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Beresford SA, Rillamas-Sun E, Rudd K, Bishop SK, Deschenie D, Ornelas IJ, Bauer MC, Lombard KA. Development of an assessment tool to measure healthy eating in Navajo children and their families. Curr Dev Nutr 2023; 7:100074. [DOI: 10.1016/j.cdnut.2023.100074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/23/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
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Ahmed F, Liberda EN, Solomon A, Davey R, Sutherland B, Tsuji LJS. Indigenous Land-Based Approaches to Well-Being: The Niska (Goose) Harvesting Program in Subarctic Ontario, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3686. [PMID: 36834382 PMCID: PMC9958717 DOI: 10.3390/ijerph20043686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Historically, goose harvesting provided a source of culturally significant, safe, and nutritious food for the Omushkego Cree of subarctic Ontario, Canada. Disruptions stemming from colonization and climate change have led to a decrease in harvesting, resulting in higher rates of food insecurity. The aim of the Niska program was to reconnect Elders and youth to revitalize goose harvesting activities and associated Indigenous knowledge within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before (n = 13) and after (n = 13) participation in the spring harvest. Likewise, cortisol samples were collected before (n = 12) and after (n = 12) the summer harvest. Photovoice and semi-directed interviews were employed after the spring (n = 13) and summer (n = 12) harvests to identify key elements of well-being from an Indigenous perspective. The changes observed in cortisol levels for the spring (p = 0.782) and summer (p = 0.395) harvests were not statistically significant. However, there was a noteworthy increase in the subjective well-being observed through the qualitative measures (semi-directed interviews and photovoice), highlighting the importance of using multiple perspectives when assessing well-being, especially in Indigenous peoples. Future programs should incorporate multiple perspectives when addressing complex environmental and health issues, such as food security and environmental conservation, especially in Indigenous homelands worldwide.
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Affiliation(s)
- Fatima Ahmed
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
| | - Eric N. Liberda
- School of Occupation and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Andrew Solomon
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | - Roger Davey
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | - Bernard Sutherland
- Peetabeck Academy, Mundo Peetabeck Education Authority, Fort Albany, ON P0L 1H0, Canada
| | - Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
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Emmanuel R, Read UM, Grande AJ, Harding S. Acceptability and Feasibility of Community Gardening Interventions for the Prevention of Non-Communicable Diseases among Indigenous Populations: A Scoping Review. Nutrients 2023; 15:791. [PMID: 36771495 PMCID: PMC9921708 DOI: 10.3390/nu15030791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
Compared with non-Indigenous populations, Indigenous populations experience worse health across many outcomes, including non-communicable diseases, and they are three times more likely to live in extreme poverty. The objectives were to identify (1) the content, implementation, and duration of the intervention; (2) the evaluation designs used; (3) the outcomes reported; and (4) the enablers and the challenges. Using the PRISMA-ScR guidelines, a search of research databases and grey literature was conducted. Seven studies met the inclusion criteria. Papers reported on acceptability, nutrition knowledge, fruit and vegetable intake, self-efficacy, motivation, and preference concerning fruit and vegetable, diet, and gardening. No study measured all outcomes. All papers reported on acceptability, whether implicitly or explicitly. The evaluation used mostly pre- and post-intervention assessments. The effect of gardening on nutrition and gardening knowledge and fruit and vegetable intake was inconclusive, and was related to a general lack of robust evaluations. Applying the He Pikinga Waiora Framework, however, revealed strong evidence for community engagement, cultural centeredness, integrated knowledge translation and systems thinking in increasing the acceptability and feasibility of gardening in Indigenous communities. Despite environmental challenges, the evidence signaled that gardening was an acceptable intervention for the Indigenous communities.
