Document Type

Thesis - Open Access

Award Date


Degree Name

Master of Science (MS)

Department / School

Health and Nutritional Sciences

First Advisor

Suzanne Stluka


American Indian, Child Obesity, Culturally Tailored Education, Nutrition Education, Obesity, Physical Activity


Objective: To assess changes in nutrition and physical activity (PA) knowledge and behavior in elementary-age participants from school districts with high American Indian enrollment after completion of a culturally tailored education curriculum.
Design: Pre-post intervention study assessing knowledge and behavior using quantitative methods. Participants: A total of 248 participants (Kindergarten through 5th grade, n=248) throughout 13 elementary classrooms in tribal communities participated in Eat Smart. Play Hard.: The Oyate Way. Intervention(s): Baseline and post intervention data from a culturally tailored nutrition and PA knowledge and behavior curriculum.
Main Outcome Measure(s): Dependent variables were nutrition and PA knowledge, and nutrition and PA behavior. Independent variable was the intervention (pre-post).
Analysis: Paired t-tests were conducted to determine if there was an overall change, as well as changes by grade by comparing pre and post-tests looking specifically at nutrition and PA knowledge and behavior. Proportion tests were used to examine the proportion of yes responses to determine if they differ pre/post for PA.
Results: A significant increase was found in PA (p = 0.01) and cultural (p = 0.03) differences were found. All macronutrient intakes (p < 0.05) decreased significantly in the fourth and fifth grade levels. Individual food groups were also found to have significance in various grade levels. Meat, poultry and fish intake (p = 0.02) had a significant decrease in the fourth and fifth grade category. Fruit/fruit juice (p = 0.03), total fiber (p = 0.04), total sugars naturally occurring in foods (p = 0.03), as well as added sugar/syrup (p = 0.01) intake significantly decreased in the third-grade category. Significant decreases in physical activity behavior (p < 0.01) were found in the following categories for all grades: part-time work, activities like dance/drill team, biking/hiking, and physical education. Individual aspects were seen within specific grade levels for specified outcomes that were examined.
Conclusions and Implications: The present study incorporated culturally tailored education as it related to nutrition and PA knowledge and behavior. This study was the first to analyze culturally tailored education and its impact on nutrition and PA knowledge as well as behaviors. It identifies the need for interventions in this specific population. Further research should be done to incorporate this the culturally tailored education with multiple levels of the SEM specifically focusing on nutrition and PA to increase success for a long-lasting change in behavior. This behavior change could decrease the risk of comorbid diseases and increase a healthier lifestyle. The focus on this population is due to AI having higher risks for comorbid diseases such as obesity and diabetes. This study helps address the need for interventions, especially in this specific age group as these diseases are likely to carry on into adulthood.

Library of Congress Subject Headings

Indian children -- Nutrition -- Study and teaching (Primary) -- South Dakota.
Exercise for children -- Study and teaching (Primary) -- South Dakota.
Physical fitness for children -- South Dakota.
Indian school children -- Nutrition.
School children -- Nutrition.
Health behavior.



Number of Pages



South Dakota State University



Rights Statement

In Copyright