A Produce Prescription Program Aimed at Reducing Food Insecurity and Type 2 Diabetes Risk among Native American Older Adults

University Of Montana, Missoula MT

Investigators

Linked publications, trials & patents

Abstract

Modified Project Summary/Abstract Section Enter the text here that is the new abstract information for your application. This section must be no longer than 30 lines of text. In the U.S., American Indians (AIs) are 2.9 times more likely to have type 2 diabetes (T2D) compared to others and 2.3 times more likely to die from T2D. Food insecurity is 20% higher among AIs compared to others. Produce Prescription Programs (PPPs) are an upstream evidence-based innovation to reduce food insecurity and improve health that have excellent potential to forefront AI community priorities. However, although PPPs are gaining popularity, no studies have focused on impact among rural AI older adults. To address this gap, we will use a community-based participatory research (CBPR) approach to develop a rigorous, hypothesis driven research program to assess the impact of a PPP intervention on food insecurity and health among rural AI older adults, and on the local food context. The study setting is the Confederated Salish and Kootenai (CSKT) of the Flathead Indian Reservation in Montana, where 30% of the population are older adults. The Research Project Lead (RPL) has been engaging in CBPR with the health department (THD) for five years, focused on rural AI older adult health. This proposal is the result of expressed CSKT community need and priorities (e.g., 50% of THD patients are food insecure, and the CSKT resolution [#21-090] states food security and food sovereignty as goals). Likewise, study goals and methods are responsive to NOT-OD-22-135, and will build the foundation for an NIH R01 submission to PAR-23-298. The study Aim 1 is to determine the acceptability of Food for Health (F4H) among rural AI older adults (N=10) and conduct informant interviews with F4H participants and THD and food resource center (FRC) personnel (N=10) to explore implementation determinants. Results will refine the F4H protocol and implementation plan for Aim 2, which is to evaluate the refined F4H’s study methods and procedures, implementation strategies, and characterize impact on health (food insecurity, T2D factors) among rural AI older adults (N=33). The RPL will benefit from mentoring by her External Mentor, an expert in nutrition research and food security, and the supportive resources of the Center for Population Health Research Cores to yield preliminary data, expertise, and community buy-in for a successful NIH R01 proposal to continue the trajectory of this research to a full scale randomized controlled trial. In the long-term, this research initiates the RPL’s independent research program using CBPR to promote health among rural AI communities.