PROJECT SUMMARYAmerican Indian (AI) youth have the highest prevalence of obesity of all ethnic groups in the United Statesplacing them at disproportionate risk for adult obesity and obesity-driven metabolic disease including diabetescardiovascular disease high blood pressure stroke and cancer. In fact greater than 41.7% of the childrenand adolescents from the Hopi Tribe Pascua Yaqui Tribe Salt River Pima-Maricopa Indian Community andthe Yavapai Apache Nationtribal communities collaborating in the proposed studyare obese. Healthbehaviors can modify obesity risk and associated morbidities such as diabetes and cardiovascular disease. Toenhance the impact of our efforts we recognize the intervention must include parental support and attention toemotional well-being and coping skills through the integration of mind-body medicine (MBM). The goal of theAchieving American Indian Youth Energy and Mental Health Balance (AYEM-B) Study is to develop and test aculturally-relevant community-led intervention that incorporates the principles of MBM skills training andparental /caregiver engagement to support AI youth in achieving healthy lifestyle choices and in reducing riskfor adult obesity and related metabolic diseases. Our hypothesis is that participation in a community-led intervention that includes MBM and the family willreduce obesity-related chronic disease risk factors in AI adolescents (n=224) as assessed by changes in bodymass index z-score (primary outcome) and the objective measures of moderate/vigorous physical activity andfruit and vegetable intake (secondary outcomes) at 6 months. We will test our hypothesis by addressing thefollowing specific aims:Specific Aim 1: Integrate an existing week-long residential wellness camp program for AI adolescents withnovel MBM and parental engagement components to establish a 6-month community-led obesity preventionintervention for AI adolescents (aged 1015 years) and their parents/caregivers.Specific Aim 2: Assess the preliminary efficacy of the newly established program on body mass index z-scorephysical activity and fruit and vegetable intake in American Indian adolescents at baseline 3 and 6 monthsusing a within-subjects design. Also evaluate changes in individual risk factors (lipids hemoglobin A1Cfasting glucose) pre- and post-intervention.Specific Aim 3: Evaluate indicators of successful program implementation and the potential for sustainabilityacross participating tribal communities including acceptability and relevance to participants parents and thecommunity and program adoption feasibility fidelity and costs.