GOOD MORNING, GOOD AFTERNOON,
AND GOOD EVENING, DEPENDING ON
WHERE YOU'RE JOINING US FROM AND
WELCOME TO THE NIH WORK TOP TO
ADDRESS CHRONIC DISEASE.
I'M ALLISON BROWN AND I SERVE AS
A COORDINATOR HERE AND I'VE HAD
THE PLEASURE OF SERVING AS ONE
OF THE PROGRAM LEADS FOR THE
WORKSHOP TODAY.
A PROUD DAUGHTER OF SOMEONE WHO
MIGRATED TO THE UNITED STATES
FOR OPPORTUNITIES, I'M EXCITED
TO HAVE YOU JOIN US TODAY.
BEFORE WE DIVE INTO THE OFFICIAL
WELCOME, I WANT TO TURN IT OVER
TO OUR TEAM TO GO OVER TECHNICAL
ITEMS FOR THE DAY.
NEXT SLIDE.
>> THANK YOU DR. BROWN AND GOOD
AFTERNOON EVERYBODY.
I'M BRITTANY, JUNIOR BE WORKSHOP
COORDINATE SHALL WITH THE NIH BL
WORKSHOP PROGRAM AND THRAWRCHG
FOR US FOR THE FIRST DAY OF THE
ADVANCING HEALTH AND EQUITY
THROUGH CULTURE CENTERED DIETARY
INTERVENTIONS TO ADDRESS CHRONIC
DISEASE VIRTUAL WORKSHOP.
THIS PRESENTATION IS BEING
RECORDED FOR INTERNAL USE ONLY.
PLEASE MAINTAIN RESEARCH
INTERGRITD AND CONFIDENTIALITY.
SO QUESTIONS AND COMMENTS
THROUGH THE VIDEO CAST LIVE
FEEDBACK USING THE FEEDBACK
BUTTON AT THE TOP RIGHT OF THE
VIDEO DESCRIPTION.
IF POSSIBLE, PLEASE STATE THE
PANELIST YOU'RE ADDRESSING TO.
LIVE CAPTIONS ARE LOCATED IN THE
TOOLBAR OF THE BOTTOM RIGHT OF
YOUR VIDEO PLAYER.
SELECT THE CLOSE CAPTIONED ICON
AND SELECT "ENGLISH" TO ENABLE
THEM.
I'M PASSING THINGS BACK OVER FOR
DR. ALLISON BROWN AND DR.
COLLINS TO DO OUR NIH WELCOME.
>> THANK YOU, BRITTANY AND
WELCOME AGAIN EVERYONE.
ON BEHALF OF MY FELLOW COSCH COR
DR. COLLINS, WE'RE EXAIPT.
EXCITED FOR YOU TO BE HERE WITH
US.
THE VIRTUAL WORKSHOP PLATFORM
ALLOWS US TO ENHANCE OUR
ACCESSIBILITY AND ENGAGE WITH
ATTENDEES NOT ONLY HERE IN THE
UNITED STATES, BUT ACROSS THE
GLOBE.
THIS TWO-DAY WORKSHOP WOULD NOT
BE POSSIBLE WOWMENT THE
COLLABORATION AND EXPERTISE OF
OUR PLANNING COMMITTEE.
WE WANT TO THANK THEM AND
ACKNOWLEDGE OUR AMAZING TEAM.
AS YOU'LL NOTE ON THE GUIDE, THE
PLANNING COMMITTEE COMPRISES NOT
ONLY OF COLLEAGUES ACROSS NIH,
BUT ALSO FEDERAL PARTNERS
INCLUDING THE USDA AND OTHER
AGENCIES.
THIS IS A COLLABORATION.
TO GIVE YOU MORE CONTEXT FOR
TODAY'S WORKSHOP, THE NIH
RELEASED THE STRATEGIC PLAN FOR
NUTRITION RESEARCH IN 2020.
THIS INCLUDE FOUR GOALS OUTLINED
IN THE FIGURE ON THE RIGHT AND
IT'S ORGANIZED AROUND THE
CENTRAL UNIFYING VISION OF
PREVISION RESEARCH.
THIS ALIGNS WITH THE WORKSHOP
THAT PRECISION NUTRITION FOCUSES
ON DIETARY INTERVENTIONS IN
DIVERSE COMMUNITIES.
NEXT SLIDE.
SNEU P NUTRITION INEQUITIES THAT
WE SEE IN THIS COUNTRY SIGNAL
THE NEED FOR MORE TARGETED
INTERVENTIONS.
ALTHOUGH MOST AMERICANS DON'T
MEET DIETARY.
THEY ARE MORE IN CULTURAL
GROUPS.
THERE ARE DIE OAT RELATED
CANCERS SHOWN ON THE FIGURE ON
THE RIGHT.
RESEARCH HIGHLIGHTS DIE OAT AS
AN IMPORTANT RISKS FACTOR TO
IMPROVE HEALTH.
MEANWHILE, WE KNOW THAT DIE OAT
IS INFLUENCED BY A VA RIETD OF
FACTORS INCLUDING CULTURE AND
ENVIRONMENTAL INFLUENCES.
SOME OF THE FACTORS WILL BE
DISCUSSED AND HIGHLIGHTED
THROUGHOUT THE TWO DAYS OFFER
THE WORKSHOP.
NEXT SLIDE.
UNDERSTANDING THE COMPLEXITIES
OF THE CAUSES OF NUTRITION
HEALTH DISPARITIES, THE NIH
OFFICE OF NUTRITION RESEARCH
COORDINATE NAITSZ THE ROURKEING
GROUP ALONG WP SEARCH OTHER
WORKING GROUPS HIGHLIGHTED ON
THE IMAGE OF THE SLIDE.
THE GOAL OF THE WORKING GROUP IS
THREE FOLD, ONE, TO ADVANCE NIH
NUTRITION RESEARCH TO UNDERSTAND
THE INTERACTION BETWEEN NOT ONLY
DIETS H ET BUT ENVIRONMENT,
BIOLOGICAL AND BEHAVIORAL
PROCESSES AND HOW THEY
CONTRIBUTE TO HEALTH
DISPARITIES.
SECONDLY TO ENCOURAGE RECH ON
RESEARCH.SINCE HEALTH DISPARITIA
CROSS COUNTRY PLAN, THE GOAL IS
TO WORK WITH OTHER GRIPES TO
SUPPORT NUTRITION AND HEALTH
DISPARITY RESEARCH.
TODAY'S WORKSHOP IS AN ACTIVITY
OF THIS WORKING GROUP.
TODAY'S WORKSHOP ALIGNS WITH THE
PRIORITIES SOCIETY ON THE 2022
WHITE KORVES ON HUNGER,
NUTRITION AND HEALTH SCLD THE
CONFERENCE REINVOLVED AROUND
FIVE PILLAR.
THIS ASK THE FIFTH 3EU8ER TO
ENHANCE NUTRITION AND FOOD
RESEARCH.
WE HOPE THIS WILL SIMULATE OUR
AUDIENCE INTO MORE SCIENCE AND
RESEARCH AS WELL AS MORE
CULTURED-CENTERED PRACTICES.
NOW I WILL TURN IT OVER TO MY
COLLEAGUE DR. COLLINS.
>> THANK YOU SO MUCH, ALLISON.
I WOULD LIKE TO SHARE WITH YOU
THE IMPORTANCE OF NUTRITION
HEALTH DISEXPAIRTS TO LET YOU
KNOW THAT THE WHITE
CONFERENCE -- DISPARITIES AND
THE WHITE HOUSE CONFERENCE
SPAWNED A NUMBER OF INITIATIVES
TO ADDRESS NUTRITIONAL HEALTH
DISPARITIES.
ONE IS THE FRAMEWORK.
