Intended and Unintended Consequences of a Community-Based Fresh Fruit and Vegetable Dietary Intervention on the Flathead Reservation of the Confederated Salish and Kootenai Tribes

Frontiers in Public Health

article

Selena Ahmed¹  Virgil Dupuis²  Michael Tyron²  MaryAnn Running Crane²  Teresa Garvin³  Michael Pierre⁴  Carmen Byker Shanks¹ 

[1] Food and Health Lab, Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, United States;Salish Kootenai College, United States;Gretchen Swanson Center for Nutrition, United States;Flathead Food Distribution Program on Indian Reservations, United States

关键词: dietary intervention;    food and nutrition education;    community-engaged research;    dietary quality;    co-design;   

DOI  :  10.3389/fpubh.2020.00331

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Tribal communities in the United States face disparities to accessing healthy foods including high-quality produce. A six-week fresh fruit and vegetable (FV) dietary intervention, Eat Fresh , was co-designed with a Community Advisory Board of local food and nutrition stakeholders on the Flathead Reservation of the Confederated Salish and Kootenai Tribes in Montana. Eat Fresh was implemented as a pilot study with low-income participants ( n = 19) enrolled in the Food Distribution Program on Indian Reservations toward improving dietary quality and perceptions of well-being. We evaluated Eat Fresh at pre- and post-intervention on the basis on food procurement practices, dietary quality using the Healthy Eating Index (HEI), Body Mass Index (BMI), blood pressure, and participant perceptions of health. Participants reported consuming a greater number of types of FVs daily during the intervention ( p 0.19 for vegetables). Overall, participants found Eat Fresh moderately challenging to adhere to with the main barriers being access to ingredients in recipes (39.51% of responses), time constraints to cook (35.80%), and lack of financial resources (33.33%). Dietary quality improved during the intervention from a mean HEI score of 48.82 (± 11.88) out of 100–56.92 (± 11.88; ( p > 0.12). HEI scores for fruit consumption significantly increased ( p < 0.05) from 1.69 (out of 5 points) during the pre-intervention to 2.96 during the post-intervention. BMI and blood pressure increased for several participants, highlighting an unintended consequence. Most participants responded that FV consumption made them feel either very good (51.16%) or good about their health (43.02%) with the majority (83%) perceiving an improvement in energy. Findings of this pilot study highlight both intended and unintended consequences of a dietary intervention that provide lessons in co-designing community-based programs.

【 授权许可】

CC BY