Promoting Dietary Quality at FDPIR Through a Fruit and Vegetable Intervention
Map by Kristen Drumheller
Nutrient-dense dietary patterns contribute to the avoidance of nutrition-related weight gain and chronic diseases. Evidence suggests that tribal communities across the United States experience nutrition-related health disparities. Accessing healthy, affordable foods is challenging in many tribal communities due to limited infrastructure, long distances to food outlets, and fewer healthy options. The food environment contributes to dietary quality by influencing what food types are available, affordable, convenient, and desirable for consumers.
In an effort to address nutrition-related challenges in the food environment faced by American Indian peoples, the Food Distribution Program on Indian Reservations (FDPIR) was implemented by Congress in 1973. However, previous research has shown that the FDPIR food environment suffers from low nutrient quality, and many participants do not meet the Dietary Guidelines for Americans 2010, especially in the fruits and vegetables categories.
Building upon years of community-based work on Montana’s Flathead Reservation of the Confederated Salish and Kootenai Tribes, the proposed project uses a randomized controlled trial design to implement a multi-phase fruit and vegetable intervention to increase dietary quality among local FDPIR participants. Phase 1 of the project will modify the FDPIR food environment through increased availability of fresh fruits and vegetables for one month, and Phase 2 will modify the FDPIR food environment with fresh fruits and vegetables coupled with providing participants with nutrition education for one month.
The project pursues three related aims:
- Aim 1: To assess changes in nutrient quality of the food environment at FDPIR before, during, and after the intervention as measured by the Healthy Eating Index (HEI-2010) and Nutrition Environment Survey-Stores (NEMS-S).
- Aim 2: To determine the effectiveness of the fruit and vegetable intervention on dietary quality of FDPIR participants as measured by the Healthy Eating Index (HEI-2010).
- Aim 3: To identify changes in food security status before, during, and after the intervention as measured by the USDA Food Security Module.
Related Publications (Selected)
Ahmed, S., & Byker Shanks, C. Quality of vegetables based on total phenolic scores is lower in more rural counties of Montana. International Journal of Environmental Research and Public Health. 2017.
Byker Shanks, C., Ahmed, S., Smith T., Houghtaling, B., Jenkins, M., Margetts, M., Schultz, D., & Stephens, L. Availability, price, and quality of fruits and vegetables in 12 rural Montana counties, 2014. Preventing Chronic Disease. 2015;12:150-158.
Byker Shanks, C., Smith, T., Ahmed, S., & Hunts, H. Assessing foods offered in the Food Distribution Program on Indian Reservations (FDPIR) using healthy eating index-2010. Public Health Nutrition. 2015;24:1-12.
Calancie, L., Leeman, J., Jilcott-Pitts, S., Kettel-Kahn, L., Evenson, K., Fleischhacker, S., Evenson, K., Schreiner, M., Byker, C., Owens, C., McGuirt, J., Barnidge, E., Dean, W., Johnson, D., Kolodinsky, J., Pitch, E., Pinard, C., Quinn, E., Whestone, L., & Ammerman, A. Nutrition-related policy and environmental strategies to prevent obesity in rural communities: A systematic review of the literature. Preventing Chronic Disease. 2015;12:140540.
Johnson, D., Quinn, E., Sitaker, M., Ammerman, A., Byker, C., Dean, W., Fleishhacker, S., Kolodinsky, J., Pinard, C., Jilcott Pitts, S. B., & Sharkey, J. R. Developing an agenda for research about policies to improve access to healthy foods in rural communities: A concept mapping study. BMC Public Health. 2014;14:592.
Dr. Byker Shanks’s research program aims to increase dietary quality of diverse populations while contributing to healthier food environments and systems, decreasing health disparities and nutrition-related diseases, and promoting positive human health and development throughout the course of life. She partners with communities, researchers, students, and stakeholders to measure and implement contextually specific strategies in food systems that facilitate dietary change and positive health outcomes. Dr. Byker Shanks’s research exists in three applied areas: (1) child nutrition in the school food environment, (2) family decisions in the consumer food environment, and (3) food assistance programs’ contributions to child and family nutrition.
Dr. Byker Shanks holds a B.S. in Dietetics and a Ph.D. in Behavioral and Community Science from Virginia Tech, and is a Registered Dietitian. She joined the faculty of Montana State University in Fall 2011 and initiated The Food and Health Lab in Fall 2013 in collaboration with Dr. Selena Ahmed to carry out basic, behavioral, and applied research that explores agricultural-nutrition-health linkages.