SO THIS FRAMEWORK IS IN ORDER TO
REDUCE DISPARITIES, YOU P NEED
TO DESIGN THE INTD PLAY OF
MULTIPLE LEVELS OF INFLUENCE
OPERATE WITHIN THE BIOLOGICAL,
BEHAVIORAL, ENVIRONMENTAL AND
HEALTHCARE DOMAINS AND SHOULD
ENCOMPASS EVERY LEVEL OF THE
SOCIO-ECOLOGICAL LEVEL.
IN ORDER TO FULLY UNDERSTAND THE
DISPARITIES, WE EVER TO ADDRESS
THE CUMULATIVE AND INTERACTIVE
EFFECTS FL NUTRITIONAL INTAKE,
DIETARY INTAKE, AND HEALTH.
WE HAVE TO LOOK AT MULTIPLE
FACTORS.
I WOULD LIKE OL HIGHLIGHT A FEW
EXAMPLES FROM THE NUTRITION
HEALTH DISPARITY FRAMEWORK.
THIS WAS DEVELOPED BY NIH
RESEARCHERS HERE AT NIH AND IN
ADDITION TO THAT, WE MODIFIED
THE NUTRITION HEALTH DISPARITIES
FRAMEWORK FROM THE NIH MD
FRAMEWORK.
THIS IS MUCH MORE NUTRITION
CENTRIC AND FOCUSED.
IT HAS THE LEVELS OF INFLUENCE
IN VISUAL AND SOCIETAL LEVEL AND
THE LEVELS OF DOMAIN OF
INFLUENCE WOULD BE THE
BIOLOGICAL, BEHAVIORAL, PHYSICAL
AND BUILT ENVIRONMENTS AND
NUTRITIONAL HEALTHCARE SYSTEM.
I WOULD LIKE TO HIGHLIGHT A FEW
EXAMPLES.
THIS WORKSHOP FOCUSES ON THE
NEEDS TO ADVANCE NUTRITIONAL
INTERVENTION AND REDUCE HEALTH
DISPARITIES.
LOOKING AT THE INDIVIDUAL LEVEL,
YOU CAN SEE THAT A CULL TRAITION
ASK ASSOCIATED KA DISPARITIES.
FOR EXAMPLE PEOPLE THAT A CULL A
CULTURE EIGHT THEIR DIETS HAVE
MORE FAST FOODS AND PROCESSED
FOODS WHEREAS THOSE THAT ADHERE
TO TRADITIONAL DIETS, THAT HAS
MORE INTAKE OF FRUITS AND
VEGETABLESES AND FIBER INTAKE
AND HOME-COOKED MEALS.
YOU CAN SEE SOCIAL NETWORK AND
FAMILIES AND PEER NORMS SOARNTED
WITH INTAKE AND HOW IT
INFLUENCES DIETARY INTAKE.
THE COMMUNITY NORMS HAVE BEEN
ALSO ASSOCIATED WITH DIETARY
INTAKE.
FOR EXAMPLE, RESEARCH SUGGESTS
THAT COMMUNITY NORMS ASSOCIATED
WITH POSITIVE COMMUNITY
CONNECTIVENESS AND COHESION.
THAT HAS BEEN ASSOCIATED WITH
DECREASED FOOD INSECURITY.
BODY SOFA ESTEEM INCLUSIVE AND
ACCEPTING ENVIRONMENT WHERE BODY
SELF-ESTEEM IS VIEWED POSITIVELY
HAS BEEN BE ASSOCIATED WITH
DECREASED DISORDERED EATING
AMONG CERTAIN POPULATIONS.
WHEN YOU LOOK AT THE SOCIETAL
EFFECTS OF SOCIAL NORMS, WE FIND
THAT THERE IS SOME SOCIETIES
WHERE THERE IS STIGMA OVER
GOVERNMENT ASSISTANCE PROGRAMS
MAY CONTRIBUTE TO THE LIMITED
BENEFITS OF THE PROGRAMS AND
INCREASE RISK FOR NUTRITION
HEALTH DISPARITIES.
THESE ARE SOME EXAMPLES OF HOW
SOCIOCULTURAL ENVIRONMENTS CAN
ENHANCE DISPARITIES.
BASICALLY UNDERSTANDING THESE
INFLUENCES CAN LEAD TO DESIGNING
AND DEVELOPING INTERVENTIONS.
THEY CAN REDUCE NUTRITIONAL
HEALTH DISTAIRTS AND IMPROVE AND
PROMOTE NUTRITION HEALTH AND
WELL-BEING.
SO WE WANTED TO HIGHLIGHT THAT
WE DID APPLY FOR CPEU CREDITS
FOR REGISTERED DIETICIANS.
THIS PARTICULAR SLIDE SHOWS THAT
THE WORKSHOP ATTENDANTS ARE HE
ELIGIBLE FOR 9 CPEU SCRED ITS.
THIS IS FOR REGISTERED
DIETICIANS AND PROFESSIONALS AS
WELL AS REGISTERED DIETETIC
TECHNICIANS AS WELL.
IT ALIGNS WITH THE PERFORMANCE
COMPETENCY AREAS SUCH AS FOOD
AND DIETETICS CAN AND APPLIES
CURRENT FOOD AND NUTRITION
SCIENCE AND NUTRITION PRACTICE
AND DMON IS STRAITS AND APPLIES
KNOWLEDGE AND CULINARY
PRACTICES.
ANOTHER IS NUTRITION POPULATION
AND GLOBAL HEALTH SUCH AS
ADVOCATING FOR DISEASE
PREVENTION TO SUPPORT ACCOUNT
IMPLEMENTATION OF 23450U TRITION
AND PROGRAMS.
AND DESIGNING AND DEVELOPING
COMMUNITY AND POPULATION HEALTH
PROGRAMS.
I JUST WANT TO SAY THAT WE HAVE
APPLIED FOR CPEUs, WE'RE
WAITING -- OUR APPLICATION
SUNDAY REVIEW.
PLEASE CONTACT IF YOU WANT TO
KNOW MORE AND IF YOU'D LIKE TO
LEARN MORE ABOUT CPEUS AND
OBTAINING CERTIFICATES TO GO TO
THE WEBSITE AFTER THE WORKSHOP
AND TO GET ANYS ADDITIONAL
UPDATES AS IT RELATES TO THESE
CERTIFICATES.
NOW I WOULD LIKE TO SAY THAT
WE'D LIKE TO TURN THE WORKSHOP
OVER TO OUR CO-CHAIRS.
O OUR CO-CHAIRS ARE DR. MERE MA
IT A AND DR. MECHANICS GREEDY
AND THEY'LL PROVIDE AN OVERVIEW
OF THE WORKSHOP PROGRAM.
THANK YOU DR. MATTEI AND DR.
McGREEVEY.
>> WE'RE EXCITED TO HAVE
EVERYONE HERE FOR DAY ONE OF OUR
WORKSHOP.
NEXT SLIDE, PLEASE.
I WANTED TO INTRODUCE THE TWO
COSHARES.
I'LL ALE HAVE DR. MATTEI FIRST.
>> GOOD MORNING, EVERYBODY OR
GOOD, GOOD EVENING, I KNOW THIS
IS A WORLDWIDE EVENT.
THANK YOU ALL FOR JOINING US
TODAY.
WE'RE PLEASED TO FINALLY BE HERE
TODAY SHOWING THE CULMINATION OF
A LOT OF WORK FOR MANY PEOPLE.
A SPECIAL THANK YOU TO OUR
PLANNING COMMITTEE TO THE NIH,
AND TO MY CO-CHAIR BREE.
WE'VE BEEN WORK TOGETHER FOR
SEVERAL MONTHS TO BRING YOU THIS
WORKSHOP HEAD TO AND WE HOPE
THAT YOU ENJOY IT AND WE'LL GO
THROUGH THE OVERVIEW OF WHAT
YOU'LL BE LISTENING TO IN THE
NEXT COUPLE OF DAYS.
THANK YOU AGAIN.
