Dataset Information

Healthy Stores Initiative Associated with Produce Purchasing on Navajo Nation.

ABSTRACT: Background: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. Objective:This study aims to understand the impact of the Healthy Navajo Stores Initiative (HNSI) on fruit and vegetable purchasing on Navajo Nation. Methods: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. Results: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 (P < 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 (P < 0.001). Customers shopping at trading posts had 120% higher odds of purchasing fruits or vegetables than did customers shopping at convenience stores (P = 0.001). Conclusions: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.

SUBMITTER: MacKenzie OW

PROVIDER: S-EPMC7053571 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Healthy Stores Initiative Associated with Produce Purchasing on Navajo Nation.

MacKenzie Onagh W OW George Carmen V CV Pérez-Escamilla Rafael R Lasky-Fink Jessica J Piltch Emily M EM Sandman Sharon M SM Clark Clarina C Avalos Que'sha J QJ Carroll Danya S DS Wilmot Taylor M TM Shin Sonya S SS

Current developments in nutrition 20191107 12

<h4>Background</h4>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.<h4>Objective</h4>This study aims to understand the impact of the Healthy Navajo Stores Initiative (HNSI) on fruit and vegetable purchasing on Navajo Nation.<h4>Methods</h4>We conducted a cross-sectional survey of 692 customers shopping at 28 convenience stores, tr ...[more]

PMID: 32154495

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Project description:ContextTo promote the health of the Navajo people, the Navajo Nation passed the Healthy Diné Nation Act (HDNA) in 2014. The HDNA included a 2% tax on "minimal-to-no-nutritional-value" foods and waived 5% sales tax on healthy foods, the first such policy in the United States and any sovereign Tribal nation. Uniquely aligned with Tribal government structures, revenue was directly allocated to 110 small local government entities (Chapters) for self-determined wellness projects.ObjectiveTo characterize HDNA-funded wellness projects, test for variation in project type, and funding amount over time by region and community size.DesignLongitudinal study assessing funded wellness projects from tax inception through 2019.SettingThe Navajo Nation.ParticipantsOne hundred ten Navajo Nation Chapters receiving funding for self-determined wellness projects.Outcome measuresThe categories and specific types of wellness projects and funding over 4 years by region and community size.ResultsOf revenue collected in 2015-2018, more than 99.1% was disbursed through 2019 ($4.6 million, $13 385 annually per community) across 1315 wellness projects (12 per community). The built recreational environment category received 38.6% of funds, equipment/supplies 16.5%, instruction 15.7%, food and water initiatives 14.0%, and social events 10.2%. Most common specific projects were walking trails ($648 470), exercise equipment ($585 675), food for events ($288 879), playgrounds ($287 471), and greenhouses ($275 554). Only the proportion allocated to instruction changed significantly over time (increased 2% annually, P = .02). Smaller communities (population <1000) allocated significantly higher proportions to traditional, agricultural, and intergenerational projects and less to the built environment.ConclusionsThrough 2019, more than 99% of HDNA revenue was successfully disbursed to 110 rural, Tribal communities. Communities chose projects related to promoting the built recreational environment, agriculture, and fitness/nutrition education, with smaller communities emphasizing cultural and intergenerational projects. These findings can inform other indigenous nations considering similar policies and funding distributions.

Dataset Information

Healthy Stores Initiative Associated with Produce Purchasing on Navajo Nation.

Publications

Healthy Stores Initiative Associated with Produce Purchasing on Navajo Nation.

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