Stotz Sarah A, Hebert Luciana E, Scarton Lisa, Begay Kelli, Gonzales Kelly, Garrow Heather, Charley Melanie, Aspaas Melanie, Charron-Prochownik Denise, Manson Spero M
Department of Food Science and Human Nutrition, College of Family and Consumer Sciences, Colorado State University, Fort Collins, CO 80523, USA.
The Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA 99163, USA.
Int J Environ Res Public Health. 2024 Dec 28;22(1):25. doi: 10.3390/ijerph22010025.
AI/AN communities are disproportionately impacted by food insecurity and gestational diabetes mellitus (GDM). Decreasing the risk of GDM can interrupt the intergenerational cycle of diabetes in AI/AN families, and can decrease diabetes-related health disparities. The goal of this study was to explore ways of supporting holistic health and reducing the risk of GDM among young American Indian and Alaska Native (AI/AN) females prior to pregnancy. Semi-structured interviews were conducted with adult AI/AN women (>18 years) who had GDM or who have young female relatives (e.g., daughters) (n = 41), AI/AN females between 12 and 24 years (n = 18), and key experts in food/nutrition and health within AI/AN communities (n = 32). Three themes emerged: (1) guidance on how to support young females' holistic wellness; (2) evidence that generations of colonial violence, including forced removal, forced poverty, and the imposition of a Western-based food system, causes deeper, systemic fracturing of traditional cultural food knowledge and practices; and the fact that (3) opportunities for improved adolescent female health are rooted in AI/AN values and how AI/AN people resist the impacts of anti-Indigenous racism through family-based, community-led, and holistic health. These themes suggest alternative understandings about the relationships between food insecurity and holistic pre-pregnancy health and can guide our next steps in decreasing health disparities in these communities.
美国印第安人和阿拉斯加原住民（AI/AN）社区受粮食不安全和妊娠糖尿病（GDM）的影响尤为严重。降低GDM风险可以中断AI/AN家庭中糖尿病的代际循环，并减少与糖尿病相关的健康差距。本研究的目的是探索在年轻的美国印第安人和阿拉斯加原住民（AI/AN）女性怀孕前支持其整体健康并降低GDM风险的方法。对患有GDM或有年轻女性亲属（如女儿）的成年AI/AN女性（>18岁）（n = 41）、12至24岁的AI/AN女性（n = 18）以及AI/AN社区内食品/营养与健康领域的关键专家（n = 32）进行了半结构化访谈。出现了三个主题：（1）关于如何支持年轻女性整体健康的指导；（2）有证据表明，包括强制迁移、强制贫困以及强加基于西方的食品系统在内的几代殖民暴力行为，导致传统文化食品知识和实践出现更深层次的系统性断裂；以及（3）改善青少年女性健康的机会植根于AI/AN价值观，以及AI/AN人群如何通过基于家庭、由社区主导的整体健康来抵御反原住民种族主义的影响。这些主题为粮食不安全与怀孕前整体健康之间的关系提供了不同的理解，并可指导我们采取下一步措施减少这些社区的健康差距。