>> SO I JUST WANTED TO MAKE SURE
THAT EVERYONE ASK QUESTIONS
DURING THE PRESENTATION USING
THE Q AND A FUNCTION.
WE'RE EXCITED TO HAVE SO MANY
PEOPLE REGISTERED FOR THIS
TWO-DAY VIRTUAL EVENT.
NEXT SLIDE, PLEASE.
THERE ARE THREE MAIN KEY
OBJECTIVES FOR THIS WORKSHOP ONE
IS REVIEWING HOW CULTURAL
FOODWAYS AND SOCIOCULTURAL
FACTORS COULD BE LESSONED TO
IMPROVE THE EFFECTIVENESS OF
DIETARY PREVENTIONS CAN OF
DIVERSE POPULATIONS INCLUDING
IMMIGRANT GROUPS, RACIAL ETHNIC
AND RURAL COMMUNITIES.
WE WANT TO IDENTIFY GAPS AND
OPPORTUNITIES.
FOR RESEARCH ON HERITAGE FOOD
WIEST TO TREAT AND MANAGE
DIET-RELATED DISEASES IN
CULTURALLY DIVERSE POPULATIONS.
WE'LL LOOK AT BIOLOGICAL
MECHANISMS, UNDERLYING RESPONSES
TO TRADITIONAL AND
EVIDENCE-BASED DIETARY PATTERNS.
NEXT SLIDE, PLEASE.
THE OVERARCHING GOAL OF THIS
WORKSHOP IS TO REVIEW THE STATE
OF THE SCIENCE AND PROVIDE
RECOMMENDATIONS FOR FUTURE
RESEARCH ON THE DEVELOPMENT AND
IMPLEMENTATION OF CULTURE
CENTERED DIETARY INTERVENTIONS
AND GUIDELINES AND INDEXES AND
CONSIDERATION OF CULTURAL
FOODWAYS AND SOCIOCULTURAL
FACTORS SUCH AS CULTURATION IN
DIETARY INTERVENTIONS.
SO WE KNOW THE UTZ IS DIVERSE
AND KNOWN FOR THE RICH TAPESTRY
OF DIVERSITY.
THIS DIVERSE TRI IS EVIDENT
RANGING FROM ETHNIC BACKGROUNDS
TO GEOGRAPHIC DIFFERENCE.
WE HAVE VAST DIFFERENCES IN
WHERE PEOPLE LIVE, RURAL AND
URBAN AND DIFFERENT RIEMENTS C
CLIMATES.
WHROORNT YOU HAVE ACCESS TO
FRESH WAT -- WHETHER OR NOT YOUE
ACCESS TO FRESH WATER OR
SALTWATER.
RACIAL/ETHNIC DIVERSITY.
THE U.S. HAS AFRICAN-AMERICANS,
ASIAN AMERICANS, NATIVE
AMERICANS AND MANY MORE.
THIS HAS ENRICHED THE NATION'S
CULTURE AND TRADITIONS AND OUR
WCUISINE AS WELL.
THERE IS RELIGIOUS DIVERSITY,
LINGUISTIC DIVERSITY, LGBTQ+
COMMUNITIES AND IT IMPACTS LOTS
OF THINGS BUT ALSO WHAT WE EAT
AND THAT'S WHY WE ARE HERE
TODAY.
EACH CONTRIBUTE TO THE CULTURAL
DIVERSITY OF OUR DIETS.
WHY ARE WE FOCUSING ON THIS
TOPIC?
WHY IS IT IMPORTANT TO CULL.
FOCUS ON PREVENTING HEALTH
EQUITY?
WE KNOW THERE IS AN INCREASING
FOCUS ON FINDING WAYS.
WE CAN ADDRESS HEALTH THROUGH
GOOD NUTRITION.
LAST YEAR, THE WHITE HOUSE HELD
A CONFERENCE AND NIH HAS AN
INITIATIVE FOCUSING ON PREVISION
NUTRITION.
SO THERE ARE WAYS THAT WE'RE
TRYING TO FIGURE OUT HOW TO
INCORPORATE MORE FOCUS ON
NUTRITION AND HEALTH.
IN ADDITION, THE 2025/2030
GUIDELINES ARE UPDATED AND WE
HAVE A FANL FOCUSED ON ISSUES
EVER INCORPORATING HEALTH EQUITY
INTO DIETARY GUIDELI GUIDELINESD
THENNING EVIDENCE-BASED FOR
DIVERSITY OF ENVIRONMENTS.
FOR TODAY, WE ARE FOCUSING ON
FOUR MAIN PANELS.
WE'LL HAVE SEVERAL SPEAKERS
WITHIN EACH.
PANEL ONE IS LOOKING AT THE
SOCIOCULTURAL FACTORS
INFLUENCING FOODWAYWAYS AND
SOVEREIGNTY UNTIL NAIT MERCHS.
PANEL TWO IS TAILORED TO BLACKS
IN THE U.S.
PANEL 3 IS LACKING AT MIGRATION
AND DIETARY AMONG LA LATINX FORE
DIVERSE CULTURES IN THE U.S.
DAY TWO WILL HAVE PRESENTATIONS
FROM THOSE WHO WORK IN SEVERAL
GOVERNMENT POSITIONS SUCH AS
USDA AND HEALTH ARE PROMOTION.
DAY TWO WILL FOCUS ON
PRACTITIONERS IN TRANSLATING
RESEARCH INTO THE COMMUNITIES.
WE'LL LOOK AT PRECISION
NUTRITION AND BIOLOGICAL
MECHANISMS AND HAVE ALL OUR
FLASH TALK PRESENTATIONS TROUT
THE DAY AS WELL.
MAKE SURE YOU JOIN US BACK FOR
DAY TWO.
NEXT SLIDE.
SO THERE HAVE BEEN MANY
INSTITUTES AND CENTERS WHO HELP
CONTRIBUTE TO THE THIS WORKSHOP
AND LOOK FORWARD TO HEARING FROM
YOU ALL ABOUT HOW TO BEST
ADVANCE OUR WORK IN HEALTH HE
HEALTHEQUITY TO ADDRESS DISEASE.
I'M HAPPY TO INTRODUCE THE
DIRECTOR OF THE NATIONAL
INSTEUNS OF HEALTH DES TAIRTS
WHO WILL BE -- HEALTH
DISPARITIES WHO WILL BE
PROVIDING OPENING REMARKS.
THANK YOU SO MUCH.
AND TO THE ORGANIZERS, OUR
INSTITUTE HAS BEEN INVOLVED IN
THIS AND TO THE CO-CHAIRS.
THIS IS GREAT TO LISTEN TO SOME
OF THE OVERVIEW.
CAN I SHARE MY SCREEN?
>> NEXT SLIDE, PLEASE.
>> NEXT SLIDE.
NEXT SLIDE.
KEEP GOING.
OKAY.
I WANT TO JUST SHARE SOME
THOUGHTS ABOUT THIS TOPIC, ALSO
SHARE THE PERSPECTIVE OF NIH OF
THE GLOBAL ISSUES OF HEALTH
DISPARITIES AND HOW GIVEN THE
NATURE OF THE WORKSHOP AND SORT
OF SUPPORTED BY WHAT I JUST
HEARD.
IN THE CONTEXT YOU ALL KNOW,
CHRONIC DISEASE IS NUMBER ONE
CAUSE OF DEATH ON A GLOBAL
LEVEL.
MOST CHRONIC DISEASES ARE MORE
COMMON IN PEOPLE WHO ARE POOR AS
WE HAVE INCREASED THE ACCESS TO
FOOD AND DEVELOPMENT.
IT USED TO BE THE OTHER WAY
AROUND.
IF YOU HAD EXCESS WEIGHT,
YOU WERE WELL OFF AND THAT
CHANGED.
