This paper describes how formative research was developed and implemented to produce obesity prevention interventions among school children in six different Native American nations that are part of the Pathways study. The formative assessment work presented here was unique in several ways: (1) it represents the first time formative research methods have been applied across multiple Native American tribes; (2) it is holistic, including data collection from parents, children, teachers, administrators and community leaders; and (3) it was developed by a multi-disciplinary group, including substantial input from Native American collaborators. The paper describes the process of developing the different units of the protocol, how data collection was implemented and how analyses were structured around the identification of risk behaviors. An emphasis is placed on describing which units of the formative assessment protocol were most effective and which were less effective.
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Thanks are due to the following people: Jackie Altaha, Belinda Beach-Altaha, Alberta Becenti, Christine Benally, Karmen Booth, Theresa Clay, Michelle Curtis, Diane Garrett, Denise Harrison, Sally Hunsberger, Sarah Levin, Juanita Pablo, Nancy Risenhoover, Anjali Sharma, Dawn Stewert, Jean White; to the following schools: Cibecue Community School, Cibecue, Arizona; John F. Kennedy Elementary School, Cedar Creek, Arizona; Todd County School District, Mission, South Dakota; HeDog School, Parmelee; North Elementary School, Mission; and the Wounded Knee School, Manderson, South Dakota; Lukachukai Boarding School, Lukachukai, New Mexico; Mesa Elementary School, Shiprock, New Mexico; St. Peter Indian Mission School, San Xavier Convent School; and to the school staff, parents/guardians and children. This research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, U01-HL-50869, U01-HL-50867, U01-HL-50905, U01-HL-50885, U01-HL-50907.