Study aims at improving health of American Indians

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American Indian children have a far greater risk of developing childhood obesity and type 2 diabetes than any other ethnic group in the United States. But little attention has been focused on the opportunities tribal policymakers have to implement policies, resolutions, and community changes to help raise a healthier generation of American Indian children.

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North Carolina is home to the sixth largest population of American Indians in the US and the highest concentration of American Indians east of the Mississippi River reside in NC. In fact, the US Census 2010 estimates that 122,110 American Indian/Alaskan Native individuals live in NC. The state is home to eight tribes and four urban Indian organizations.

A new study from the American Indian Healthy Eating Project presents an approach for integrating multidisciplinary research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. Using community-based participatory research, researchers at the Center for Health Promotion and Disease Prevention partnered with the North Carolinian Commission of Indian Affairs, the North Carolina American Indian Health Board, and seven American Indian tribes in North Carolinian to develop policy and planning approaches to improve access to healthy, affordable foods within American Indian communities.

The seven participating tribes were Coharie Indian Tribe, Haliwa-Saponi Indian Tribe, Lumbee Tribe of NC, Occanneechi Band of Saponi Nation, Meherrin Indian Tribe, Sappony, and Waccamaw Siouan Tribe.

This innovative public health, planning, and policy project is the first project exclusively focused on American Indians funded by the Healthy Eating Research program of the Robert Wood Johnson Foundation. The project was started in fall 2008 by Sheila Fleischhacker, PhD, JD during her post-doctoral fellowship at UNC and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate “Tools for Healthy Tribes”-a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods.

The study, “Tools for Healthy Tribes: Improving Access to Healthy Foods in Indian Country,” was published in September’s issue of the American Journal of Preventive Medicine.

“We have received more than 50 calls from tribal leaders, organizations, and relevant government agencies interested in applying lessons learned from “Tools for Healthy Tribes” in their communities and national initiatives,” said Dr. Fleischhacker.

Fleischhacker explained how the Center for Health Promotion and Disease Prevention in partnership with the American Indian Center at UNC, the NC Commission of Indian Affairs, and seven tribes and four urban Indian organizations in North Carolina were able to secure funding from Kate B. Reynolds Charitable Trusts for a new initiative known as Healthy, Native North Carolinians.

Dr. Fleischhacker expressed her excitement “”in seeing how the data gathered and dissemination strategies have helped seven tribes and four urban Indian organizations participating in Healthy, Native North Carolinians start to develop, implement, and evaluate community changes to foster sustainable ways to promote healthy eating and active living within their communities and across the state.”

Greg Jacobs, Tribal Administrator of Coharie Indian Tribe, said his tribe has already implemented helpful strategies utilizing the lessons learned from the American Indian Healthy Eating Project and the grant support provided directly to each participating tribe and urban Indian organization through Healthy, Native North Carolinians.

“We have created two community gardens and are enjoying the support provided by UNC to learn how to ensure sustainable approaches to promoting healthy eating and active living among our people,” said Jacobs.

Technical assistance is a critical ingredient of Healthy, Native North Carolinians and it’s been a learning experience for researchers and staff involved at the Center for Health Promotion and Disease Prevention and the American Indian Center, both at UNC.

“I’ve enjoyed working directly with tribal leaders as they build their understanding and confidence in how they can utilize grant support to advance their own tribally-led goals to create sustainable community changes around healthy eating and active living,” said Randi R. Byrd, Project Director, Healthy, Native North Carolinians and Program Assistant American Indian Center.

“These grants and partnerships have helped me facilitate conversations more effectively among our tribal leaders about health issues, as well as other opportunities they would like to address and expand upon.”

Edgar Villanueva, Founding Executive Director of the North Carolina American Indian Health Board said the board will continue to partner with Health, Native North Carolinians to consider even more approaches to raising a healthier generation of American Indian children.

“The North Carolina American Indian Health Board has appreciated the opportunity to help the American Indian Healthy Eating Project create a strategy to present this innovative research project to the seven participating tribes back in 2008 and continue to consider the research ethics of the endeavor as it evolved and transitioned into Healthy, Native North Carolinians,” said Villanueva.

Students have also been essential team members. More than 10 have worked on the project in various capacities from various disciplines including psychology, food science, English, regional and urban planning, and health policy.

Ashley McPhail, MPH Student at UNC, member of the Lumbee Tribe, and healthy eating research assistant on the American Indian Healthy Eating Project discussed how “working on the American Indian Healthy Eating Project allowed me to work with tribal leaders on fostering sustainable healthy eating changes while also allowing me to harness the skills necessary to pursue a masters’ degree in public health from UNC!  My goal is to learn more advanced skills and culturally appropriate approaches to help my people live longer, healthier lives!”

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