Transforming Risk Factors in a High Stroke Risk Native American Population Through a Cultural Nutritional Program

Change in incidence of stroke and transient ischemic attack (TIA)

时间窗: Baseline to 1 year

Number of incidences of stroke or TIA during the study

Change in number of participants that meet American Heart Association (AHA) Simple Rules for Diastolic Blood Pressure.

时间窗: Baseline to 1 year

The AHA's simple rules for diastolic blood pressure: Normal = Less than 80 mm Hg; Elevated = Less than 80 mm Hg with a systolic reading of 120-129 mm Hg; Stage 1 Hypertension = 80-89 mm Hg; Stage 2 Hypertension = 90 mm Hg or higher; Hypertensive Crisis = Higher than 120 mm Hg (along with a systolic reading higher than 180 mm Hg). Researchers will be reporting the change in number of participants with diastolic blood pressure \<90 mmHg.

Change in number of participants that meet AHA's Simple Rules for Systolic Blood Pressure.

时间窗: Baseline to 1 year

The AHA uses these simple rules for systolic blood pressure (the top number): Normal is less than 120, Elevated is 120-129, Stage 1 Hypertension is 130-139, and Stage 2 Hypertension is 140 or higher. A systolic reading of 180 or higher indicates a hypertensive emergency. Researchers will be reporting the change in number of participants with systolic blood pressure \<140 mmHg.

Change in number of participants that meet AHA Simple Rules for Body Mass Index (BMI)

时间窗: Baseline to 1 year

The AHA uses the following guidelines for Body Mass Index (BMI) in adults: Underweight = Less than 18.5; Normal Weight = Between 18.5 and 24.9; Overweight = Between 25 and 29.9; and, Obesity = 30 or higher. Researchers will be reporting any improvement in BMI.

Change in Montreal Cognitive Assessment (MoCA)

时间窗: Baseline to 1 year

MoCA is scored out of a total of 30 points, with a score of 26 or above generally considered normal. The MoCA assesses various cognitive domains, including memory, visuospatial abilities, language, and executive functions. A lower score indicates potential cognitive impairment, with specific cutoffs for mild (19-23), moderate (10-18), and severe (0-9) impairment.

Change in NIH Toolbox Score

时间窗: Baseline to 1 year

NIH Toolbox Cognition Battery consists of tests of multiple constructs to asses for cognitive, sensory, motor and emotional function

Change in Native American Acculturation Scale (NAAS)

时间窗: Baseline to 1 year

NAAS is a 20-item questionnaire developed to assess the level of acculturation in Native Americans. It measures an individual's connection to both traditional Native American culture and mainstream American culture. Scores range from a low of 1, indicating low acculturation (or high Native American identity) to a high of 5, indicating high acculturation (or high mainstream American identity), with a score of 3 indicating "bicultural". The NAAS examines areas like identity, language, friendships, behaviors, attitudes, and generational/geographic background.

Change in knowledge of health through a structured culturally competent school education programs about nutrition

时间窗: Baseline to 1 year