Intended and Unintended Consequences of a Community-Based Fresh Fruit and Vegetable Dietary Intervention on the Flathead Reservation of the Confederated Salish and Kootenai Tribes.

Autor:	Ahmed S; Food and Health Lab, Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT, United States., Dupuis V; Extension, Salish Kootenai College, Pablo, MT, United States., Tyron M; Extension, Salish Kootenai College, Pablo, MT, United States., Running Crane M; Extension, Salish Kootenai College, Pablo, MT, United States., Garvin T; Gretchen Swanson Center for Nutrition, Omaha, NE, United States., Pierre M; Flathead Food Distribution Program on Indian Reservations, Pablo, MT, United States., Byker Shanks C; Food and Health Lab, Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2020 Aug 07; Vol. 8, pp. 331. Date of Electronic Publication: 2020 Aug 07 (Print Publication: 2020).
DOI:	10.3389/fpubh.2020.00331
Abstrakt:	Tribal communities in the United States face disparities to accessing healthy foods including high-quality produce. A six-week fresh fruit and vegetable (FV) dietary intervention, Eat Fresh , was co-designed with a Community Advisory Board of local food and nutrition stakeholders on the Flathead Reservation of the Confederated Salish and Kootenai Tribes in Montana. Eat Fresh was implemented as a pilot study with low-income participants ( n = 19) enrolled in the Food Distribution Program on Indian Reservations toward improving dietary quality and perceptions of well-being. We evaluated Eat Fresh at pre- and post-intervention on the basis on food procurement practices, dietary quality using the Healthy Eating Index (HEI), Body Mass Index (BMI), blood pressure, and participant perceptions of health. Participants reported consuming a greater number of types of FVs daily during the intervention ( p < 0.005 for fruits and p > 0.19 for vegetables). Overall, participants found Eat Fresh moderately challenging to adhere to with the main barriers being access to ingredients in recipes (39.51% of responses), time constraints to cook (35.80%), and lack of financial resources (33.33%). Dietary quality improved during the intervention from a mean HEI score of 48.82 (± 11.88) out of 100-56.92 (± 11.88; ( p > 0.12). HEI scores for fruit consumption significantly increased ( p < 0.05) from 1.69 (out of 5 points) during the pre-intervention to 2.96 during the post-intervention. BMI and blood pressure increased for several participants, highlighting an unintended consequence. Most participants responded that FV consumption made them feel either very good (51.16%) or good about their health (43.02%) with the majority (83%) perceiving an improvement in energy. Findings of this pilot study highlight both intended and unintended consequences of a dietary intervention that provide lessons in co-designing community-based programs. (Copyright © 2020 Ahmed, Dupuis, Tyron, Running Crane, Garvin, Pierre and Byker Shanks.)
Databáze:	MEDLINE
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