DIET CONTRIBUTES TO A BUNCH OF
CHRONIC CONDITIONS MANY ARE
CARDIOVASCULAR VEELTED AND ALSO
CANCERS YOU HEARD.
IT CAN BE AN EFFECTIVE THERAPY
ALTHOUGH IT'S BEEN A CHALLENGE
TO IMPLEMENT AND HAVE ADHERENCE
ON A SUSTAINABLE BASIS TO
DIETARY CHANGES ON A POPULATION
LEVEL.
ONE THING THAT WE COULD DO MORE
OF EVEN FROM THE NIH PERSPECTIVE
IS ADDRESSING STRUCTURAL
FACTORS.
ONE OBVIOUS IS THE COST OF
HEALTHY FOOD IS SUBSTANTIALLY
HIGHER AND THE COST OF ULTRA
PROCESSED AND ACCESS TO ULTRA
PROCESSED FOOD IS EASIER AND
LOWER.
LEER COST, EASIER ACCESS.
LOWER COST, EASIER ACCESS.
FROM MY RESEARCH PERSPECTIVE,
I'M A GENERAL INTERNIST.
I WORKED ABOUT MULTIPLE
DIFFERENT DISCIPLINES.
ONE COMFORT CHALLENGES IN
NUTRITION SCIENCE IS HARD TO
MESH WHAT ARE PEOPLE EAT.
I KNOW IT'S GOTTEN BETTER AND
QUESTIONNAIRES ARE MORE FOCUSED
AND BETTER PROGRAMS TO ANALYZE
IT MORE.
THEY ARE RELIABLE, BUT THEY'RE
TEDIOUS TO ADMINISTER.
TO DISSEMINATE MORE INFORMATION
ABOUT THIS PERSPECTIVE, ADDING
QUESTIONS TO STANDARDIZED
SURVEYS WOULD BE ONE WAY OF
EXPANDING IT.
THE PUBLIC ALSO EXPRESSES
FRUSTRATION SOMETIMES.
THEY SAY IT'S GOOD TO EAT THIS
THEN CHANGE THEIR MINDS, IT'S
BETTER TO EAT THIS.
THE MANTRA EAST MOSTLY PLANTS,
NOT TOO MUCH AND ALSO THE IDEA
AS REAL FOOD AS OPPOSED TO
THINGS THAT GET PROCESSED OR
OVERLY PACKAGED IS ONE THAT CAN
GUIDE OUR NUTRITION WITHOUT
GETTING PRESCRIPTIVE AND PREVK
EXPECTING PREFERENCES.
FOOD PRODUCTION IS IS A PROBLEM.
U.S. PRODUCES OVER 3,000
CALORIES PER DAY PER PERSON TO
BE CONSUMED AND WE ONLY NEED
HALF THAT MUCH SLIGHTLY MORE
DEPENDING ON THE SITUATION FOR
ACTUALLY BEING NOURISHED.
THE OBESITY EPIDEMIC OCCURRED
DURING MY CAREER OVER THE LAST
40 YEARS.
AND WE KIND OF WATCHED IT.
WE DIDN'T DO ANYTHING ABOUT IT.
WE MADE LOTS OF OBSERVATIONS
ABOUT IT.
BUT IT IS QUITE STRIKING LOOKING
BACK.
WE SAW, ALL THEE E THOUGH NOT
PROPORTIONALLY, THE SAME
INCREASE IN DIABETES THAT
FOLLOWED OVER TIME.
I MENTIONED THE TERM OF
"SPUBTIVE CULTURAL" WHEN I
STARTED DOING RESEARCH, IT WAS
ON CIGARETTE SMOKING AND SOCIAL
PSYCHOLOGISTS TAUGHT ME THE
APPROACH OF ASKING PEOPLE ABOUT
THEIR ATTITUDES AND BELIEFS AND
BEHAVIOR FOR WHITE COMPARED TO
LATINOS.
AND TO LOOK AT SIMILAR ATTITUDES
AND BEHAVIORS AND IT PAVED THE
WAY FOR WHAT I WOULD SAY
TAILORED INTERVENTIONS.
CULTURAL SPECIFIC INTERVENTIONS.
CLEARLY IN DIETARY HABITS,
NUTRITIONAL HABITS VARY ACROSS
HERITAGE GROUPS.
NIH STARTS WITH THE PREMISE THAT
RACE AND EPT NISITY AS A
SELF-IDENTIFIED SOCIAL CONSTRUCT
AND SOCIAL CAN CLASS OR
SOCIOIMLK SSOCIOECONOMIC ARE WAT
SHOULD BE MEASUREDDED IN A
STANDARDIZED WAY AND CONSIDERED
AS POSSIBLE CONTRIBUTORS TO THE
OUTCOMES THAT WE'RE OBSERVING.
THIS MAY BE SORT OF PREACHING TO
THE CONVERTED IN THIS AUDIENCE,
BUT IT'S NOT UNIVERSALLY
ENDORSED BY CLINICAL RESEARCHERS
IN PARTICULAR.
I BELIEVE THIS IS A GLOBAL ISSUE
NOT A U.S. CENTRIC CONCERN.
RACE AND ETHNICITY ARE GLOBAL
ISSUES ESPECIALLY AS WE SEE MORE
DIVERSIFICATION IN DIFFERENT
PARTS OF THE WORLD.
PREDICTION OF LIFE EXPECTANCY
AND MORTALITY ARE STRONG IN THE
U.S.
IT'S VARIED TREMENDOUSLY IN THE
LAST 25 YEARS.
AFRICAN AND LATINO HOUSEHOLDS,
ABOUT A THIRD OR SO HAVE SOME
LEVEL OF FOOD INSECURITY.
COMPARED TO ABOUT MAYBE 15% OR
HALF THAT MANY AMONG WHITE
HOUSEHOLDS.
AND IF YOU LOOK AT PEOPLE WITH
LESS THAN HIGH SCHOOL, THE
NUMBER GOES UP TO 40%.
AMERICAN INDIAN AND ALASKAN
NATIVE HAVE MORE PROBLEMS
DESPITE OBESITY BEING HIGH AMONG
AFRICAN-AMERICAN AND LATINO
POPULATIONS, CHILDREN AS WELL.
IMMIGRANTS WHO ARE MORE CULL
TRAITED AND BECOME MORE FLUENT
IN THE ENGLISH LANGUAGE AND
ADOPT MORE MAINSTREAM ATTITUDES
HAVE LOWER DIET QUALITY.
THIS IS MOSTLY STUDIED AMONG THE
LATINO HISPANIC POPULATIONS.
THIS IS THE IDEA THAT
ACCULTURATION IS BAD FOR YOUR
HEALTH.
THIS IS ONE OF THE AREAS WHERE
EVIDENCE POINTS IN THAT
DIRECTION ALTHOUGH NOT ALL DO.
JUST AS EXAMPLE OF DATA
SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM, HOUSEHOLDS
ENROLLED HAD A LOWER RATE OF
FOOD INSECURITY.
BLACK HOUSEHOLDS COMPARED TO
WHITE.
YOU CAN SEE THAT THESE KINDS
EVER INTERVENTIONS, PROGRAM
INTERVENTIONS SUPPORTED BY THE
FEDERAL GOVERNMENT REALLY DO
MAKE A DIFFERENCE IN THE MOST
VULNERABLE POPULATION GROUPS.
SO, NIMHD RESEARCH PRIORITIES
ARE SUMMARIZED HERE.
IN USING THIS IN THE LAST
SEVERAL MONTHS IN MY TALKS.
I SAID THE FIRST BULLET AND GO
BACK TO OUR ORIGINAL FOUND BEING
AND WHAT WE HAVE TRADITIONALLY
WORKED IN I THINK WE NEED TO
REMAIN PRIORITIZING THE FACTORS
OF RACE AND/OR ET NIS YIPT IN
SOCIAL ECONOMIC STATUS.
