Eagle Adventure

Overview

The Eagle Adventure (EA) was designed to address the need for culturally relevant SNAP-Ed programming to prevent type 2 diabetes in Indian Country. EA was developed using the CDC Eagle Book series as the central theme. Through this series of four books, wise animal characters are brought to life. Mr. Eagle, Miss Rabbit and a clever trickster, Coyote, engage Rain That Dances and his young friends in the joy of being physically active, eating healthy foods and learning from their elders about traditional ways of being healthy. Throughout the program, youth and their families learn that type 2 diabetes can be prevented through healthful dietary and physical activity (PA) choices. Students in grades 1-3 are introduced to the program through the EA play, which embraces traditions of Native American storytelling. Students participate in hands-on activities and food experiences in each of the lessons.

Eagle Adventure (EA) was designed after formative evaluation with Native American families in Oklahoma. The formative evaluation was mixed methods and included methods such as focus groups, surveys and photovoice to identify what health and nutrition information was most important to families. EA is based on the Eagle Books published by the Centers for Disease Control and Prevention. The books and EA are based on traditions of Native American storytelling and cultures but speak to all children. EA reinforces making healthy choices to grow-up healthy and prevent the development of type 2 diabetes. EA uses the socioecological model as a framework for program components and social cognitive theory constructs to address behavior change. Since 2010, over 10,000 students have participated in EA in partnership with numerous tribes throughout Oklahoma.

EA includes the following social marketing components: school and radio announcements, newspaper messages, place-based signage, and social media components to extend healthful messages beyond the classroom to community settings. Not Our Destiny (www.NotOurDestiny.com) is a complementary intergenerational social marketing campaign that is asset-based and shares stories of health from Native Americans who engage in healthful activities.

Intervention Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time

SNAP-Ed Strategies: Direct Education, Social Marketing, PSE Change

Intervention Reach and Adoption

Students in grades 1-3 are the primary audience for EA in elementary school settings. Parents, family members, and teachers are the secondary audience.

Settings: Tribal Reservations, Schools

Age/Population Group: Elementary School

Race: American Indian or Alaska Native

Ethnicity: All

Intervention Components

Discussions with school partners begin several months before implementation. Pre/Post in-school surveys are ideally administered 2 weeks before the play and 2 weeks after lesson 4. Following the play, there are 4 in-class lessons intended to be implemented 2 weeks apart. At each lesson, the educator assistant monitors classroom components to identify fidelity to process. Between each lesson, school announcements, take-home activities and social media connections are promoted to encourage education beyond the classroom. When possible, radio, news announcements and convenience store signage should be placed in places identified as important to the audience. Teacher evaluation and parent evaluation should be disseminated on the last lesson day and picked up on the day of post-evaluation for students. A medal is awarded to each child for participation.

Intervention Materials

Eagle Adventure Resources are available online here. Resources include a program manual (complete description of the program process and script); parent tip sheets (take home materials for caregivers of students); nestwork (family-based health homework); and evaluation instruments. A demonstration of the play is also available for viewing on the website. Eagle Books can be downloaded/ordered here.

Evidence Summary

Beginning with the pilot administration of EA as part of the Wave 1 study, the EA was one of two interventions that had statistically significant impact on children asking for or helping themselves to vegetables as a snack. External evaluation also noted promising trends (though results did not achieve statistical significance) in increased willingness to try new vegetables and greater at-home availability of fruits and vegetables. A major limitation of the external evaluation was reliance on parent reports of child average daily at-home consumption of fruits and vegetables of child participants given the severe limitations of parent recall as low-income students make most food and activity choices in school settings. As noted previously, the CDC Westat evaluation revealed promising and sustaining qualitative results. Further, our internal evaluation consistently reveals significance in food and PA choice behaviors among students and their families.

External process evaluators reported "caregiver survey results and focus group discussions revealed a relatively high level of use and satisfaction with the program materials." The Westat team completed in-depth interviews with current EA team members, a teacher from an EA school, among others. Focus groups were also held with seven parents and eight children at an elementary school where EA had been implemented. Parents believed, EA messages "were coming through 'loud and clear' for several reasons: the books were easy to read; the stories were presented through animals (which can have cultural meanings); the artwork was really appealing; and...being a school-based based program made the messages more meaningful."

Improvements at p<.01 were seen from pre- to post-test in: (1) Student desire to consume healthy foods and drinks over less healthy foods and drinks, and (2) Student desire to engage in moving activities over sedentary activities.

Traditional Foods in Native America-Part IV: A Compendium of Stories from the Indigenous Food Sovereignty Movement in American Indian and Alaska Native Communities (2015).

For additional evidence please see the following paper:

Fox, J., Jackson, T., Miracle, S., O'Hara, U., & Parker, S. (2020). Type 2 Diabetes Prevention Among Native Americans: The Eagle Adventure Program. American Journal of Health Studies, 35(2). https://doi.org/10.47779/ajhs.2020.197

Evidence Base: Research-tested

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

	Readiness and Capacity - Short Term (ST)	Changes - Medium Term (MT)	Effectiveness and Maintenance - Long Term (LT)	Population Results (R)
Individual	ST1, ST3	MT1, MT3
Environmental Settings		MT5, MT6
Sectors of Influence	ST8		LT19