Healthy Stores Initiative Associated with Produce Purchasing on Navajo Nation
Open Access
- 1 December 2019
- journal article
- research article
- Published by Elsevier BV in Current Developments in Nutrition
- Vol. 3 (12), nzz125
- https://doi.org/10.1093/cdn/nzz125
Abstract
Background: American Indians and Alaska Natives experience diet-related health disparities compared with non-Hispanic whites. Navajo Nation's colonial history and remote setting present unique challenges for healthy food access. Objective: This study aims to understand the impact of the Healthy Navajo Stores Initiative (HNSI) on fruit and vegetable purchasing on Navajo Nation. Methods: We conducted a cross-sectional survey of 692 customers shopping at 28 convenience stores, trading posts, and grocery stores on Navajo Nation. Individual- and household-level sociodemographic data and food purchasing behaviors were collected. Descriptive and bivariate analyses for customers' individual- and household-level characteristics were conducted using chi-squared tests. The impact of individual-, household-, and store-level factors on fruit and vegetable purchasing was assessed using multiple logistic regression modeling. Results: Store participation in the HNSI was significantly associated with customers' purchase of produce. Customers experienced 150% higher odds of purchasing produce if they shopped in participating stores, compared with nonparticipating stores (P < 0.001). Store type was strongly associated with customers' purchase of fruits or vegetables. Customers shopping at a grocery store had 520% higher odds of purchasing produce than did customers shopping at convenience stores (P < 0.001). Customers shopping at trading posts had 120% higher odds of purchasing fruits or vegetables than did customers shopping at convenience stores (P = 0.001). Conclusions: Our findings reveal increased produce purchasing at stores participating in the HNSI. Customers were significantly more likely to purchase fruits or vegetables in stores enrolled in a healthy store intervention than in nonenrolled stores, after controlling for quantity of produce stocked and store type. Customers shopping in grocery stores and trading posts were significantly more likely to purchase produce than customers shopping in convenience stores. These findings have implications for food access in rural tribal communities.Keywords
Funding Information
- CDC (NU58DP005874-03)
This publication has 19 references indexed in Scilit:
- Changes in quantity, spending, and nutritional characteristics of adult, adolescent and child urban corner store purchases after an environmental interventionPreventive Medicine, 2015
- Fresh produce consumption and the association between frequency of food shopping, car access, and distance to supermarketsPreventive Medicine Reports, 2015
- Access to Supermarkets and Fruit and Vegetable ConsumptionAmerican Journal of Public Health, 2014
- High levels of household food insecurity on the Navajo NationPublic Health Nutrition, 2013
- Healthy Bodegas: Increasing and Promoting Healthy Foods at Corner Stores in New York CityAmerican Journal of Public Health, 2012
- Obesity prevalence and the local food environmentHealth & Place, 2009
- Neighborhood Retail Food Environment and Fruit and Vegetable Intake in a Multiethnic Urban PopulationAmerican Journal of Health Promotion, 2009
- Nutrition Environment Measures Survey in Stores (NEMS-S): Development and EvaluationAmerican Journal of Preventive Medicine, 2007
- Individual Weight Change Is Associated with Household Food Security StatusJournal of Nutrition, 2006
- Food Insecurity Is Positively Related to Overweight in WomenJournal of Nutrition, 2001