Neqpiaput Iinruugut (Our Food is Medicine): Testing a tribally-driven intervention to prevent heart disease among Alaska Native communities - Project Summary/ Abstract There is an urgency to address disparities in coronary heart disease (CHD) among Yup’ik Alaska Native People living remote, frontier communities in the Yukon Kuskokwim Delta Region (YKD). Well-intentioned mainstream interventions in Native communities have fallen short of their intended goals, largely because they focus too narrowly on changing dietary behaviors without addressing the deeper root cause of CHD, i.e., the lasting harms of colonization and historical trauma and disruption of traditional food systems. Consistent with a robust body of research, Yup’ik tribal leaders and Elders recognize that this limited perspective is ineffective and potentially harmful, as it perpetuates stereotypes that poor health is their own fault. Most interventions continue to reflect individualistic causes and solutions, despite broad acknowledgment that colonization was, and continues to be, harmful to Native Peoples. In response to direct calls for action by Yup’ik Elders and community leaders we propose to confront disparities in CHD through a tribally driven, Indigenous food sovereignty (IFS) intervention, called Neqpiaput Iinruugut (Our Food is Medicine). Neqpiaput Iinruugut reconnects Yup’ik People with their cultural strengths by blending an established and thriving Yup’ik Elder-designed behavioral health program rooted in ancestral wisdom (Calricaraq) with a carefully selected set of Yup’ik Elder-designed teaching/learning workshops on traditional foodways. This 12-month, strengths-based and tribally led intervention will be delivered by community interventionists in three complementary layers: (a) monthly in-person community gatherings; (b) quarterly in-person, hands-on workshops; and (c) a Facebook group for participants to access knowledge resources and engage with other community members between monthly sessions. This intervention is designed to address health factors beyond the individual, catalyzing systems that synergize reduction of CHD risk and progress toward IFS. The cornerstone of this study is the longstanding and trusting CBPR relationship between The Center for Alaska Native Health Research, the Yukon Kuskokwim Health Corporation (the tribal healthcare organization in the YKD), and the Calricaraq Elders Council, comprised of approximately 40 Elders from across the region. Our specific aims are to 1) Determine the effectiveness of Neqpiaput Iinruugut on CHD risk, 2) Determine if cultural buffers (growth in cultural identity, Yup’ik wellness, community connectedness, social support, and family cohesion) mediate the effect of the intervention on CHD risk, and 3) Examine the impact of Neqpiaput Iinruugut on IFS indicators. Findings have the potential to reduce the burden of CHD in Alaska Native communities while advancing the field of tribally driven diet-related disease interventions.