WE'RE INTERESTED IN ALL
SECTIONALITY WITH RACE AND
ETHNICITY WITH ALL THE
POPULATIONS DESIGNATED AS HAVING
HEALTH DISPARITIES, UNDERSCORE
RURAL POPULATIONS AND LGBTQ+
PERSONS AND PERSON WITH
DISABILITIES AND ALL OTHER
CONDITIONS AS WELL.
THAT'S HOW WEAVE WE'VE OPERATEDE
OUR FOUNDING AS A CENTER IS 23
YEARS AGO.
WE NEED TO REEVALUATE THE IDEA
THAT EVERYONE IS COMPARED TO
WHITES.
WHITES ARE THE MAJORITY
POPULATION AND CONTINUE TO BE
THE MAJORITY POPULATION AND WILL
BE FOR AT LEAST ANOTHER DECADE
OR SO.
60% OF THE U.S.
AND GENERALLY THOUGHT THEY HAD
BETTER OUTCOMES BUT THAT HASN'T
TURNED OUT TO BE THE CASE AS YOU
PROBABLY ARE AWARE AND SO, I
THINK RE-THINKING OF A REFERENCE
POINT IN TERMS OF AN
ASPIRATIONAL GOAL FOR BASED ON
NATIONAL METRICS IS THE WAY
WE'RE MOVING IN THIS DIRECTION,
NOT YET FINALIZED AS A PROCESS
INTERNALLY AT THE INSTITUTE.
YOU SAW THE FRAMEWORK ALREADY.
NEXT SLIDE IS CERTAINLY MADE ME
HAPPY TO SEE THE NUTRITIONAL
RESEARCH FRAMEWORK.
I THINK THIS WAS DISCUSSED IN
THE PREVIOUS PRESENTATION.
NEXT SLIDE.
I'LL SKIP THIS.
WE DO FUND A NUMBER OF THINGS IN
THIS AREA TO MAKE PEOPLE AWARE
FOR THE AUDIENCE, THREE MULTIPLE
CRIME DISEASE RESEARCH CENTERS
FUNDED ON A CONGRESSIONAL
MANDATE INCLUDE INTERVENTIONS
THAT FOCUS ON NUTRITION, DIETER
AND CHRONIC DISEASE.
THESE ARE CENTERS THAT ARE
SUPPOSED TO OR EXPECTED TO
DEVELOP AND IMPLEMENT
INTERVENTIONS UPSTREAM AS WELL
AS THE PEOPLE WITH THE DISEASE.
WE HAVE R-1s FOCUSED ON
AMERICAN INDIAN AND ALASKAN
NATIVE POPULATIONS AROUND FOOD
IN DIFFERENT PARTS OF THE
COUNTRY.
DIETARY INTERVENTION GRANTS THAT
WE'VE FUNDED INCLUDING R-K AND
R-21, COFUSSING ON BLACK WOMEN
AND OBESE BLACK MEN IN THE RURAL
SOUTH AND MEKSEN AMERICAN MEN
WITH THE INTENTION TO PREVENT
LIVER DISEASE.
GROCERIES FOR HELPING BLOOD
PRESSURE CONTROL IN GOOD DESERTS
AND HOUSEHOLDS OR FAMILY FOCUSED
INTERVENTIONS WHICH HAVE BEEN
DONE IN OTHER OUTCOMES.
BEHAVIORAL OUTCOMES MIGHT BE
ANOTHER DIRECTION TO MOVE INTO.
SO, EMPHASIS ON THIS MULTI-LEVEL
ASPECT FROM THE FRAMEWORK, NOT
JUST INDIVIDUAL BUT THINK OF
FAMILY AND HOUSEHOLD AND
COMMUNITY.
I EMPHASIZED THE IDEA OF
STRUCTURAL POLICY INTERVENTIONS
LIKE THE JUNK FOOD TAX AND BENCH
BEVERAGE TAXES.
INSTEAD OF SEEING FAST FOODS
THAT ARE EASY TO PICK UP, YOU
SEE HEALTHIER FOODS.
AND PEOPLE HAVE ACTUALLY DONE
THIS PARTICULARLY RELATED TO
RURAL AREAS AND INDIAN
COUNTRIES.
KEEP OUT THINGS THAT ARE NOT
AUTOMATICALLY IN THE BIOMEDICAL
RESEARCH LANE TO BEGIN WITH.
AND TAILERINGING INTERVENTIONS
TO LEVERAGE CONSUMPTION OF
HEALTHIER FOODS ALL CULTURES AND
HERITAGES HAVE SOME COMPONENT OF
THEIR DIET THAT IS HEALTHY IF
NOT HEALTHIER THAN WE'RE USED TO
EATING IN HIGH INCOME SOCIETIES
AND FINDING WAYS TO LEVERAGE
THAT AND REALLY VALUE THAT I
THINK IS AN APPROACH AND
INTERVENTION THAT IS VERY
PROMISING.
THANK YOU VERY MUCH FOR YOUR
ATTENTION AND I LOOK FORWARD TO
THE SUMMARY FROM THIS WORKSHOP.
THANK YOU, ALLISON.
>> NEXT SLIDE, PLEASE.
NEXT SLIDE, PLEASE.
NEXT SLIDE.
NOW WE'LL HAVE AING PRESENTATION
FROM JOEL GITTELSOHN ONLY CENTER
FOR HUMAN NUTRITION.
HE COULDN'T JOIN US TODAY, BUT
HE DID A PRERECORDING.
WE'LL TURN IT OVER TO THE
RECORDING.
>> GOOD MORNING I'M A PROFESSOR
WITH THE CENTER FOR HUMAN
NUTRITION, DEPARTMENT
INTERNATIONAL HEALTH, JOHNS
HOPKINS.
I'M HAPPY TO SPEAK TO YOU ON
ASPECTS MUCH FOOD AND DIET AND
PRESENT TO YOU KEY OR CORE
CONCEPTS.
I'M GOING TO TALK ABOUT
IMPORTANT ASPECTS ON HOW
CULTURAL IS RELATED TO FOOD AND
HOW TO DO WE EXPLORE AND COME TO
UNDERSTAND FOOD CULTURE.
I MENTION THESE FOR THINKING
ABOUT DESIGNING CULTURALLY
TAILORED INTERVENTIONS.
WHEN I TEACH ABOUT NUTRITION AND
CULTURE, ONE OF THE FIRST THINGS
I DO SI SHOW SOME OF THE SLIDES
WHICH ARE FROM A BOOK CALLED
"WHAT THE WORLD EATS" AND IT
SHOWS THE FOOD CONSUMPTION IN A
WEEK BY FAMILIES AROUND THE
WORLD KRLD I ASK STUDENTS WHAT
DO YOU THINK THAT DIFFERENTIATES
THE PICTURES 6 WH OFFER WHAT PEE
ARE THINKING?
I GET ANSWERS LIKE ECONOMICS,
WHAT IS AFFORDABLE,
INTERNATIONAL DISPARKTS
ENVIRONMENT AND GLOBALIZATION
AND INDIVIDUAL CHOICE
PREFERENCES AND SO FORTH.
EVENTUALLY WE TYPICALLY GIT TO
THE IDEA THAT ONE OF THE KEY
DIFFERENCES IS CULTURE.
IN FACT, CULTURE -- ALL OF OUR
TECHNICAL ACHIEVEMENTS ARE
THINGS THAT WE LEARN THAT WE
PASS ON THROUGH OUR CULTURE AND
FOOD CHOICE IS ONE OF THOSE
THINGS WHICH IS LARGELY
CULTURALLY DETERMINED AND WHAT
IS APPROPRIATE TO EAT AND WHAT
IS CONSIDERED HEALTHY OR
UNHEALTHY.
WE LEARN THESE THROUGH OUR
CULTURE.
PEOPLE'S PREFERENCES FOR
DIFFERENT KINDS EVER FOODS ARE
HIGHLY RELATED TO THEIR CULTURE.