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Affiliation(s)
- Rosana Emmanuel
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
| | - Ursula M Read
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Antonio Jose Grande
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Department of Medicine, Universidade Estadual de Mato Grosso do Sul-(UEMS), P.O. Box 351, Dourados 79804-970, Brazil
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
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Brown MC, Hawley C, Ornelas IJ, Huber C, Best L, Thorndike AN, Beresford S, Howard BV, Umans JG, Hager A, Fretts AM. Adapting a cooking, food budgeting and nutrition intervention for a rural community of American Indians with type 2 diabetes in the North-Central United States. HEALTH EDUCATION RESEARCH 2023; 38:13-27. [PMID: 36342521 PMCID: PMC9853931 DOI: 10.1093/her/cyac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/06/2022] [Accepted: 10/18/2022] [Indexed: 05/24/2023]
Abstract
American Indian (AI) communities experience persistent diabetes-related disparities, yet few nutrition interventions are designed for AI with type 2 diabetes or address socio-contextual barriers to healthy eating. We describe our process of adapting the evidence-based Cooking Matters® program for use by AI adults with type 2 diabetes in a rural and resource-limited setting in the North-Central United States. We conducted three focus groups with AI adults with diabetes to (i) identify Cooking Matters® adaptations and (ii) gather feedback on appropriateness of the adapted intervention using Barrera and Castro's cultural adaptation framework. Transcripts were coded using an inductive, constant comparison approach. Queries of codes were reviewed to identify themes. Contextual considerations included limited access to grocery stores and transportation barriers, reliance on government food assistance and the intergenerational burden of diabetes. Adaptations to content and delivery included incorporating traditional and locally available foods; appealing to children or others in multigenerational households and prioritizing visual over written content. Our use of Barrera and Castro's framework adds rigor and structure to the cultural adaptation process and increases the likelihood of future intervention success. Other researchers may benefit from using this framework to guide the adaptation of evidence-based interventions in AI communities.
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Affiliation(s)
- Meagan C Brown
- Department of Epidemiology, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA and Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA 98101, USA
| | - Caitie Hawley
- Department of Medicine, University of Washington, Health Sciences Building, Box 356420, 1959 NE Pacific Street, Seattle, WA 98195-6420, USA
| | - India J Ornelas
- Department of Health Systems and Population Health, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Corrine Huber
- Missouri Breaks Industries Research Inc., 18 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA
| | - Lyle Best
- Missouri Breaks Industries Research Inc., 18 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA
| | - Anne N Thorndike
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA and Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Shirley Beresford
- Department of Epidemiology, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Barbara V Howard
- Field Studies Division, Medstar Health Research Institute, 6525 Belcrest Rd #700c, Hyattsville, MD 20782, USA
- Georgetown and Howard Universities Center for Clinical and Translational Science, 4000 Reservoir Rd NW #7, Washington, DC 20057, USA
| | - Jason G Umans
- Georgetown and Howard Universities Center for Clinical and Translational Science, 4000 Reservoir Rd NW #7, Washington, DC 20057, USA
- Field Studies Division and Biomarker, Biochemistry, and Biorepository Core, Medstar Health Research Institute, 6525 Belcrest Rd #700c, Hyattsville, MD 20782, USA
| | - Arlette Hager
- Cheyenne River Sioux Tribe Adult Diabetes Program, 24276 166th St. Airport Road, P.O. Box 590 Eagle Butte, SD 57625, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA
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Beresford SA, Ornelas IJ, Bauer MC, Garrity GA, Bishop SK, Francis B, Rillamas-Sun E, Garcia LV, Vecenti FS, Lombard KA. Group Randomized Trial of Healthy Eating and Gardening Intervention in Navajo Elementary Schools (Yéego!). AJPM FOCUS 2022; 1:100033. [PMID: 37791240 PMCID: PMC10546586 DOI: 10.1016/j.focus.2022.100033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Few healthy eating, school-based interventions have been rigorously evaluated in American Indian communities. Gardening and healthy eating are priorities in the Navajo Nation. Collaborations between researchers and local partners supported the design and implementation of this project. Design The Yéego! Healthy Eating and Gardening Study was a group-randomized controlled trial to evaluate a school-based healthy eating and gardening intervention in 6 schools in the Navajo Nation. Schools were randomized 1:2 to intervention or comparison. Setting/participants The Shiprock and Tsaile/Chinle areas in the Navajo Nation were selected. Elementary schools were screened for eligibility. All students in third and fourth grades were invited to participate in the assessments. Intervention Delivered during 1 school year in the intervention schools, the intervention included a culturally relevant nutrition and gardening curriculum and a school garden. Main outcome measures Student self-efficacy for eating fruits and vegetables, student self-efficacy for gardening, and student healthy foods score from a modified Alternative Healthy Eating Index were assessed in third and fourth graders at the beginning and end of a school year affected by the COVID-19 pandemic. Primary analyses used repeated measures linear mixed models accounting for students nested within schools to estimate the intervention effect and 95% CIs. Results Students in the intervention schools had self-efficacy scores for eating fruits and vegetables that were 0.22 points greater (95% CI=0.04, 0.41) than those in the comparison schools, although the student healthy foods score increased in the intervention schools by 2.0 (95% CI=0.4, 3.6); the differential change was modest at 1.7 (95% CI=-0.3, 3.7). The self-efficacy to grow fruits and vegetables in the school garden increased among those in the intervention schools (OR=1.92; 95% CI=1.02, 3.63) but not significantly more than it increased in the comparison schools (OR=1.29; 95% CI=0.60, 2.81). Conclusions The intervention was efficacious in improving self-efficacy for eating fruits and vegetables among third- and fourth-grade students over a school year. The findings warrant further evaluation of the intervention in larger-group randomized trials with schools in Navajo communities. Trial registration This study is registered at clinicaltrials.gov NCT03778021.
