Healthy stores intervention associated with psychosocial improvements in adult American Indian consumers

Abstract

Obesity and diet‐related chronic diseases are at epidemic levels in American Indian (AI) populations. We conducted a 14 month intervention (Navajo Healthy Stores (NHS)) to change the food environment in parts of the Navajo Nation (NN), in partnership with the NN Special Diabetes Program. We worked in large and small food stores in 7 randomly selected areas of the NN, matched with 6 comparison areas. NHS involved encouraging stores to stock healthier foods, point of purchase promotions (shelf labels, posters, giveaway items) interactive sessions), and community media (radio and newspaper). A random sample of 146 adult Navajo community members were interviewed pre and post intervention, in both intervention and comparison areas. No intervention impact was seen by treatment group. When we stratified by level of exposure to the intervention, we found that more highly exposed respondents visited intervention stores more frequently, significantly improved their healthy food self‐efficacy and behavioral intentions (p<0.05), and had a positive trend toward improved frequency of purchase of healthy foods. Changing the food environment by working with retail food stores is a potentially effective means for addressing the obesity epidemic in rural AI communities.