An interventional study of Neqpiaput linruugut (Our Food is Medicine) in Cardiovascular (CV) Risk, sponsored by University of Alaska Fairbanks. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-10-27.
Sponsored by University of Alaska Fairbanks · Not applicable, Interventional, and Prevention
This study Neqpiaput Iinruugut ("Our Food is Medicine"), will test if a tribally designed Indigenous food sovereignty intervention can lower the risk of coronary heart disease in Alaska Native adults ages 18 to 65 years old. Designed by Yup'ik Elders, the 12-month intervention combines Calricaraq, an established Elder-designed behavioral health program rooted in ancestral wisdom, with hands-on activities focused on traditional foodways. About 150 adults in three Alaska Native communities will take part. The main questions it aims to answer are:
Researchers will compare communities receiving the intervention to communities waiting to start it (a dynamic wait-listed design) to see if the intervention lowers Framingham Risk Scores.
Participants will:
Neqpiaput Iinruugut (Our Food Is Our Medicine) is a culturally grounded, tribally designed intervention intended to reduce cardiovascular disease risk among Yup'ik adults by strengthening food sovereignty and cultural protective factors. The intervention is grounded in an Indigenist stress-coping framework that recognizes historical and ongoing stressors as contributors to cardiovascular disease risk and cultural identity, relationships, traditional food systems, and other cultural resources as potential protective factors.
Colonization disrupted Yup'ik cultural and traditional food systems, contributing to historical trauma, chronic stress, and reduced access to traditional foods. These changes may influence cardiovascular health through multiple pathways, including psychosocial stress and changes in diet. Neqpiaput Iinruugut takes a strengths-based approach that builds on Yup'ik knowledge, values, relationships, and traditional food practices to address these pathways.
The study will evaluate Neqpiaput Iinruugut among Yup'ik adults in three rural Alaska Native communities in the Yukon-Kuskokwim Delta. Communities are randomly assigned to the order in which they begin the intervention, with intervention start dates staggered by 12 months. All three communities receive the 12-month intervention.
Neqpiaput Iinruugut is delivered in each community by local interventionists and Elders with support from research staff and includes three components: (1) Calricaraq, a Yup'ik program for healing from historical trauma and reconnecting with cultural identity, delivered as an initial 3-day gathering followed by monthly 2- to 3-hour talking and learning circles (12 modules total); (2) quarterly Indigenous food sovereignty workshops at months 3, 6, 9, and 12 that include Elder stories, talking circles, hands-on subsistence activities, subsistence resources, and a shared traditional meal; and (3) a private, moderated community Facebook group that shares Elder teachings and reinforces concepts from the Calricaraq gatherings and food sovereignty workshops.
The primary goal of the study is to determine whether participation in Neqpiaput Iinruugut reduces estimated cardiovascular disease risk. The study will also examine hypothesized pathways of change, including perceived stress and responses to historical loss; cultural protective factors including Yup'ik wellness, cultural identity, connectedness, and family relationships; and food-related factors including traditional food consumption and Indigenous food sovereignty. Traditional food intake will also be assessed using stable isotope biomarkers measured from dried blood spot samples collected by finger stick. Participants are assessed during the 12-month intervention and six months after the intervention ends to examine both intervention-related change and maintenance of changes.
University of Alaska Fairbanks is the lead sponsor of 7 studies on the registry; 3 are open to participants now.
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Exclusion Criteria:
Participants in all three communities will receive the 12-month Neqpiaput Iinruugut intervention. Communities will be randomly assigned to the order in which they begin the intervention, with intervention start dates staggered by 12 months
Behavioral: Neqpiaput linruugut (Our Food is Medicine)
Neqpiaput Inruugut is a 12-month, tribally designed intervention delivered in each community by local interventionists and Elders with support from research staff. It has three components: (1) Calricaraq, a Yup'ik program for healing from historical trauma and reconnecting with cultural identity, delivered as an initial 3-day gathering followed by monthly 2 to 3 hour talking and learning circles (12 modules in total); (2) quarterly Indigenous food sovereignty workshops at months 3, 6, 9, and 12, each with Elder stories, talking circles, hands-on subsistence activities, subsistence resources, and a shared traditional meal; and (3) a private, moderated community Facebook group that shares Elder teachings and reinforces concepts from the gatherings and workshops.