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Affiliation(s)
- Shirley A.A. Beresford
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
| | - India J. Ornelas
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
| | | | | | - Sonia K. Bishop
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
| | - Brandon Francis
- Agricultural Science Center at Farmington, College of Agricultural, Consumer, and Environmental Sciences, New Mexico State University, Farmington, New Mexico
| | - Eileen Rillamas-Sun
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
| | | | | | - Kevin A. Lombard
- Agricultural Science Center at Farmington, College of Agricultural, Consumer, and Environmental Sciences, New Mexico State University, Farmington, New Mexico
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Indigenous Land-Based Approaches to Well-Being: The Amisk (Beaver) Harvesting Program in Subarctic Ontario, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127335. [PMID: 35742603 PMCID: PMC9224250 DOI: 10.3390/ijerph19127335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022]
Abstract
The act of decolonizing knowledge systems involves recovering and renewing traditional, non-commodified cultural patterns, such as the sustenance of intergenerational relationships and traditional practices. A decline in beaver harvesting, which was once an integral part of the Omushkego Cree culture, has resulted in an overabundance of beavers and dams, which has negatively affected communities by increasing the local flooding events and impacting the water quality. The aim of the Amisk (beaver) program was to reconnect the Elders and youth to revitalize traditional on-the-land activities and, in the present case, beaver harvesting and associated activities within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before and after participation in the program. Photovoice, along with semi-directed interviews, were employed to identify the key elements of well-being from a First Nations’ perspective. For the beaver harvesting activities, the changes observed in the cortisol concentrations were not statistically significant (p = 0.094). However, the act of beaver dam removal was associated with a statistically significant increase in the post-participation cortisol concentration (p = 0.021). It was noteworthy that increased stress during the removal of the beaver dams–as indicated by the elevated post-activity cortisol levels–were not reflected in a decrease in the qualitative measures (semi-directed interviews and photovoice) of well-being from an Indigenous perspective. In fact, there was a noted increase in the subjective well-being of the participants, which highlights the importance of multiple perspectives when assessing well-being, especially in Indigenous peoples. However, the cortisol findings of the present pilot project need to be interpreted with caution, due to the limited sample sizes.
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Yazzie D, Tallis K, Curley C, Sanderson PR, Eddie R, Shin S, Behrens TK, George C, Antone-Nez R, Jumbo-Rintila S, Begay GA, de Heer H“D. The Navajo Nation Healthy Diné Nation Act: A Description of Community Wellness Projects Funded by a 2% Tax on Minimal-to-No-Nutritious-Value Foods. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E471-E479. [PMID: 34016908 PMCID: PMC8589869 DOI: 10.1097/phh.0000000000001371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT To promote the health of the Navajo people, the Navajo Nation passed the Healthy Diné Nation Act (HDNA) in 2014. The HDNA included a 2% tax on "minimal-to-no-nutritional-value" foods and waived 5% sales tax on healthy foods, the first such policy in the United States and any sovereign Tribal nation. Uniquely aligned with Tribal government structures, revenue was directly allocated to 110 small local government entities (Chapters) for self-determined wellness projects. OBJECTIVE To characterize HDNA-funded wellness projects, test for variation in project type, and funding amount over time by region and community size. DESIGN Longitudinal study assessing funded wellness projects from tax inception through 2019. SETTING The Navajo Nation. PARTICIPANTS One hundred ten Navajo Nation Chapters receiving funding for self-determined wellness projects. OUTCOME MEASURES The categories and specific types of wellness projects and funding over 4 years by region and community size. RESULTS Of revenue collected in 2015-2018, more than 99.1% was disbursed through 2019 ($4.6 million, $13 385 annually per community) across 1315 wellness projects (12 per community). The built recreational environment category received 38.6% of funds, equipment/supplies 16.5%, instruction 15.7%, food and water initiatives 14.0%, and social events 10.2%. Most common specific projects were walking trails ($648 470), exercise equipment ($585 675), food for events ($288 879), playgrounds ($287 471), and greenhouses ($275 554). Only the proportion allocated to instruction changed significantly over time (increased 2% annually, P = .02). Smaller communities (population <1000) allocated significantly higher proportions to traditional, agricultural, and intergenerational projects and less to the built environment. CONCLUSIONS Through 2019, more than 99% of HDNA revenue was successfully disbursed to 110 rural, Tribal communities. Communities chose projects related to promoting the built recreational environment, agriculture, and fitness/nutrition education, with smaller communities emphasizing cultural and intergenerational projects. These findings can inform other indigenous nations considering similar policies and funding distributions.
