Impact of a Fruit and Vegetable Prescription Program on Health Outcomes and Behaviors in Young Navajo Children

Leandra J Jones; Joan VanWassenhove-Paetzold; Kymie Thomas; Carolyn Bancroft; E Quinn Ziatyk; Lydia Soo-Hyun Kim; Ariel Shirley; Abigail C Warren; Lindsey Hamilton; Carmen V George; Mae-Gilene Begay; Taylor Wilmot; Memarie Tsosie; Emilie Ellis; Sara M Selig; Gail Gall; Sonya S Shin

doi:10.1093/cdn/nzaa109

Impact of a Fruit and Vegetable Prescription Program on Health Outcomes and Behaviors in Young Navajo Children

Curr Dev Nutr. 2020 Jul 21;4(8):nzaa109. doi: 10.1093/cdn/nzaa109. eCollection 2020 Aug.

Authors

Leandra J Jones¹, Joan VanWassenhove-Paetzold¹, Kymie Thomas¹, Carolyn Bancroft¹, E Quinn Ziatyk², Lydia Soo-Hyun Kim³, Ariel Shirley¹, Abigail C Warren¹, Lindsey Hamilton¹, Carmen V George¹, Mae-Gilene Begay⁴, Taylor Wilmot¹, Memarie Tsosie¹, Emilie Ellis¹, Sara M Selig¹, Gail Gall¹, Sonya S Shin¹

Affiliations

¹ Community Outreach and Patient Empowerment Program, Gallup, New Mexico.
² Chinle Comprehensive Health Care Facility, Chinle, Arizona.
³ Northern Navajo Medical Center, Shiprock, New Mexico.
⁴ Navajo Nation Community Health Representative Outreach Program, Navajo Department of Health, Window Rock, Arizona.

Abstract

Background: Rates of childhood obesity are higher in American Indian and Alaska Native populations, and food insecurity plays a major role in diet-related disparities. To address this need, local healthcare providers and a local nonprofit launched the Navajo Fruit and Vegetable Prescription (FVRx) Program in 2015. Children up to 6 y of age and their caregivers are enrolled in the 6-mo program by healthcare providers. Families attend monthly health coaching sessions where they receive vouchers redeemable for fruits, vegetables, and healthy traditional foods at retailers participating in the FVRx program.

Objectives: We assessed the impact of a fruit and vegetable prescription program on the health outcomes and behaviors of participating children.

Methods: Caregivers completed voluntary surveys to assess food security, fruit and vegetable consumption, hours of sleep, and minutes of physical activity; healthcare providers also measured children's body mass index [BMI (kg/m²)] z score at initiation and completion of the program. We calculated changes in health behaviors, BMI, and food security at the end of the program, compared with baseline values.

Results: A total of 243 Navajo children enrolled in Navajo FVRx between May 2015 and September 2018. Fruit and vegetable consumption significantly increased from 5.2 to 6.8 servings per day between initiation and program completion (P < 0.001). The proportion of participant households reporting food insecurity significantly decreased from 82% to 65% (P < 0.001). Among children classified as overweight or obese at baseline, 38% achieved a healthy BMI z score at program completion (P < 0.001). Sixty-five percent of children were retained in the program.

Conclusions: The Navajo FVRx program improves fruit and vegetable consumption among young children. Children who are obese or overweight may benefit most from the program.

Keywords: American Indians; Navajo; body mass index; indigenous; produce prescription program, childhood obesity; rural.