More Outside Your Door (MOYD): A Multilevel Intervention Promoting Traditional Diet and Physical Activity to Decrease Risk of Obesity in Alaska Native Preschoolers

What this Trial Is About

Researchers are evaluating a program called More Outside Your Door designed to reduce childhood obesity among Yup'ik Alaska Native preschool children aged 3 to 5 years. This 5-year study focuses on promoting traditional nutrient-rich foods and increasing physical activity, especially outdoor activities tied to Yup'ik culture, to improve diet and activity habits early in life. The goal is to lower the risk of obesity-related diseases and address health disparities in this Indigenous population. The study uses a stepped-wedge design involving 12 rural Alaskan communities with Head Start preschool programs. Communities are grouped into three wedges, with each wedge receiving an 8-month culturally tailored intervention focused on traditional foods, outdoor physical activities, and healthy lifestyle promotion. While one wedge undergoes the intervention, the others serve as controls, and the intervention includes school, family, and community-level components to encourage healthy behaviors. Participants and their families engage in health screenings and activities at the Head Start programs. Researchers assess outcomes such as body mass index, physical activity levels using actigraphy, outdoor time, sleep quality, and dietary intake through biomarkers measured from fingernail samples over three years. The study also collects data on educational progress, traditional and processed food consumption, and community play space use. A process evaluation is conducted to understand how well the intervention is implemented and disseminated.

More Outside Your Door: a Diet/physical Activity Intervention to Decrease Risk of Obesity in Alaska Native Preschoolers