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Affiliation(s)
- Del Yazzie
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Kristen Tallis
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Caleigh Curley
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Priscilla R. Sanderson
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Regina Eddie
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Sonya Shin
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Timothy K. Behrens
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Carmen George
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Ramona Antone-Nez
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Shirleen Jumbo-Rintila
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Gloria Ann Begay
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
| | - Hendrik “Dirk” de Heer
- Navajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona (Mr Yazzie and Ms Antone-Nez); Department of Health Sciences (Mss Tallis, Curley, and Sanderson and Drs Behrens and de Heer) and College of Nursing (Dr Eddie), Northern Arizona University, Flagstaff, Arizona; Brigham and Women's Hospital, Boston, Massachusetts (Dr Shin and Ms George); College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (Dr Behrens); Navajo Division of Community Development, Window Rock, Arizona (Ms Jumbo-Rintila); and Diné Food Sovereignty Alliance, Gallup, New Mexico (Ms Begay)
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The Impact of Land-Based Physical Activity Interventions on Self-Reported Health and Well-Being of Indigenous Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137099. [PMID: 34281031 PMCID: PMC8296996 DOI: 10.3390/ijerph18137099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 01/03/2023]
Abstract
For many Indigenous communities, decreased participation in traditional land-based activities has led to higher rates of chronic disease and a decrease in well-being. This systematic review explores how traditional land-based activities impact self-reported health and well-being of Indigenous adults, using Indigenous and Western perspectives. A search of three electronic databases (PubMed, Scopus, and Web of Science) identified nine studies which explored the experiences and perspectives of Indigenous adults taking part in land-based subsistence and ceremonial activities. A thematic analysis of these studies identified many interconnected physical, spiritual, mental, emotional, and community benefits. Community engagement throughout all stages of the interventions was an important factor in effectively addressing challenges and barriers stemming from colonization, decreased knowledge transfer, and increased use of technology. Participants reported developing more effective stress management techniques, a greater awareness of modifiable risk factors along with increased engagement with Elders. Ultimately, land-based subsistence and ceremonial activities were identified as playing an influential role in the lives of Indigenous adults. The involvement of community members allowed for the development of more culturally relevant interventions. Future community-specific research is needed to increase engagement in traditional physical-activities, improve well-being and overall reduce the risk of chronic disease.
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Malberg Dyg P, Christensen S, Peterson CJ. Community gardens and wellbeing amongst vulnerable populations: a thematic review. Health Promot Int 2021; 35:790-803. [PMID: 31369084 DOI: 10.1093/heapro/daz067] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The aim of the thematic review is to document the effects of community gardens on wellbeing amongst vulnerable populations. We searched for articles published between 1980 and 2017 in major databases resulting in the inclusion of 51 articles. Vulnerable populations included, amongst others, ethnic minorities and refugees, socioeconomically disadvantaged neighbourhoods or low-income or food insecure families. Our findings suggest that community garden participation may have a positive impact on physical health, such as reducing body weight and hypertension, and increasing physical activity and food knowledge. However, findings relating to community gardens and their potential to enhance food security were inconsistent. Furthermore we found that community gardens can have a positive influence both at the individual level (i.e. self-esteem, independence, personal control, etc.), particularly for refugees; the relational and social level (i.e. relationships, social connections, community and neighbourhood). Community garden participation have the potential to enhance wellbeing amongst vulnerable populations. However, two articles in our review presented potential food safety concerns related to community gardens, indicating that, particularly in urban settings, attention must be given to minimizing potential food safety concerns, e.g. by using raised garden beds. Based on this review, we recommend that further research and evaluation on non-US-based community gardens is carried out, as community gardens are practiced globally but there is little research to document the effects of community gardens on wellbeing amongst vulnerable populations outside of the USA.