WHAT FOODS ARE SUPERIOR AND WHAT
ARE INFERIOR.
LET'S TALK ABOUT WHAT WE MEAN BY
CULTURE.
WHAT IS CULTURE.
THIS IS NOT AN EASY THING TO
DEFINE.
I'M GOING TO GIVE THE DRENGS THE
DEFINITIONTHE WAY I LIKE TO LOO.
A BODY EVER VALUES, KNOWLEDGE,
IDEAS AND APPROACHES THAT
CHARACTERIZE A PARTICULAR GROUP.
THIS PROVIDES GUIDELINES AND
RULES FOR HOW YOU SHOULD BEHAVE
WITHIN A PARTICULAR GROUP.
AND IT GUIDES AND ENCOMPASSES
MANY OTHER AREAS OF HOW WE THINK
ABOUT HEALTH AND ECONOMICS,
RELIGION, KINSHIP AND ALL THOSE
DIFFERENT THINGS.
LET'S TALK A LITTLE BIT GO
CHARACTERISTICS OF CULTURE.
THE CULTURE, THAT INFORMATION
VALUES AND KNOWLEDGE THAT YOU
SHARE WITH A GROUP OF PEOPLE IS
SOMETHING THAT YOU SHARE WITH
THOSE PEOPLE AND YOU LEARN IT
FROM YOSH PARENTS OR FROM YOUR
ELDERS AND TYPICALLY PASS IT ON
TO YOUR CHILDREN TO OTHER PEOPLE
IN YOUR CULTURAL GROUP.
THERE IS SYMBOLISM INVOLVED IN
TUL TOUR.
IN
CULTURE.
CULTURE IS SYMBOLIC AND SYSTEMIC
AND PATTERNED.
THERE IS AN ORDER TO HOW CULTURE
IS ORGANIZED.
AND CULTURE HELPS TO DETERMINE
WHAT IS SALIENT AND IMPORTANT OR
LESS IMPORTANT.
IF WE'RE GOING TO DIG DOWN INTO
CULTURE AND UNDERSTAND IMPORTANT
ASPECTS EVER CULTURE RELATED TO
FOOD, I'M GOING TO TALK ABOUT
A -- INTRODUCE A FEW DIFFERENT
TERMS THAT YOU ARE PROBABLY
INITIALLY FAMILIAR WITH.
I'M THINKING I'M FOCUSING ON
SORT OF HOUSEHOLD FAMILY ASPECTS
EVER CULTURE.
OF CULTURE.
THESE ARE FOOD CLASSIFICATION
SYSTEMS, SYMBOLIC MEANING OF
FOOD AND INTERTRA HOUSEHOLD
SHARES.
FOODWAYS ARE THE RULES WE SHARE
WITHIN A GROUP THAT GUIDE FOOD
PREPARATION AND INTAKE.
THE RULES FOR WHAT FOODS SHOULD
GO TOGETHER AND EXPWIEND HOW
THEY SHOULD BE SEGREGATED AND
WHICH FOODS SHOULD BE KEPT APART
OR EVEN THE SEQUENCING AND
ORDERING EVER FOODS.
FOODWAYS CONSIDER WHAT WE
CONSIDER A MEAL AND WHAT IS NOT
A MEAL.
WHAT DIFFERENTIATES IN OUR
CULTURE FOR EXAMPLE BETWEEN A
MEAL AND A SNACK.
IN A SYSTEM THAT I GLEUP IN THE
USA, I GREW UP IN A THREE-PART
SYSTEM.
A MEAL WAS A MEAT, STARCH AND A
VEGETABLE.
THERE ARE PLENTY OF OTHER TYPES
EVER MEALS.
IN THE PACIFIC ITEMS YOU CAN SEE
TO THE RIGHT, THIS MEAL IS
COMPRISED OF A STAIP AND IS A
CAN COMPLEMENT.
THE DESCRSH ST -- THE STAIP STN
COMPLEMENT.
WHAT IS CONSIDERED FOOD?
WHAT THINGS ARE CONSIDERED FOODS
AND NOT CONSIDERED FOODS.
IN MY CULTURE SETTING, INSECTS
ARE RARELY CONSIDERED FOODS
ALTHOUGH THEY ARE EDIBLE, THEY
ARE NOT CONSIDERED SOMETHING WE
WOULD EAT.
THERE ARE CUISINE RULES HOW IT
SHOULD BE COOKED AND FLAVORED, 9
THE PREPARATION OR PROCEDURES
FOR PREPARING FOODS AND MEAL
FORMATS, THE RULES FOR SELECTION
EVER SIDE DISHES, ORDER OF
SERVING, PLACEMENT OF FOODS IN
FRONT EVER YOU, MEAL CYCLE HOW
FOODS MAY OR MAY NOT DIFFER
WITHIN A DAY, WEEKENDS VERSUS
THE REST OF THE FIVE DAYS OF THE
WEEK.
SEASONALITY ANNUALLY AND SO
FORTH.
IT INCLUDES HOW FOODS ARE SHARED
BETWEEN HOUSEHOLDS AND HOW THEY
MIGHT BE ALLOCATED WITHIN
HOUSEHOLDS.
I WANLTD TO WANT TO STEP DEEPED
CLASSIFICATION SYSTEM.
THEY ARE USED AROUND P AROUND
THE WORLD KMED I WANT THOUGH
NOTE THAT ALL CULTURES HAVE
MULTIPLE OVERLAPPING SYSTEMS OF
FOOD CLASSIFICATION.
SOME SYSTEMS ARE MORE USED THAN
OTHERS WITHIN A PARTICULAR
CULTURE.
THESE CAN RESPECT CORE CULTURAL
VALUES.
ONE VALUE MIGHT HAVE THE NOTION
OF BALANCE.
THIS IS OFTEN REFLECTED IN THE
FOODS THAT PEOPLE CHOOSE TO EAT
AND HOW THOUGH THINK ABOUT
FOODS.
SYSTEMS LIKE IS THIS FOR FOOD
CLASSIFICATION OFTEN HAVE A
SETAL IS RULES FOR ASSIGNING A
FOOD TO A PARTICULAR CATEGORY.
THEY CAN GUIDE DECISIONS ON WHAT
TO EAT AND WHAT NOT TO EAT.
IF YOU WORK IN DIFFERENT SEGHTS
AROUND THE WORLD, EWELL' FIND
COMMON FOOD CLASSIFICATION
SYSTEMS AND IT VARIES FROM
SETTING TO SETTING.
THE FOODS THAT YOU WOULD EAT FOR
A FEAST OR SPECIAL OCCASION
VERSUS THE STAPLE FOODS AND
TYPICALLY STAPLE FOODS ARE
CONSUMED BY EVERYONE EQUALLY,
BUT SPECIALTY FOODS MAY BE MORE
PRESENTATIONLY ALLOCATED TO
CERTAIN HIGHER STATUS PEOPLE
THAN OTHERS DEPENDING ON THE
CULTURAL GROUP WE'RE WORKING
WITH.
VALENCE REFERS TO THE HOT AND
CAN COLD FOOD SYSTEM.
THIS IS IN LATIN AMERICA, SOUTH
ASIA, EAST ASIA CONSIDERING SOME
FOODS HAVING INHERENT QUALITIES
OF HOTNESS OR COLDNESS FOR THE
HEATING PROPERTIES AND COOLING
PROPERTIES OF THOSE FOODS.
OTHER SYSTEMS INCLUDE THINGS
THAT ARE HEALTHY AND UNHEALTHY.
WE TYPICALLY DO THAT IN THE USA.
WE TALK ABOUT FOODS AS BEING
HEALTHY OTHER FOODS AS BEING
JUNK FOODS NOT HEALTHY, THAT
SORT OF THING.
DIGEST BILITYD, SOME FOODS HEAVY
VERSUS OTHER FOODS BEING LIGHT.
