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        Emerging Infectious Diseases Journal
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        Volume 4: No. 4, October 2007

        SPECIAL TOPIC
        Development of a Culturally Appropriate, Home-Based, Nutrition and Physical Activity Curriculum for Wisconsin American Indian Families

        The Figure is a flow chart describing the participatory process used in developing the curriculum for the Healthy Children, Strong Families (HCSF) intervention. The figure consists of eight levels of boxes arranged vertically, flowing top to bottom and connecting downward with arrows. Three parallel boxes at the first level of the graph are labeled as follows: "academic researchers, “tribal research and wellness staff,” and “child development and home visiting specialists and dietitians.” Lines flow downward from each of these three boxes to connect at one point with a single second-level box labeled 揹raft framework for curriculum.?This box connects by a downward line to the third-level box labeled 揵rainstorm ideas for activities and incentives with community.?A line flows downward from this box to a single fourth-level box labeled 揹raft each lesson.?This box is in turn connected by a downward flowing line to a single fifth-level box labeled 揹iscussions and modifications with mentors and wellness staff.?

        At this point, two-way lines on either side of the box labeled 揹iscussions and modifications with mentors and wellness staff?connect this box back up to the third-level box labeled 揵rainstorm ideas for activities and incentives with community.?The line on the left flows through an outer box labeled 揂merican Indian community mentors.?The line on the right flows through two outer boxes, the lower one labeled 搊ther community members,?and the upper labeled 搕ribal wellness staff.?

        A downward flowing line connects the fifth-level box, 揹iscussions and modifications with mentors and wellness staff,?with the sixth-level box below it, which is labeled 揻inalize each lesson.?This box in turn connects downward with a seventh-level box labeled 搇esson delivery by mentors.?Finally, the seventh-level box connects downward to the eighth and final level box labeled 搈entor feedback and lesson modification.?

        This final, eighth-level box has two lines flowing out and up from either side, connecting it with the fifth-level five box labeled 揹iscussions and modifications with mentors and wellness staff.?/p>

        Figure. Participatory process for curriculum development in the Healthy Children, Strong Families intervention.

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