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Affiliation(s)
- Pernille Malberg Dyg
- University College Copenhagen, Department of Nursing and Nutrition, 2200 Copenhagen, Denmark
| | - Søren Christensen
- Roskilde University, Institute for People and Technology, 4000 Roskilde, Denmark
| | - Corissa Jade Peterson
- University College Copenhagen, Department of Nursing and Nutrition, 2200 Copenhagen, Denmark
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Martinez Tyson D, Teran E, Đào LUL, Chee V, Hernández I, Flores M, Reina Ortiz M, Izurieta R, Baldwin JA. "Cancer is in style": lifestyle change and the perceived impact of globalization on Andean indigenous communities in Ecuador. ETHNICITY & HEALTH 2021; 26:153-167. [PMID: 29973064 DOI: 10.1080/13557858.2018.1493437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America.Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques.Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets.Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America.
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Affiliation(s)
| | - Enrique Teran
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Vanessa Chee
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Isabel Hernández
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
- Facultad de Enfermería, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Mercedes Flores
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Ricardo Izurieta
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Julie A Baldwin
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
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Lombard K, Ornelas IJ, Deschenie D, Nez F, Bishop S, Osterbauer K, Rillamas-Sun E, Beresford SAA. Can Community Gardens with Workshops Increase Gardening Behavior? A Navajo Wellness Collaboration. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2021; 14:64-76. [PMID: 35127273 PMCID: PMC8813171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
UNLABELLED This project evaluated the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors, which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet many on the Navajo Nation have limited knowledge and capacity to garden. METHODS We used a quasi-experimental pre-post study design to estimate the effect of a community gardening intervention. Primary outcomes of interest were gardening frequency and fruit and vegetable consumption. Community gardens were constructed and planted in two communities on the Navajo Nation. In addition, a series of gardening workshops were held in each community. Community members were recruited to complete surveys at time points before and after the workshops. The time between baseline and follow-up was approximately one year. RESULTS We surveyed 169 participants at one time point at least, across both communities, and 25 of these participated in the gardening workshops. Within the 169, there was a cohort of 32 participants completing both baseline and follow-up surveys. For this cohort, interest in gardening increased from 78% to 97% (p=0.014), but none of the changes in gardening self-efficacy, knowledge or gardening frequency reached statistical significance. There were no measurable changes in reported fruit and vegetable consumption, self-efficacy or knowledge. Overall, the reported financial barriers to gardening increased from baseline to follow-up from 4.6 to 5.5 (p=0.035). Among those who completed follow-up, those who attended at least one workshop gardened more frequently than those who did not attend any workshops (21 times per month compared to 10 times per month (p=0.065). CONCLUSION Despite enthusiasm for the community garden in both the communities studied and the increased interest in gardening, workshop attendance and participant retention in the study were low. These factors limited our ability to evaluate the potential efficacy of the intervention on gardening and healthy eating behaviors. Nonetheless, we found some evidence that participating in gardening workshops may lead to increased gardening frequency. Future studies should augment the intervention to include explicit efforts to reduce barriers to long term engagement and extend intervention reach.
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Affiliation(s)
- Kevin Lombard
- New Mexico State University Agricultural Science Center at Farmington
| | | | - Desiree Deschenie
- New Mexico State University Agricultural Science Center at Farmington
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Moralez EA, Thompson B, Englund K, Drennan M, Mandall N, Loest H. The Health Disparities Field Experience: College students and community health workers in the field. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:323. [PMID: 33426127 PMCID: PMC7774606 DOI: 10.4103/jehp.jehp_510_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/21/2020] [Indexed: 06/12/2023]
Abstract
CONTEXT Immersing students studying health promotion and disease prevention into community settings facing health disparities is an essential supplement to their academic experience. As part of many public health professions, these students will likely need to understand the values and beliefs of different cultures so that decisions of appropriate health promotion and treatment can be made equitably. This paper evaluates an education immersion program that was part of a National Cancer Institute funded collaboration supporting the recruitment and training of university students in cancer research. The primary aim of the Health Disparities Field Experience (HDFE) was to facilitate an experience for students pursuing a health-related degree to understand the conceptual issues in border/rural health and the cultural contexts related to health disparities among medically and financially indigent populations in the region. SUBJECTS AND METHODS This study was conducted using qualitative research methods using a variation of the content analysis approach using open codes to categorize the data. Six students were selected to participate in the HDFE (five graduate students and one undergraduate) and all six of the participants completed pre- and post-test surveys. RESULTS From the analysis of the data, posttest qualitative responses indicated that three participants saw racism as a primary cause of cancer-related disparities, a change from their pretest responses. When asked about the personal impact of the HDFE, respondents mentioned the importance of the experiential component. CONCLUSIONS Participants learned about health disparities from the HDFE and expressed high satisfaction with this approach to education.