THAT'S ANOTHER COMMON FOOD
CLASSIFICATION SYSTEM IS OUR
FOODAL IS FOOD IS PURE AND THEID
IMPURE.
A DISTINCTION BETWEEN WHAT WE
EAT AND WHAT THEY EAT.
THESE ARE THE MOST COMMON
CLASSIFICATION SYSTEMS FOR FOOD.
WE HAVE OTHER ONES THAT WE USE
THAT WE LEARN AS PART OF OUR
HEALTH EDUCATION COURSES AND
THAT SORT OF THING.
WE TALK ABOUT THE THREE FOOD
GROUPS OR THE FIVE FOOD GROUPS
OR USING PER MEEDZ OR SOMETHING
LIKE THAT.
-- PYRAMIDS.
IN OTHER LOW INCOME SETTINGS,
THESE SYSTEMS YOU SEE BEFORE YOU
ARE COMMONLY USED TO THIS DAY.
WHAT ABOUT FOOD PROSCRIPTIONS
AND PREVIPTIONS? PREDESCRIPTION?
THIS INCLUDES THE RULES ON WHAT
TO EAT OR NOT TO EAT.
THESE AND WHEN TO EAT THOSE
FOODS OR WHEN NOT TO EAT THOSE
NOODZ.
FOODS.
THESE ARE NORMS OR IDEALIZED
BEHAVIORS COMMONLY USED FOR
PEOPLE IN VULNERABLE STATES, SO
PREGNANT OR POSTPARTUM.
THERE IS A SLIDE FROM KOREA
WHERE THEY HAVE POSTPARTUM
HOSPITALS WHERE WOMEN STAY IN
AFTER THEY DELIVER AND ARE
TREATED SPECIALLY WITH SPECIAL
FOODS.
DURING LACTATION AND
MENSTRUATION IF ONE IS AN INFANT
OR SICK OR ELDERLY, THESE ARE
ALL TIMES WHEN FOODS MAY BE
PROSCRIBED OR PRESCRIBED DURING
THOSE TIMES.
ANOTHER THING TO CONSIDER ABOUT
FOOD IS THE SIGNIFICANCE OR THE
MEANING OF FOOD OR IN SOME WAY
WHAT IS WE CALL THE SYMBOLISM OF
FOOD.
FOOD CAN HAVE OTHER PURPOSES
THAN JUST BEING SOMETHING THAT
YOU CONSUME.
IT CAN SERVE TO REINFORCE THE
STATUS OR AUTHORITY
RELATIONSHIPS BETWEEN
INDIVIDUALS.
IT CAN SHOW A MEANS EVER OF
DEMONSTRATING PROPER BEHAVIOR.
THEY CAN BE ETHNIC.
THOSE FOODS ARE HEALTHY OR
UNHEALTHY.
IN THIS PICTURE, YOU COULD SAY
THIS IS A COMMON ONE WE USE IN
THE U.S. WHERE THE FOODS YOU
CHOOSE TO EAT OR FOODS THAT YOU
CHOOSE NOT TO EAT ARE AN
EXPRESSION EVER YOUR OWN
PERSONAL CONTROL.
THAT SEEMS TOOB TO BE AN IMPORT
THING IN OUR SOCIETY.
ANOTHER WAY TO LOOK AT IT IS
FOOD CAN BE HEALTH-ENHANCING
USINGED TO ACHIEVE BALANCE.
FROM THE PREVIOUS EXAMPLE OF
CLASSIFICATION OF OT H HOT AND
COLD, THAT'S AN IMPORTANT
DISTINCTION.
FOOD CAN BE CONSIDERED AN ETHNIC
MARKER AS A WAY OF DEFINING US
FROM A PERSONAL, SOCIAL OR
POLITICAL PERSPECTIVE AND TIED
IN WITH CORPS CULTURAL VALUES
LIKE TRADITIONALISM.
WE VALUE THE TRADITIONAL WAY OF
LIVING THEREFORE WE VALUE THE
FOODS WE CONSUMED AS PART OF OUR
GROUP.
I WOULD LIKE TO TURN ATTENTION
NOW TO THE IDEA OF FOOD
ALLOCATION.
WHEN I SAY FOOD ALLOCATION WHAT
I'M TALKING ABOUT IS PREFERENCE
FOOD ALLOCATION OR FAVORITISM.
THIS ALSO COMMONLY FOLLOWS
CULTURAL RULES, FOODS THAT ARE
PROSCRIBED IS TO FOODS YOU
SHOULD EAT OR NOT EAT.
AND ORPHAN HIERARCHY OR
DIFFERENCES IN 1259 US BETWEEN
INDIVIDUALS WITHIN A GROUP.
I'M REFERRING TO INFORMAL
ALLOCATION VERSE YOURS FORMAL.
--
VERSUS FORMAL.
I WANT TO GIVE AN EXAMPLE OF A
MEAL I NOABD NE OBSERVED IN NEP.
IN THIS HOUSE WHICH WAS EYE A UR
CLASS HOUSEHOLD, A WOMAN WAS
MAKING A TYPE OF BREAD.
THE SMILE CHILD WAS SERVED FIRST
OF RICE.
NEXT THESE TWO PEOPLE NOT
MEMBERS OF THE HOUSE WERE SERVE
A VARIETY OF DIFFERENT FOODS,
RICE, DAAL, ROTI AND YOGURT.
AND THEY GOT OFFERED SECOND
HELPINGS.
AND THEN THE MALE HEAD OF HOUSE
EIGHT.
ATE SO PEOPLE WERE EATING IN A
SEQUENCE OR ORDER.
THEN A DAUGHTER-IN-LAW LAW ATE
ROTI THEN THE SON WAS SERVED BY
HIS MOTHER.
THE LAST THING I WANT TO EXPLORE
IS WHO WERE THESE PEOPLE?
MAYBE YOUR GUESS IS THESE WERE
HONORED GUESTS BUT ACTUALLY THEY
ARE OR WERE OF A LOWER CAST.
THEY ARE ARTISANS, AND THEY WERE
DOING SOME OF THE SEWING FOR
THEIR FAMILY.
THEY WERE ACTUALLY OF A LOWER
CASTE AND NOT ALLOWED TO COME
INTO THE HOUSE.
THEY HAD TO EAT OUT OF SPECIAL
BOWLS AND PLATES USED TO SERVE
LOWER CASTE PEOPLE.
HERE IS AN EXAMPLE OF FOOD AND
HOW IT IS SERVED OBSERVES SOCIAL
RELATIONSHIPS AND HIKER ARKEE HY
WITHIN THE SKULL TOUR.
IT'S MORE THAN WHAT THEY EAT.
IT'S HOW IT IS SERVED AND
DISTRIBUTED.
ALL VERY IMPORTANT.
WHAT IS OUR TECHNIQUES?
WHAT IS OUR STRATEGYS WE MIGHT
USE TO EXPLORE AND COME TO
UNDERSTAND CULTURE?
A LARGE PART OF THE WORK THAT WE
DO IS BASED ON OBSERVATION
PARTICULARLY CALLED PARTICIPANT
OBSERVATION.
WE DO A LOT OF INTERVIEWING IN
TERMS OF OUR WORK TO UNDERSTAND
OR E PLOR CULTURE.
WEES SOMETIMES USE GROUP METHODS
AND I'LL HAVE TO SAY LIKE FOCUS
GROUPS -- MANY OF THESE METHODS
ARE EQUAL 25EU QUALITATIVE AND R
WRITING BOOK REPORTS FOR
RESEARCH.
I WILL SAY NOW DAYS THERE ARE
TOOLS CALLED FES OR RAMMED
ASSESSMENT PROCEDURES TO EXPLORE
VITAMIN A AND HEALTH AND ARE
COOKBOOKS THAT CAN BE USED TO
EXPLORE THESE TOPICS IN A IS
SEMI-STRUCTURED WAY FOR GUIDANCE
FOR INTERVENTION.
