Alaska Native Elders' perspectives on dietary patterns in rural, remote communities

Enhancing Nursing Care through Cultural Competence: Focus on the Inupiat Community

INTRODUCTION

This article explores the historical and cultural background of the Inupiat community, highlighting health disparities and emphasizing culturally competent care's role in addressing them.

METHODS

Inupiat health beliefs, communication styles, family dynamics, and dietary habits are examined in relation to Western medical practices within tribal health systems. Strategies for cultural education include curriculum development, simulations, clinical assignments, and partnerships with Inupiat healthcare professionals.

RESULTS

Challenges in providing culturally competent care to the Inupiat community are identified, including barriers in nursing education and legal implications for nursing practice. Strategies for enhancing nursing cultural competency are outlined.

DISCUSSION

This paper advocates integrating cultural competency into nursing practices to improve care for the Inupiat community, focusing on training, education, and policy recommendations. It emphasizes the importance of respecting and integrating Inupiat cultural practices to enhance health outcomes and healthcare experiences.

Impact of Nutrition Interventions on Vitamin and Mineral Intake among Native American Children and Parents: Insights from Food Resource Equity for Sustainable Health (FRESH) Study

The Food Resource Equity for Sustainable Health (FRESH) study started as a tribe community-based nutrition education program in 2018, implemented with children and parents in Osage Nation. The purpose of the FRESH study is to examine the effects of a farm-to-school family intervention on diet. The FRESH study did not directly intervene on adult caregiver participants' diet, and, as far as we know, it is the first of its kind to implement a farm-to-school intervention in rural/tribally owned Early Childhood Education. Two communities received intervention and two served as wait-list controls. Outcomes included diet and other secondary health outcomes including vitamin and mineral intake. There were 193 children (n = 106 intervention; n = 87 control) and 170 adults (n = 93 intervention; n = 77 control) enrolled. Among adult caregiver participants, carbohydrate, cholesterol, and caffeine intake significantly decreased after the intervention (p < 0.05). There is a hidden hunger issue among caregivers in Native American populations. The family-based nutritional intervention, which includes educational components for caregivers, might have some effect on improving micronutrient status. Future studies focusing on key micronutrients through efficient methods are warranted.

Indigenous food sovereignty assessment-A systematic literature review

AIMS

The aims of this systematic review were to (1) identify assessment approaches of Indigenous food sovereignty using the core domains of community ownership, inclusion of traditional food knowledge, inclusion/promotion of cultural foods and environmental/intervention sustainability, (2) describe Indigenous research methodologies when assessing Indigenous food sovereignty.

METHODS

Guided by Indigenous members of the research team, a systematic review across four databases (Medline, Embase, CINAHL and PsycINFO) was performed. Studies in any language from 1996 to 2021, that used one or more of the core domains (identified from a recent scoping review) of community ownership, inclusion of traditional food knowledge, inclusion/promotion of cultural foods and environmental/intervention sustainability were included.

RESULTS

From 20 062 records, after exclusion criteria were applied, 34 studies were included. Indigenous food sovereignty assessment approaches were mostly qualitative (n = 17) or mixed methods (n = 16), with interviews the most utilised (n = 29), followed by focus groups and meetings (n = 23) and validated frameworks (n = 7) as assessment tools. Indigenous food sovereignty assessment approaches were mostly around inclusion of traditional food knowledge (n = 21), or environmental/intervention sustainability (n = 15). Community-Based Participatory Research approaches were utilised across many studies (n = 26), with one-third utilising Indigenous methods of inquiry. Acknowledgement of data sovereignty (n = 6) or collaboration with Indigenous researchers (n = 4) was limited.

CONCLUSION

This review highlights Indigenous food sovereignty assessment approaches in the literature worldwide. It emphasises the importance of using Indigenous research methodologies in research conducted by or with Indigenous Peoples and acknowledges Indigenous communities should lead future research in this area.

Developing a culturally relevant physical activity guide for Alaska Native Head Start students in rural Alaska: the Got Neqpiaq? Study

Background: Concern was voiced by Elders, teachers, and parents that and playtime activities of the Head Start preschool programme were not aligned with the local Alaska Native culture in their communities.Methods: The Alaska Native Tribal Health Consortium partnered with 12 Head Start preschool programmes, administered by Rural Alaska Community Action Program in rural Alaska, to explore with community members Alaska Native value-based solutions to the concerns they raised. Local input was gathered via focus groups, interviews, and surveys.Results: We worked together with communities to create a physical activity guide specific to preschool-age children in the region. The guide includes activity descriptions, lesson plans, flash cards, and photos of traditional Alaska Native physical activities and games specific to the region. This manuscript details the community engagement process foundational to the physical activity guide's adoption and implementation.Conclusions: The processes by which the guide was developed were strength-based and participatory. Widespread community engagement and participation led to a guide that was readily adopted because the community had taken ownership of the content. The lessons learned have been invaluable in developing long-term community-based partnerships and in setting the precedent to further incorporate local/regional culture into rural Alaska Head Start programmes.