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Affiliation(s)
| | - Beti Thompson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Centre, Seattle, Washington, USA
| | - Kaitlin Englund
- Department of Plant and Environmental Sciences, College of Agricultural, Consumer and Environmental Sciences, New Mexico State University, Las Cruces, New Mexico
| | - Marilyn Drennan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Centre, Seattle, Washington, USA
| | - Nicole Mandall
- Public Health, St. Lawrence University, Canton, New York, USA
| | - Helena Loest
- Department of Plant and Environmental Sciences, College of Agricultural, Consumer and Environmental Sciences, New Mexico State University, Las Cruces, New Mexico
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Tsuji LJS, Tsuji SRJ, Zuk AM, Davey R, Liberda EN. Harvest Programs in First Nations of Subarctic Canada: The Benefits Go Beyond Addressing Food Security and Environmental Sustainability Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8113. [PMID: 33153153 PMCID: PMC7663715 DOI: 10.3390/ijerph17218113] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/04/2022]
Abstract
By breaking down barriers that impacted the ability of subarctic First Nations people to harvest waterfowl, the Sharing-the-Harvest program provided a safe, nutritious, and culturally appropriate food (i.e., geese) to James Bay Cree communities while also helping to protect the environment by harvesting overabundant geese. However, the impacts extend beyond those described above. Thus, the objectives of the present paper are twofold: to document the food sharing networks of the Sharing-the-Harvest program; and to examine the benefits associated with the harvest program beyond food security and environmental sustainability issues, as revealed through semi-directed interviews. In the regional initiative, harvested geese were shared with all James Bay communities; sharing is an important part of Cree culture. Where detailed information was collected, the goose-sharing network reached 76% of the homes in one of the communities. Likewise, in the local initiative, the goose-sharing network had a 76% coverage rate of the homes in the community. Although decreasing food insecurity was an important focus of the harvest-sharing programs, there were other benefits, from an Indigenous perspective, of being on the land, as identified by the Cree harvesters through semi-directed interviews (e.g., the transmission of Indigenous knowledge, the strengthening of social networks, and the feeling of wellness while out on-the-land). Thus, by participating in the on-the-land harvest programs, the Cree gained benefits beyond those solely related to strengthening food security and contributing in part to environmental sustainability. The Sharing-the-Harvest protocol has the potential to be adapted and employed by other Indigenous (or marginalized) groups worldwide, to help improve health and wellness, while, also protecting the environment from overabundant and/or invasive species.
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Affiliation(s)
- Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada;
| | - Stephen R. J. Tsuji
- School of Environmental Studies, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Aleksandra M. Zuk
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada;
- School of Nursing, Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Roger Davey
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada;
| | - Eric N. Liberda
- School of Occupational and Public Health, Ryerson University, Toronto, ON M5B 2K3, Canada;
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Implementation of the Navajo fruit and vegetable prescription programme to improve access to healthy foods in a rural food desert. Public Health Nutr 2020; 23:2199-2210. [PMID: 32398182 DOI: 10.1017/s1368980019005068] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To utilise a community-based participatory approach in the design and implementation of an intervention targeting diet-related health problems on Navajo Nation. DESIGN A dual strategy approach of community needs/assets assessment and engagement of cross-sectorial partners in programme design with systematic cyclical feedback for programme modifications. SETTING Navajo Nation, USA. PARTICIPANTS Navajo families with individuals meeting criteria for programme enrolment. Participant enrolment increased with iterative cycles. RESULTS The Navajo Fruit and Vegetable Prescription (FVRx) Programme. CONCLUSIONS A broad, community-driven and culturally relevant programme design has resulted in a programme able to maintain core programmatic principles, while also allowing for flexible adaptation to changing needs.
