Perceptions of food environments and nutrition among residents of the Flathead Indian Reservation
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RESEARCH ARTICLE
Open Access
Perceptions of food environments and nutrition among residents of the Flathead Indian Reservation Carmen Byker Shanks1,2, Selena Ahmed1,2* , Virgil Dupuis3, Bailey Houghtaling4, Mary Ann Running Crane3, Mike Tryon5 and Mike Pierre6
Abstract Background: Indigenous food systems have been displaced with the emergence of colonization, industrialization, and cultural, economic, political, and environmental changes. This disruption can be seen in marked health and food environment disparities that contribute to high obesity and diabetes mellitus prevalence among Native American peoples. Methods: A Community-Based Participatory Research (CBPR) approach was used to document food environment experiences among residents of the Flathead Reservation in rural Montana. Participants were identified using purposive sampling techniques to participate in a survey and a semi-structured interview. Descriptive statistics helped to describe participant demographics, food access variables, and household food security status. Food environment perceptions were analyzed using the constant comparison method among trained researchers. Results: Participants completed surveys (n = 79) and interviews (n = 76). A large number participated in federal nutrition assistance programs. Many self-reported experiencing diet-related chronic diseases. Major themes included the community food environment, dietary norms, and food-health connections. Subthemes were represented by perceptions of food environment transitions and the important role of food in familial life. Further, opportunities and challenges were identified for improving community food environments. Conclusions: Perceptions of the food environment were linked to strategies that could be targeted to improve dietary quality along a social-ecological model continuum. There is need for skill-based education that directly addresses the time and monetary constraints that were commonly experienced by residents. Coinciding food environment interventions to promote dietary quality that engage community members, store management, and government policy stakeholders are also needed to reestablish healthy Native American food systems and environments within this community. Keywords: Food environment, Dietary behaviors, Native American, Food system, Dietary quality, Food security
* Correspondence: [email protected] 1 Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA 2 Food and Health Lab at Montana State University, Montana State University, 960 Technology Boulevard Room 245, Bozeman, MT 59718, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
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