Center for Indigenous Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Program in Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Int J Environ Res Public Health. 2024 Nov 11;21(11):1496. doi: 10.3390/ijerph21111496.
Mainstream approaches to nutrition typically focus on diet consumption, overlooking multi-dimensional aspects of nutrition that are important to American Indian/Alaska Native (AI/AN) communities. To address health challenges faced by AI/AN communities, strengths-based measures of nutrition grounded in community worldviews are needed. In collaboration with AI/AN communities in Baltimore and Minneapolis, we developed the Indigenous Nourishment Scales through three phases. Phase 1 involved focus group discussions with nine community-research council (CRC) members ( = 2) and four in-depth interviews ( = 4) to gather perspectives on existing models of nutrition. Phase 2 refined scales through two additional focus group discussions ( = 2) with a total of nine participants and two in-depth interviews ( = 2). Finally, in Phase 3, we held ten ( = 10) cognitive interviews with AI/AN community members to refine the scales. Participants appreciated the measures' ability to provoke reflection on their relationship with nutrition and suggested adjustments to better capture cultural nuances, such as incorporating concepts like "being a good relative" to land. The Indigenous Nourishment Scales represent a departure from conventional approaches by encompassing multiple dimensions of nourishment, offering a framework that addresses epistemic injustices in nutrition measurement and grounds health measurement efforts directly in community perspectives and worldviews.
主流的营养方法通常侧重于饮食摄入，而忽略了对美洲印第安人/阿拉斯加原住民（AI/AN）社区很重要的营养多维方面。为了解决 AI/AN 社区面临的健康挑战，需要基于社区世界观的以优势为基础的营养衡量标准。我们与巴尔的摩和明尼阿波利斯的 AI/AN 社区合作，通过三个阶段开发了土著滋养量表。第一阶段涉及九位社区研究委员会（CRC）成员（= 2）和四位深入访谈（= 4）的焦点小组讨论，以收集对现有营养模型的看法。第二阶段通过另外两次焦点小组讨论（= 2）和总共九位参与者和两位深入访谈（= 2）来完善量表。最后，在第三阶段，我们与 AI/AN 社区成员进行了十次（= 10）认知访谈，以完善量表。参与者赞赏这些措施能够促使他们反思自己与营养的关系，并建议进行调整以更好地捕捉文化细微差别，例如将“成为一个好亲属”等概念纳入土地。土著滋养量表通过包含滋养的多个维度，提供了一个框架，解决了营养测量中的认知不公正问题，并直接将健康测量工作建立在社区观点和世界观的基础上，这与传统方法有所不同。
