A Randomised Controlled Trial Testing a Behavioural Intervention Program for the Prevention of Type 2 Diabetes Among American Indian Youth: The Tribal Turning Point Study

Background American Indian youth experience a high risk of overweight/obesity and type 2 diabetes. Objectives To evaluate the effect of a behavioural intervention on diabetes risk factors among American Indian youth with overweight/obesity. Methods Between 2018 and 2023, youth (7–10 years) were randomised to the tribal turning point (TTP) intervention ( n = 87) or control arm ( n = 95). Community coaches delivered the core intervention in the first 6 months (10 group classes, 4 individual sessions with motivational interviewing) followed by the booster intervention in the second 6 months (2 group classes, 3 individual sessions). The control arm received 4 health/safety classes over 12 months. Data were collected at baseline, 6, and 12 months. Co‐primary outcomes were 12‐month change in BMI and fasting insulin. Results There were no significant differences by randomization for either primary outcome at 12 months. Among youth who completed 6‐month assessments before the COVID‐19 pandemic, the TTP intervention, compared to the control arm, was associated with significantly decreased change values for age/sex‐adjusted BMI z‐scores ( p = 0.028) and waist circumference ( p = 0.040) at 6 months. Conclusions In this trial among American Indian youth spanning the COVID‐19 pandemic, the TTP intervention yielded short‐term improvements on obesity measures but only in the subset who participated before the pandemic.