Addressing food insecurity in a Native American reservation using community-based participatory research

TLDR

Food insecurity in many Native American communities has significant health and welfare implications for families. The study aimed to identify and address upstream causes of food insecurity on a rural California reservation. Using a community‑based participatory research approach, the authors adapted the THRIVE tool with digital storytelling and focus groups, then developed policies such as community‑supported agriculture, a commodity food program, EBT integration, culturally appropriate foods at the farmers' market, and grocery store shelf‑space reallocation. The assessment revealed racial injustice and physical and financial barriers as key drivers, and the participatory approach and adapted THRIVE tool proved effective for uncovering structural determinants and launching policy interventions to reduce health disparities.

Abstract

The food insecurity faced by many Native American communities has numerous implications for the health and welfare of families. To identify and address upstream causes of food insecurity in a rural California reservation, we conducted a community assessment using the Tool for Health and Resilience in Vulnerable Environments (THRIVE). Guided by a community-based participatory research orientation, the THRIVE tool was adapted using digital storytelling and implemented in a series of focus groups. As a result of the THRIVE assessment, community members identified racial injustice and physical and financial barriers to accessing healthy and culturally appropriate foods as areas of greatest importance. Subsequently, the project partnership developed policies to reduce identified barriers which included an integrated community supported agriculture and commodity food program, the introduction of Electronic Benefits Transfer and culturally appropriate foods at the local farmers' market and reallocation of shelf space at the grocery store to include vegetables and fruits as well as special foods for diabetics. Results suggest that a participatory research orientation coupled with the use of a culturally adapted THRIVE tool may be an effective means for identifying structural determinants of food insecurity and initiating novel policy interventions to reduce health disparities experienced by Native American communities.