Introduction. Diet-related chronic diseases, such as hypertension and obesity, are prevalent in Native American (NA) communities where poor food environments are prominent and healthy food access is limited. The Chickasaw Healthy Eating Environments Research Study (CHEERS) is an NIH-funded study aimed to improve Body Mass Index and blood pressure control among NA adults with uncontrolled hypertension.

Methods. This multi-level randomized trial, guided by a community-based participatory research orientation, was co-created by tribal and university partners and is implemented within the Chickasaw Nation of Oklahoma. In partnership with Feed the Children, we created hypertension-specific food boxes that contain DASH diet foods, coupons for purchasing vegetables and fruits, educational materials, and heart healthy recipes for supporting healthy eating. Food boxes are packed and shipped monthly to intervention participants with a 30-day supply of: one fruit serving/day, one vegetable serving/day, one serving of unsalted nuts or seeds/day, one serving of beans or lentils/day, and two servings of fatty fish/week. The study intervenes at the environmental level by improving healthy food access and at the policy level by assessing Tribal leaders’ readiness to implement CHEERS across the Tribal nation. The CHEERS intervention launched in 2018 and is currently ongoing.

Results. We will present our participatory approach in co-developing the CHEERS study methods, baseline findings, and lessons learned.

Discussion. CHEERS is the first innovative food box intervention to be conducted in NA communities. Food box interventions show promise in improving dietary intake and reducing hypertension and obesity in rural and poor food environments.