Food access interventions in American Indian and Alaska Native communities

A scoping review

Abstract

American Indian and Alaska Native (AI/AN) com­munities in the United States represent culturally rich food landscapes and traditions. Yet, food access in AI/AN communities remains a public health issue. Food access is influenced by a myriad of factors that may interact at different levels of the social ecological model (SEM). Using a scoping review methodology, we aimed to map the existing Indigenous community food access literature in the U.S. to the SEM to identify common SEM impact leve ls that food access interventions are targeting. We further reflected on AI/AN community food access intervention gaps to inform future interven­tion targets. A systematic search strategy was devel­oped and carried out in the following electronic databases with search dates from 1988 to 2023: PubMed, CINAHL, SocIndex, Academic Search Premier, ERIC, and Google Scholar. We then car­ried out deductive content analysis through the lens of the SEM using qualitative software. Intervention targets were identified based on what changes were highlighted in articles at each SEM level. Fourteen articles met the inclusion criteria for the review. Interventions targeted the ‘intrapersonal’ and ‘com­munity’ SEM levels the most, while the ‘institu­tional’ and ‘public policy’ levels were the least tar­geted. Food access was promoted in various inter­vention formats, including supporting community and/or school gardens; providing seeds; providing traditional foods at school, family, and community events; and providing meals to families. Our review found that valuable research has been conducted on AI/AN food access interventions with many interventions targeting multiple levels of the SEM. Our review highlights the importance of leveraging strengths in AI/AN communities to enhance food access, including through culturally aligned pro­grams and traditional foods. Further collaboration between AI/AN communities and researchers may lead to the development of more informed multi­level interventions that further integrate Indige­nous methodological and culturally based approaches to improving food access.