Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA.
Food and Health Lab at Montana State University, Montana State University, 960 Technology Boulevard Room 245, Bozeman, MT, 59718, USA.
BMC Public Health. 2020 Oct 12;20(1):1536. doi: 10.1186/s12889-020-09584-7.
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.
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.
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.
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.
随着殖民化、工业化以及文化、经济、政治和环境的变化，本土食品体系已经被取代。这种破坏在明显的健康和食品环境差距中可见一斑，这导致美洲原住民人群中肥胖症和糖尿病的患病率居高不下。
采用社区参与式研究（CBPR）方法，记录蒙大拿州农村的 Flathead 保留地居民的食品环境体验。参与者是通过有目的的抽样技术确定的，以参与调查和半结构化访谈。描述性统计数据有助于描述参与者的人口统计学特征、食品获取变量和家庭粮食安全状况。经过培训的研究人员使用恒比法分析食品环境感知。
参与者完成了调查（n=79）和访谈（n=76）。许多人参加了联邦营养援助计划。许多人自我报告患有与饮食相关的慢性疾病。主要主题包括社区食品环境、饮食规范和食品与健康的联系。子主题则代表了对食品环境转变的看法，以及食品在家庭生活中的重要作用。此外，还确定了改善社区食品环境的机会和挑战。
对食品环境的看法与可以用来改善饮食质量的策略有关，可以沿着社会生态模式的连续体进行。需要进行基于技能的教育，直接解决居民普遍面临的时间和金钱限制。还需要同时进行食品环境干预，以促进饮食质量，让社区成员、商店管理人员和政府政策利益相关者参与其中，以在这个社区重新建立健康的美洲原住民食品体系和环境。