Diet quality is positively associated with intake of traditional foods and does not differ by season in remote Yup'ik communities

This study evaluated whether traditional food intake and diet quality differed by season in Yup'ik communities and examined the relationship between intake of traditional food groups and diet quality. Data were collected from 38 participants, ages 14-79 years, from two Yup'ik communities in Southwest Alaska from 2008 to 2010. Self-reported intake (24-h recalls) and dietary biomarker (nitrogen stable isotope ratio) data were collected twice in distinct seasons. Diet quality was assessed using the Healthy Eating Index. A paired sample t-test was used to test for seasonal differences in traditional food intake and diet quality, and linear regression was used to evaluate associations between traditional food intake and diet quality. Total traditional food intake and overall diet quality did not significantly differ by season, but there were differences in traditional food group intake and diet quality component scores. Diet quality was strongly associated with intake of traditional food groups including fish, tundra greens, and berries. Given the strong relationship between traditional food intake and diet quality, policies should aim to ensure continued access to traditional foods in Yup'ik communities amid environmental changes in the circumpolar North.

Alaska Native Parents' Decision-Making About Food, Beverages, and Screen Time for Young Children: Formative Insights From the "Got Neqpiaq?" Project

With rising childhood obesity rates, ensuring children adopt healthy habits early is imperative. Given the unique context for Alaska Native families living in rural remote communities, who are concurrently experiencing changes in traditional practices, we investigated what impacts parents' decisions as they relate to daily living before revising a preschool curriculum focused on healthy habits. The objective of this study was to explore factors influencing parents' decisions about their children's foods, beverages, and activities. In focus group discussions with AN parents of young children across 12 communities, we asked about meals, traditional foods, beverages, physical activity, and screen time. All sessions were recorded, transcribed, and analyzed using open and selective coding to allow the most important themes to emerge. As parents discussed how they make decisions, several trends emerged related to adults' and children's food and beverage preferences; the impact of adult modeling on children; and how convenience, seasonality, access, and a reluctance to engage in conflict all impact decision-making. Parents and other community members shared important perspectives on exposing children to traditional subsistence foods and activities and passing important traditional knowledge to them at an early age. These perspectives will form the basis for preschool curricula in these communities.

Seeking Sweetness: A Systematic Scoping Review of Factors Influencing Sugar-Sweetened Beverage Consumption in Remote Indigenous Communities Worldwide

It is well-established that remote Indigenous communities have higher rates of sugar-sweetened beverage (SSB) consumption than non-Indigenous counterparts, which results in higher rates of chronic diseases such as type 2 diabetes mellitus (T2DM), obesity, and kidney disease. The aetiology leading to this behaviour remains understudied and overlooked. Therefore, the aim of this literature review is to understand the underpinning factors that contribute to SSB consumption in remote Indigenous communities. Studies were identified through five databases (n = 2529) and grey literature searching (n = 54). Following the PRISMA guidelines, each paper was assessed for eligibility, which left 34 studies for inclusion in the review. Within these papers, 37 different factors were found to influence SSB consumption in remote Indigenous communities. These were organised according to the Determinants of Nutrition and Eating (DONE) framework. SSB consumption was found to influence intake through each main level of the framework; individual (n = 9), interpersonal (n = 18), environmental (n = 9), and policy (n = 3). Preference was identified to be the most common factor to influence intake (n = 19), followed by health literacy (n = 15) and community availability (n = 12). Despite this, interventions to reduce SSB intake have never targeted this factor. This paper highlights the importance of a multi-level whole-of-system approach and suggests that an individual’s taste/preference should shape the direction of future research and intervention in this area.

Impact of Assistance Programs on Indigenous Ways of Life in 12 Rural Remote Western Alaska Native Communities: Elder Perspectives Shared in Formative Work for the "Got Neqpiaq?" Project

For more than 50 years, government programmes in the USA have been in place to help those in need have consistent access to food and education. However, questions have surfaced regarding whether or not these support impact traditional ways, such as cultural activities, food preferences, and overall health, particularly for Indigenous populations. In this paper, we share insights voiced by Alaska Native Elders in the Yukon-Kuskokwim region of Alaska and their perceptions of regulations, assistance, and the impact government assistance programmes have had on their culture. Elders raised concerns so that those administering these programmes will consider how best to meet food security and education needs without interfering with Indigenous cultural practices and traditional lifestyle.

Preserving the food preservation legacy

This paper deals with the question about how early humans managed to feed themselves, and how they preserved and stored food for times of need. It attempts to show how humans interacted with their environments and demonstrate what lessons can be learnt from the about 3.4 million years of food processing and preservation. It includes a discussion about how hominins shifted from consumption of nuts and berries toward meat and learnt to control and use fire. Cooking with fire generated more food-related energy and enabled humans to have more mobility. The main trust of the paper is on historical food preservations, organized from the perspectives of key mechanical, thermal, biological and chemical processes. Emerging food processes are also highlighted. Furthermore, how humans historically dealt with food storage and packaging and how early humans interacted with their given environments are discussed. Learnings from the history of food preservation and culinary practices of our ancestors provide us with an understanding of their culture and how they adapted and lived with their given environments to ensure adequacy of food supply. Collaboration between food scientists and anthropologists is advocated as this adds another dimension to building resilient and sustainable food systems for the future.