A Qualitative Assessment of Healthy Food Access in Navajo Nation

Background: The Navajo population experiences high rates of food insecurity, contributing to high rates of chronic disease. We conducted in-depth interviews with Navajo tribal members in order to understand food insecurity in this community and inform the design of an intervention to improve access to healthy foods. Methods: Thirty individuals were interviewed over a three-month period, including Chapter House officials, Community Health Representatives and heads of households living in the Crownpoint Service Unit in Navajo Nation. Data was coded, grouped into analytical categories and integrated into a thematic framework. Results: Food insecurity in Navajo Nation demonstrates variability at the structural, community, and individual and household levels. Income, transportation, vendors, Chapter Houses, social support and health literacy were the main factors contributing to participants’ access to healthy foods. Responses to food insecurity were explored through coping strategies as well as through food purchasing strategies such as price, proximity, shelf life, family preferences, and ease of preparation. Lastly, participants discussed their endorsement for a proposed intervention to increase access to healthy foods. Conclusion: Food insecurity in Navajo Nation is a complex issue, influenced by the dynamic relationship between determinants of individual behavior and the broader environmental context in which they are embedded. A community-based multi-level intervention is necessary in order to achieve sustainable improvement in access to healthy foods

Development of the Department of Veterans Affairs Centers of Excellence in Primary Care Education Trainee Participant Survey: Measuring Trainees’ Perceptions of an Interprofessional Education Curriculum

Background: The Trainee Participant Survey was developed for the evaluation of the Department of Veterans Affairs, Centers of Excellence in Primary Care Education (VA CoEPCE), which developed and delivered an interprofessional education (IPE) postgraduate curriculum to learners of multiple professions at seven geographically diverse VA facilities across the United States.Methods and findings: Perceptions of the curriculum by learners across professions were assessed to identify differences in curricular perceptions and unmet needs to inform programmatic changes. The comparison of responses by profession revealed no statistically significant differences across the core domains; precepting, supervising, mentoring; or program practices. Trainee professions differed significantly on satisfaction and system impacts.Conclusion: The Trainee Participant Survey has excellent psychometric properties and can serve as a model for evaluating future IPE programs