Variation in WIC Cash-Value Voucher Redemption Among American Indian Reservation Communities in Washington State

In 2009, a cash-value voucher (CVV) was added to the U.S. Department of Agriculture (USDA) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) package to encourage fresh fruits and vegetable purchases. Access to fresh fruit and vegetables on American Indian (AI) reservations is limited. We compared the average proportion of CVVs redeemed between 27 reservation-based WIC clinics with 185 non-reservation-based WIC clinics and the proportion of CVVs redeemed in WIC clinics in tribes with high access to fresh fruits and vegetables with their counterparts with low access. Reservation-based WIC clinics had significantly lower CVV redemption compared to non-reservation-based clinics (65 vs 81%, respectively, P < .0001). Additionally, CVV redemption was similar among reservation-based WIC clinics where a supermarket was located within or outside the reservation. CVV redemption is significantly lower in tribal than non-tribal WIC clinics. Research is needed to identify barriers to CVV redemption within the tribal WIC population

Methods for assessing willingness to try and vegetable consumption among children in indigenous early childcare settings: The fresh study

Food preferences begin in early childhood, and a child’s willingness to try (WTT) new vegetables is an important determinant of vegetable intake. Young children living in rural communities are at increased risk for food insecurity, which may limit exposure to and consumption opportunities for vegetables. This manuscript describes the validation of the Farfan-Ramirez WTT (FR-WTT) measure using baseline data from the FRESH study, a gardening intervention for Native American families with preschool-aged children in Osage Nation, Oklahoma. Individually weighed vegetable containers were prepared with six types of vegetables and ranch dip. Researchers presented children (n = 164; M = 4.3 years, SD = 0.8) with these vegetables preceding a snack-or lunch time and recorded the child’s FR-WTT for each vegetable using a 5-point scale, ranging from “did not remove food (0)” to “put food in mouth and swallowed (4)”. After the presentation period, contents were re-weighed to calculate vegetable consumption. Household parents/guardians completed the Child Food Neophobia Scale (CFNS) for their child. FR-WTT scores were positively correlated with consumption weights of all vegetables (r = 0.7613, p \u3c 0.0001) and each vegetable individually (r = 0.2016–0.7664). The total FR-WTT score was inversely correlated with the CFNS score (r = 0.3268, p \u3c 0.0001). Sensitivity analyses demonstrated similar relationships by BMI, food security, and age. In conclusion, the FR-WTT is a valid method for assessing young children’s vegetable eating behavior and intake

Design and Methods of a Participatory Healthy Eating Intervention for Indigenous Children: The FRESH Study

ObjectiveTo increase vegetable and fruit intake, reduce body mass index (BMI), and improve parental blood pressure among American Indian families.DesignRandomized, wait-list controlled trial testing a multi-level (environmental, community, family, and individual) multi-component intervention with data collection at baseline and 6 months post-intervention.SettingTribally owned and operated Early Childhood Education (ECE) programs in the Osage Nation in Oklahoma.ParticipantsAmerican Indian families (at least one adult and one child in a ECE program). A sample size of 168 per group will provide power to detect differences in fruit and vegetable intake.InterventionThe 6-month intervention consisted of a (1) ECE-based nutrition and gardening curriculum; (2) nutrition education and food sovereignty curriculum for adults; and (3) ECE program menu modifications.Main outcome measuresThe primary outcome is increase in fruit and vegetable intake, assessed with a 24-h recall for adults and plate weight assessments for children. Secondary outcomes included objective measures of BMI among adults and children and blood pressure among adults