Tools for healthy tribes: improving access to healthy foods in Indian country.
There is growing recognition that policymakers can promote access to healthy, affordable foods within neighborhoods, schools, childcare centers, and workplaces. Despite the disproportionate risk of obesity and type 2 diabetes among American Indian children and adults, comparatively little attention has been focused on the opportunities tribal policymakers have to implement policies or resolutions to promote access to healthy, affordable foods. This paper presents an approach for integrating formative research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. This paper explains how the American Indian Healthy Eating Project evolved through five phases and discusses each phase's essential steps involved, outcomes derived, and lessons learned. Using community-based participatory research and informed by the Social Cognitive Theory and ecologic frameworks, the American Indian Healthy Eating Project was started in fall 2008 and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate Tools for Healthy Tribes-a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods. Formal and informal strategies can engage tribal leaders in the development of culturally appropriate and tribe-specific sustainable strategies to improve such access, as well as empower tribal leaders to leverage their authority toward raising a healthier generation of American Indian children.
Center for Health Promotion and Disease Prevention, Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina 27599, USA. sheilafly9@gmail.com
Sheila
S
Fleischhacker
Randi R
RR
Byrd
Gowri
G
Ramachandran
Maihan
M
Vu
Amy
A
Ries
Ronny A
RA
Bell
Kelly R
KR
Evenson
D055812:Community-Based Participatory Research; D003299:Cooperative Behavior; D005523:Food Supply / Q000706:statistics & numerical data*; D006266:Health Education; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D009752:Nutritional Status; D011582:Psychological Theory; D011634:Public Health; D040241:Social Marketing; D014481:United States