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Eddie RS, Montoya C, Averill J. School Nutrition Policies and Practices on an American Indian Reservation: Research and Policy Considerations. Policy Polit Nurs Pract 2020; 21:71-81. [PMID: 32393113 DOI: 10.1177/1527154420923744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Navajo (Diné) and other American Indian children are more affected by overweight and obesity than their U.S. counterparts. In this descriptive study, the authors combined a socioecological and Navajo cultural framework to analyze the various factors that influence food choices available to children in schools. The Healthy Hunger-Free Kids Act of 2010 updated nutrition standards for school meals and all other foods and beverages sold in schools. Some studies have shown that improved nutrition standards were not favorably received by students and school food programs. To better understand these broader trends in a Navajo context, the researcher administered in-person surveys to 6 principals and 14 food service workers from a sample of 6 schools and performed on-site observations of two schools. Data were analyzed using a combination of descriptive statistics, matrix analysis, and thematic analysis techniques. Results showed that schools were offering more healthy food options in school lunches and that some schools were still serving unhealthy foods, such as pizza, tater tots, and French fries. Classroom and fundraising events provided other sources for low-nutrient foods and beverages. Participants had mixed responses about the updated nutrition standards, and food waste of healthy foods was a major concern. This study proposes opportunities for nurses to engage in research and advance stronger policies that increase healthy food options and limit access to less healthy foods.
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Ornelas IJ, Osterbauer K, Woo L, Bishop SK, Deschenie D, Beresford SAA, Lombard K. Gardening for Health: Patterns of Gardening and Fruit and Vegetable Consumption Among the Navajo. J Community Health 2019; 43:1053-1060. [PMID: 29779075 DOI: 10.1007/s10900-018-0521-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
American Indians, including Navajo, are disproportionately affected by obesity and diabetes, in part due to diet-related health behaviors. The purpose of this study was to assess the patterns of gardening and fruit and vegetable (FV) consumption among residents in two communities on the Navajo Nation in order to inform a community gardening intervention. We analyzed survey data collected from participants in the Yéego Gardening study conducted in two communities in the Navajo Nation (N = 169). We found that 51% of the sample gardened, and on average participants gardened 8.9 times per month. Lack of time (53%) and financial barriers, such as gas for transportation or irrigation (51 and 49%, respectively), were reported as barriers to gardening. Most participants reported low levels of self-efficacy (80%) and behavioral capability (82%) related to gardening. Those with higher levels of gardening self-efficacy and behavioral capability reported more frequent gardening. Average daily FV consumption was 2.5 servings. Most participants reported high levels of self-efficacy to eat FV daily (64%) and high behavioral capability to prepare FV (66%). There was a positive association between FV consumption and gardening, with those gardening more than 4 times per month eating about 1 more serving of FV per day than those gardening 4 or fewer times per month. Further research is needed to better understand how gardening can increase fruit and vegetable availability and consumption among residents of the Navajo Nation.
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Affiliation(s)
- India J Ornelas
- Health Services, University of Washington, Box 359455, Seattle, WA, 98195, USA. .,Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, USA.
| | - Katie Osterbauer
- Nutritional Sciences, School of Public Health, University of Washington, Seattle, USA
| | - Lisa Woo
- Nutritional Sciences, School of Public Health, University of Washington, Seattle, USA
| | - Sonia K Bishop
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Desiree Deschenie
- New Mexico State University Agricultural Science Center, Farmington, USA
| | - Shirley A A Beresford
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, USA.,Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Kevin Lombard
- New Mexico State University Agricultural Science Center, Farmington, USA.,Plant and Environmental Sciences, New Mexico State University, Las Cruces, USA
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Schure M, Goins RT, Jones J, Winchester B, Bradley V. Dietary Beliefs and Management of Older American Indians With Type 2 Diabetes. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:826-833. [PMID: 30579895 PMCID: PMC6586536 DOI: 10.1016/j.jneb.2018.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/30/2018] [Accepted: 11/06/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES This qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM). DESIGN Semistructured in-person interviews were conducted and digitally recorded. SETTING Southeastern American Indian tribal community. PARTICIPANTS A total of 28 noninstitutionalized older tribal members aged >60 years. PHENOMENON OF INTEREST Study participants' beliefs and experiences with dietary practices and management related to T2DM. ANALYSIS Transcribed qualitative interviews were coded using an inductive content analysis approach. RESULTS Four themes regarding T2DM dietary beliefs and T2DM dietary management emerged from the analyses: diet changes, portion control, health care professional and family influence, and barriers to healthy eating. Study participants described how their beliefs, practices, and experiences in these 4 areas related to T2DM. CONCLUSIONS AND IMPLICATIONS American Indian older adults face a variety of challenges to dietary management of T2DM. Future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM. Clinicians and diabetes educators and Native communities have an instrumental role in identifying culturally appropriate messages and programs to help persons effectively manage T2DM.
