intervention design through project evaluation.