Research Brief| Volume 52, ISSUE 6, P632-639, June 2020

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Cultural Connectedness as Obesity Prevention: Indigenous Youth Perspectives on Feast for the Future

Published:January 13, 2020DOI:



      To describe a community-based obesity-prevention initiative that promoted cultural connectedness and traditional food revitalization and gained insight into youth participants’ perspectives on the program through a photovoice methodology.


      Photovoice methods were used with fourth- and fifth-grade youths (aged 9–11 years) in the US Southwest who had participated in the Feast for the Future program. A total of 44 youths from 3 communities met for 8–9 sessions; they took photos of current food environments and traditional food systems, and discussed them as well as Feast for the Future and hopes for the future, and then prepared a final presentation. Photovoice sessions were recorded, transcribed verbatim, then open coded using Atlas.ti.


      Five common themes emerged: traditional food is farmed or gardened, traditional foods are healthy, Feast for the Future supported positive connections to culture, hope for more farming or gardening for future generations, and store or less nutrient-dense food is unhealthy.

      Conclusions and Implications

      Photovoice can be an effective way to engage Indigenous youths in conversations about their culture and food environments. The findings suggest that attention to revitalizing traditional food systems and supporting cultural connectedness may be an effective approach to obesity prevention in tribal communities, although future research would be needed to assess the impact of the intervention on obesity rates.

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        • Pettitt DJ
        • Talton J
        • Dabelea D
        • et al.
        Prevalence of diabetes in U.S. youth in 2009: the SEARCH for diabetes in youth study.
        Diabetes Care. 2014; 37: 402-408
        • Schiller JS
        • Lucas JW
        • Peregoy JA
        Summary health statistics for U.S. adults: national health interview survey, 2011.
        Vital Health Stat 10. 2012; 256: 1-218
        • Bullock A
        • Sheff K
        • Moore K
        • Manson S
        Obesity and overweight in American Indian and Alaska native children, 2006–2015.
        Am J Public Health. 2017; 107: 1502-1507
        • Stokes A
        • Ni Y
        • Preston SH
        Prevalence and trends in lifetime obesity in the U.S., 1988–2014.
        Am J Prev Med. 2017; 53: 567-575
        • Kaufman P
        • Dicken C
        • Williams R
        Measuring access to healthful, affordable food in American Indian and Alaska native tribal areas.
        US Department of Agriculture, Economic Research Service, Washington, DC2014
        • Rice K
        • Te Hiwi B
        • Zwarenstein M
        • et al.
        Best practices for the prevention and management of diabetes and obesity-related chronic disease among indigenous peoples in Canada: a review.
        Can J Diabetes. 2016; 40: 216-225
        • Jernigan VBB
        • Huyser KR
        • Valdes J
        • Simonds VW
        Food insecurity among American Indians and Alaska natives: a national profile using the current population survey-food security supplement.
        J Hunger Environ Nutr. 2017; 12: 1-10
        • Adams EJ
        • Grummer-Strawn L
        • Chavez G
        Food insecurity is associated with increased risk of obesity in California women.
        J Nutr. 2003; 133: 1070-1074
        • Kursmark M
        • Weitzman M.
        Recent findings concerning childhood food insecurity.
        Curr Opin Clin Nutr Metab Care. 2009; 12: 310-316
        • Walker RE
        • Kawachi I.
        Use of concept mapping to explore the influence of food security on food buying practices.
        J Acad Nutr Diet. 2012; 112: 711-717
        • Weber JA.
        Talking about hunger in a land of plenty.
        J Am Diet Assoc. 2006; 106: 804-807
        • Bender MS
        • Clark MJ
        • Gahagan S
        Community engagement for culturally appropriate obesity prevention in Hispanic mother–child dyads.
        J Transcult Nurs. 2014; 25: 373-382
        • Davis SM
        • Going SB
        • Helitzer DL
        • et al.
        Pathways: a culturally appropriate obesity-prevention program for American Indian schoolchildren.
        Am J Clin Nutr. 1999; 69: 796S-802S
        • Lofton S
        • Julion WA
        • McNaughton DB
        • Bergren MD
        • Keim KS
        A systematic review of literature on culturally adapted obesity prevention interventions for African American youth.
        J Sch Nurs. 2016; 32: 32-46
        • Wang C
        • Burris MA.
        Photovoice: concept, methodology, and use for participatory needs assessment.
        Health Educ Behav. 1997; 24: 369-387
        • Rani PK
        • Kasoju R
        • Komara V
        • et al.
        Envisioning eye care from a rural perspective: a photovoice project from India.
        Int Q Commun Health Educ. 2017; 272684X17736153
        • Makungu C
        • Stephen S
        • Kumburu S
        • et al.
        Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam.
        Malar J. 2017; 16: 410
        • Houle J
        • Coulombe S
        • Radziszewski S
        • et al.
        An intervention strategy for improving residential environment and positive mental health among public housing tenants: rationale, design and methods of Flash on my neighborhood.
        BMC Public Health. 2017; 17: 737
        • Markus SF.
        Photovoice for healthy relationships: community-based participatory HIV prevention in a rural American Indian community.
        Am Indian Alsk Native Ment Health Res Online. 2012; 19: 102-123
        • Holliday CE
        • Wynne M
        • Katz J
        • Ford C
        • Barbosa-Leiker C
        A CBPR approach to finding community strengths and challenges to prevent youth suicide and substance abuse.
        J Transcult Nurs. 2018; 29: 64-73
        • Krueger RA
        • Casey MA.
        Focus Groups: A Practical Guide for Applied Research.
        Sage Publications, Inc, 2014
        • McHugh ML
        Interrater reliability: the kappa statistic.
        Biochem Med. 2012; 22: 276-282
        • Smith LT.
        Decolonizing Methodologies: Research and Indigenous Peoples.
        2nd ed. Zed Books, London2012
        • Braun KL
        • Browne CV
        • Ka'opua LS
        • Kim BJ
        • Mokuau N
        Research on indigenous elders: from positivistic to decolonizing methodologies.
        Gerontologist. 2014; 54: 117-126
        • Lincoln YS
        • González y González EM
        The search for emerging decolonizing methodologies in qualitative research: further strategies for liberatory and democratic inquiry.
        Qual Inq. 2008; 14: 784-805
        • Khayyat Kholghi M
        • Bartlett G
        • Phillips M
        • Salsberg J
        • McComber AM
        • Macaulay AC
        Evaluating an indigenous health curriculum for diabetes prevention: engaging the community through talking circles and knowledge translation of results.
        Fam Pract. 2018; 35: 80-87
        • Gittelsohn J
        • Jock B
        • Redmond L
        • et al.
        OPREVENT2: design of a multi-institutional intervention for obesity control and prevention for American Indian adults.
        BMC Public Health. 2017; 17: 105
        • Bashore L
        • Alexander GK
        • Jackson DL
        • Mauch P
        Improving health in at-risk youth through Photovoice.
        J Child Health Care Commun. 2017; 21: 463-475