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Affiliation(s)
- Mark Schure
- Health & Human Development, Montana State University, Bozeman, MT.
| | - Ruth Turner Goins
- Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, NC
| | | | | | - Vickie Bradley
- Public Health and Human Services, Eastern Band of Cherokee Indians, Cherokee, NC
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Brown B, Dybdal L, Noonan C, Pedersen MG, Parker M, Corcoran M. Group Gardening in a Native American Community: A Collaborative Approach. Health Promot Pract 2019; 21:611-623. [PMID: 30786795 DOI: 10.1177/1524839919830930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background. There is increasing awareness of the potential health benefits derived from gardening activities. Gardening practices are gaining momentum in Native American (NA) communities, yet no efforts have applied a community-based participatory research approach within a social-ecological model to understand opportunities and barriers for group gardening on an American Indian reservation. Objectives. The primary objective of this study was to identify influences across social-ecological levels that promote or hinder the implementation of community gardens and use of locally grown foods on the reservation; a secondary objective was to assess the feasibility of implementing a group gardening program for NA adults and potential of collecting health outcome measures. Method. Community members and academicians collaborated to develop and implement this study. The study (1) conducted interviews with key stakeholders to identify influences across social-ecological levels that promote or hinder the implementation of community gardens and using locally produced food and (2) assessed the physical and psychological well-being of NA adults participating in a group gardening feasibility study. Results. Major factors influencing using locally grown food and community gardens that emerged from nine interviews included knowledge/experience, self-efficacy, Elders, traditional ways, community values, generational gaps, and local tribal policies. Twenty NA adults with prediabetes or diabetes participated in the feasibility study. The Profile of Mood States Inventory showed consistently positive change in score for participants in the group gardening program versus the comparison group. Conclusions. This study identified key influences for growing locally grown food, and approaches for implementing group gardening programs for NA adults.
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Affiliation(s)
| | | | | | | | - Martin Parker
- Chippewa Cree Tribal Health Center, Box Elder, MT, USA
| | - Mary Corcoran
- Chippewa Cree Tribal Health Center, Box Elder, MT, USA
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Ornelas IJ, Deschenie D, Jim J, Bishop S, Lombard K, Beresford SA. Yéego Gardening! A Community Garden Intervention to Promote Health on the Navajo Nation. Prog Community Health Partnersh 2017; 11:417-425. [PMID: 29332855 PMCID: PMC6582943 DOI: 10.1353/cpr.2017.0049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Yéego Gardening! is a community garden intervention to increase gardening behavior, increase access to low-cost fruit and vegetables, and ultimately increase consumption in Navajo communities. OBJECTIVES To design a theory-based, culturally relevant intervention with three components: a community garden, monthly workshops on gardening and healthy eating, and community outreach. METHODS Gardens were constructed and maintained in collaboration with community-based organizations in two Navajo communities. Monthly workshops were held throughout the growing season and incorporated aspects of Navajo culture and opportunities to build confidence and skills in gardening and healthy eating behaviors. In addition, program staff attended community events to promote gardening and healthy eating. CONCLUSIONS Community input was essential throughout the planning and implementation of the intervention. If effective, community gardens may be a way to increase fruit and vegetable availability and intake, and ultimately reduce risk of obesity and diabetes.
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Teufel-Shone NI, Cordova-Marks F, Susanyatame G, Teufel-Shone L, Irwin SL. Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program. J Community Health 2015; 40:891-8. [PMID: 25791877 DOI: 10.1007/s10900-015-0009-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk.
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Affiliation(s)
- Nicolette I Teufel-Shone
- Family and Child Health, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85724, USA,
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Patchell B, Edwards K. The Role of Traditional Foods in Diabetes Prevention and Management among Native Americans. Curr Nutr Rep 2014. [DOI: 10.1007/s13668-014-0102-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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