Change in Framingham Risk Score
Estimated 10-year risk of coronary heart disease, using the Framingham Risk Score based on age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure medication use, diabetes status, and smoking status. Total and HDL cholesterol are measured from a fasting finger-stick blood sample using a Cholestech LDX point-of-care analyzer, and blood pressure is measured using an OMRON IntelliSense professional digital monitor. Remaining inputs are self-reported on the Demographic and Medical History Questionnaire. Higher scores indicate greater estimated 10-year cardiovascular disease risk.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in perceived stress
Perceived stress will be assessed using the 10-item Perceived Stress Scale (PSS-10), which measures the degree to which participants perceive situations in their lives as stressful, including feelings of overload and lack of control. Higher scores indicate greater perceived stress.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in historical loss-associated symptoms
Historical loss-associated symptoms will be assessed using an adapted Historical Loss Associated Symptoms Scale (HLASS), which measures emotional and behavioral responses associated with thinking about historical losses, including grief, anger, shame, and feelings of loss. Higher scores indicate more frequent symptoms associated with historical loss.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in Yup'ik wellness
Assessed using the Yup'ik Wellness Questionnaire, which measures two dimensions of engagement with Yup'ik cultural systems: frequency of participation in cultural practices and the importance participants place on those practices. Higher frequency ratings indicate more frequent engagement, and higher importance ratings indicate greater importance placed on the activity.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in Yup'ik cultural identity
Cultural identity will be assessed using one item measuring the degree to which participants identify with Yup'ik way of life. Higher ratings indicate greater identification with/following of a Yup'ik way of life.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in Kass'aq (non-Native) cultural identity
Cultural identity will be assessed using one item measuring the degree to which participants identify with Kass'aq way of life. Higher ratings indicate greater identification with/following of a Kass'aq way of life.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in connectedness
Connectedness will be assessed using the Awareness of Connectedness scale, which assesses reciprocity and connectedness to family, community, and land. Higher scores indicate greater awareness of connectedness.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in family relationship
Family relationships are assessed using 16 items from the Brief Family Relationship Scale (BFRS) addressing family support and cohesion, communication and expressiveness, and conflict. Higher scores indicate greater cohesion and lower conflict.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in traditional food consumption
Traditional food consumption will be assessed using a six-item survey measuring frequency of consumption across six traditional food categories: fish, marine mammals, land mammals, wild birds or eggs, berries, and wild plants or greens. Higher responses indicate more frequent traditional food consumption.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in Indigenous food sovereignty
Indigenous food sovereignty is assessed using 19 items addressing subsistence knowledge and skills, teaching and learning, food sharing, relationships, access, adaptability, stewardship, and impacts of colonization and changes in traditional food systems.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in well-being
Well-being is assessed using 14 item Warwick-Edinburgh Mental Well-being Scale (WEMWBS) addressing positive mental well-being during the previous two weeks, including optimism, feeling useful, relaxation, energy, coping, clear thinking, positive self-regard, connection with others, confidence, and feeling loved. Higher scores indicate greater positive mental well-being.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in stable isotope biomarker of traditional food intake
Stable isotope ratios are measured from dried blood spot samples collected by finger stick as objective biomarkers of traditional food intake.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Change in frequency of thoughts about historical loss
Historical loss will be assessed using the 15-item Historical Loss Scale (HLS), which assesses the frequency with which participants think about collective losses experienced by Yup'ik people, including loss of land, language, cultural and spiritual practices, family ties, traditional foods, natural resources, and traditional knowledge. Higher scores indicate more frequent thoughts about historical losses when responses are coded in that direction.
Time frame: Baseline (B), 6-month intervention midpoint (T1), 12-month end of intervention (T2), and 18-month follow-up (T3)
Plan to share: No
Start is estimated for Oct 2026; primary completion for Mar 2030, 41 months later.
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University of Alaska Fairbanks