Engaging in Community-Based Participatory Policy Work with Native American Tribal Communities to Address Obesity: The THRIVE Study

Background:  Poor access to healthy foods increases the risk for chronic diseases, which are highly prevalent among American Indian people in Oklahoma, whose burdens of obesity (42%), diabetes (15%), and hypertension (38%) exceed those of the general U.S. population. Although many tribes have implemented individual-level efforts to prevent and control obesity, few studies have assessed the environmental correlates of obesity in tribal communities, and none have developed interventions to improve the food environments of Oklahoma tribal nations.

Methods/Results: The THRIVE study – Tribal Health and Resilience in Vulnerable Environments – is a community based participatory research study, employing community based participatory policy work (CBPPW) methodologies, with the Chickasaw and Choctaw Nations of Oklahoma.  The study is implementing healthy "makeovers" within tribally owned and operated convenience stores to increase fruit and vegetable consumption among tribal members. The first phase of THRIVE – community assessment and intervention planning -- is currently underway. This presentation will detail these processes, including the engagement of diverse health, business, and policy leader stakeholders -- and the analysis of critical factors such as community culture, leadership, financial support, and sustainability, in preparing for these interventions, which lie at the intersection of public health and tribal economic sustainability.

Conclusions: This study is creating a "roadmap" for engaging in CBPPW to implement evidence-based obesity prevention policies in tribal communities and beyond. Discussion of this process and initial assessment findings will assist other communities in fighting obesity with rigorous methods and community involvement.