Healthy makeovers in rural tribal convenience stores as part of the Tribal Health and Resilience in Vulnerable Environments (THRIVE) study

Background:  Poor access to healthy food increases the risk for obesity, diabetes, hypertension, and cancer. These conditions are highly prevalent among American Indian (AI) adults 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 address 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 with the Chickasaw and Choctaw Nations of Oklahoma to implement healthy "makeovers" within 20 tribally owned convenience stores to increase fruit and vegetable intake among tribal members. Preliminary findings suggest that AIs experience unique challenges in accessing healthy food and safe places to exercise in rural tribal communities. We will describe these findings as well as efforts to engage stakeholders from diverse tribal community sectors-- health, business, and policy leaders -- and the analysis of critical factors such as community culture, leadership, financial support, and sustainability, in preparing for the healthy makeover interventions, which lie at the intersection of tribal economic and public health sustainability.

Conclusions: This study is generating new and important information regarding aging and the built environment in rural tribal nations. Initial study assessment findings will inform other communities as to how to support healthy aging in diverse tribal settings using rigorous methods and community involvement.