MacKenzie Onagh W, George Carmen V, Pérez-Escamilla Rafael, Lasky-Fink Jessica, Piltch Emily M, Sandman Sharon M, Clark Clarina, Avalos Que'sha J, Carroll Danya S, Wilmot Taylor M, Shin Sonya S
Community Outreach and Patient Empowerment Program, Gallup, NM, USA.
Warren Alpert Medical School, Brown University, Providence, RI, USA.
Curr Dev Nutr. 2019 Nov 7;3(12):nzz125. doi: 10.1093/cdn/nzz125. eCollection 2019 Dec.
American Indians and Alaska Natives experience diet-related health disparities compared with non-Hispanic whites. Navajo Nation's colonial history and remote setting present unique challenges for healthy food access.
This study aims to understand the impact of the Healthy Navajo Stores Initiative (HNSI) on fruit and vegetable purchasing on Navajo Nation.
We conducted a cross-sectional survey of 692 customers shopping at 28 convenience stores, trading posts, and grocery stores on Navajo Nation. Individual- and household-level sociodemographic data and food purchasing behaviors were collected. Descriptive and bivariate analyses for customers' individual- and household-level characteristics were conducted using chi-squared tests. The impact of individual-, household-, and store-level factors on fruit and vegetable purchasing was assessed using multiple logistic regression modeling.
Store participation in the HNSI was significantly associated with customers' purchase of produce. Customers experienced 150% higher odds of purchasing produce if they shopped in participating stores, compared with nonparticipating stores ( < 0.001). Store type was strongly associated with customers' purchase of fruits or vegetables. Customers shopping at a grocery store had 520% higher odds of purchasing produce than did customers shopping at convenience stores ( < 0.001). Customers shopping at trading posts had 120% higher odds of purchasing fruits or vegetables than did customers shopping at convenience stores ( = 0.001).
Our findings reveal increased produce purchasing at stores participating in the HNSI. Customers were significantly more likely to purchase fruits or vegetables in stores enrolled in a healthy store intervention than in nonenrolled stores, after controlling for quantity of produce stocked and store type. Customers shopping in grocery stores and trading posts were significantly more likely to purchase produce than customers shopping in convenience stores. These findings have implications for food access in rural tribal communities.
与非西班牙裔白人相比，美国印第安人和阿拉斯加原住民面临与饮食相关的健康差异。纳瓦霍族的殖民历史和偏远环境给获取健康食品带来了独特挑战。
本研究旨在了解“健康纳瓦霍商店倡议”（HNSI）对纳瓦霍族水果和蔬菜购买情况的影响。
我们对在纳瓦霍族的28家便利店、贸易站和杂货店购物的692名顾客进行了横断面调查。收集了个人和家庭层面的社会人口统计学数据以及食品购买行为。使用卡方检验对顾客的个人和家庭层面特征进行描述性和双变量分析。使用多元逻辑回归模型评估个人、家庭和商店层面因素对水果和蔬菜购买的影响。
商店参与HNSI与顾客购买农产品显著相关。与未参与的商店相比，如果顾客在参与的商店购物，购买农产品的几率高出150%（<0.001）。商店类型与顾客购买水果或蔬菜密切相关。在杂货店购物的顾客购买农产品的几率比在便利店购物的顾客高出520%（<0.001）。在贸易站购物的顾客购买水果或蔬菜的几率比在便利店购物的顾客高出120%（=0.001）。
我们的研究结果显示，参与HNSI的商店的农产品购买量有所增加。在控制了农产品库存数量和商店类型后，参与健康商店干预的商店中的顾客比未参与的商店中的顾客更有可能购买水果或蔬菜。在杂货店和贸易站购物的顾客比在便利店购物的顾客更有可能购买农产品。这些发现对农村部落社区的食品获取具有启示意义。