I'VE MENTIONED BEFORE THIS
NOTION OF CORE CULTURAL VALUES.
WE WANT TO LEARN ABOUT FROM ANY
CULTURE WE WORK WITH.
THESE ARE THE KEY PRINCIPLES AND
IDEALS THAT GUIDE THE BEHAVIOR,
NORMS AND DECISION MAKING OF A
PARTICULAR GROUP OR SOCIETY.
THIS IS AN NON-EXHAUSTIVE LIST
BUT THINGS LIKE VILDISM.
THAT IS STRONG WITHIN THE UNITED
STATES.
HARMONY, FREEDOM, ANOTHER ONE
STRONG IN THE UNITED STATES.
REBE EXPECT FOR ELDERS, FAMILY,
RESILIENCE ARE ALL PART OF CORE
CULTURAL VALUES.
IF YOU THINK IN TERMS OF CORE
CULTURAL VALUES, THESE ARE
THEMES THAT RESONATE WITH
PEOPLE, WHAT DOES IT MEAN TO
BRING CULTURE INTO INTERVENTION
PROGRAMS?
AND WHAT IT MEANS IS IF YOU'RE
DOING A GOOD JOB OF BRINGING
CULTURAL INTO INTERVENTION
PROGRAMS, YOU'RE PROBABLY USING
THE PREFERRED COMMUNICATIONS
METHODS.
YOU'RE ALMOST ALWAYS USING THE
LOCAL LANGUAGE AND TERMINOLOGY
USED BY THE COMMUNITIES THAT
YOU'RE WE WORKING WITH ASK USING
APPROPRIATE ROLE MODELS TO
CONVEY INFORMATION.
REINFORCING THINGS THAT PEOPLE
ARE ALREADY DOING.
YOU WORKING WITH AND DO NOT GO
AGAINST THE CORE CULTURAL VALUES
IN A PARTICULAR SETTING AND TRY
TO WORK WITHIN OR IN PARTNERSHIP
OR COLLABORATION OR AT LEAST
ACKNOWLEDGING LOCAL CULTURAL
SYSTEMS, KNOWLEDGE, PERCEPTIONSS
AND ATTITUDES AND TYPICALLY WE
WORK WITH AND LINK TO LOCAL
INSTITUTIONS WHEN WE DO THIS TO
SCHOOLS, CHURCHES, TO COMMUNITY
CENTERS, TO RECREATION CENTERS.
INTERVENTIONS THAT ARE
CULTURALLY LINKED MAKES SENSE TO
PEOPLE.
THEY RESONATE TO PEOPLE.
THEY'RE MEMORABLE AND SERVE TO
BUILD ENGAGEMENT AND LONG-TERM
USE.
JUST AS A QUICK EXAMPLE AS I
CLOSE, HERE ARE SOME EXAMPLES OF
DIFFERENT MESSAGING THAT WOULD
REFLECT CORE CULTURAL VALUES.
IN A SETTING WHERE INDIVIDUALISM
IS A CORE CULTURAL VALUE, THE
MESSAGE WOULD REFERENCE YOU --
DIRECTED TO YOU.
EAT SUCH AND SUCH HEALTHY FOOD
TO LIVE A LONG AND HEALTHY LIFE.
THAT'S YOU.
IT'S YOUR RESPONSIBILITY.
YOU AS AN INDIVIDUAL.
ON THE OTHER HAND, IN A SETTING
WHERE FAMILY A CORE CULTURAL VAL
WHY YOU, A DIFFERENT MESSAGE MAY
BE IMPORTANT TO BE THERE FOR
YOUR FAMILY AND BE SUPPORTIVE OF
YOUR FAMILY AND DO WHAT IS RIGHT
FOR YOUR FAMILY.
I HOPE EUP' ENJOYED THIS BRIEF
DESTRUCTION TO SOME OF THE CORE
CONCEPTS AND TERMINOLOGY
ASSOCIATED WITH CULTURE.
PLEASE FEEL FREE TO CONTACT ME
MY e-MAIL IS LISTED IN THIS
SLIDE.
THANK YOU VERY MUCH.
THANKS SO MUCH FOR THE
PRESENTATION.
AND I'M GLAD HE WAS ABLE TO
RECORD SOMETHING FOR US AND
PROVIDE US WITH AN OVERVIEW OF
KU8 TOUR AND FOODWAYS.
I'M HAPPY -- CULTURE AND FOOD
WAIST.
I'M HAPPY TO INTRODUCE DR.
MATTEI AT THE HAZA HARVARD SCHOF
PUBLIC HEALTH.
SHE LAS GUIDED EVIDENCE-BASED
POLICY AND PROGRAMS FOR BETTER
ACCESS TO HEALTHY FOOD AND
CARDIOMETABOLIC HEALTH TO ALIGN
WITH VALUES AND ENVIRONMENTAL
STABILITY.
I WILL TURN THIS OVER TO DR.
MATTEI.
>> WELCOME EVERYBODY.
AND I THINK THIS IS A PERFECT
WAY OF DR. GITTALSOHN'S
PRESENTATION.
SO NEXT SLIDE, PLEASE.
SO, DIETARY INTERVENTION DID NOT
NECESSARILY TRANSLATE TO HEALTH
BENEFITS.
WE HAVE TO TEST WHATEVER WE HAVE
THAT IS EVIDENCE THAT WE HAVE
AND WOULD BE THE DIETARY
GUIDELINES AND HOW TO ADAPT THAT
AND HOW WE AS PROVIDERS,
CONSUMERS AND EVERYBODY CAN
ADOPT AND SUSTAIN THOSE
EVIDENCE-BASED GUIDELINES TO
OBTAIN THE MOST HEALTH BENEFITS
OUT OF THAT.
THAT'S FOR THE WHOLE SOCIETY.
AND WHOLE SOCIETY MEANS
EVERYBODY.
NEXT SLIDE, PLEASE.
SO AS I MENTIONED IN NUTRITION,
THE EVIDENCE IS MOSTLY COMPILING
THE DIETARY GUIDELINES FOR
AMERICANS.
WHAT IS SIFTING THROUGH THE
EVIDENCE AND WE'RE GOING THROUGH
ANOTHER ROUND OF EVIDENCE THAT
HAS BEEN GENERATED TO PUT FORTH
THE RECOMMENDATIONS FOR HEALTHY
EATING.
THE EVIDENCE STATES THAT EATING
HEALTHY PREVENTS CHRONIC
DISEASE.
BUT WE SEE MANY PEOPLE WITH
CHRONIC DISEASE.
6 TO 10 OF ADULTS HAVE MORE THAN
ONE CHRONIC DISEASE.
VUL TERRIBLE POPULATION HAVE
MORE CONDITIONS.
WHAT WILL WE HAVE TO REMEMBER IS
THAT THERE IS A BIG GAP BETWEEN
HEFFICACIOUS EVIDENCE AND THE
EFFECTIVE SOLUTIONS.
BECAUSE REAL LIFE HAPPENS IN
BETWEEN THOSE TWO THINGS.
SO, NEXT SLIDE, PLEASE.
WHAT WE THEN HAVE IS TO BE
THINKING IS HOW DO WE LI LEAP FM
THIS TO EFFECTIVENESS.
IN EFFICACY, WE TEST WHETHER
IT'S IN THIS PARTICULAR GROUP
AND EFFECTIVENESS, WE'RE TESTING
WHETHER IT'S WORKING FOR A
DIVERSE GROUP OF PEOPLE, FOR
EVERYBODY.
AND WE HAVE TO ADDRESS THESE
REAL LIFE CHALLENGES.
WE SAW THIS FIGURE WITH THE
FRAMEWORK FOR HEALTH DISPARITIES
RESEARCH.
IT SHOWS LEVELS OF INFLUENCE
THONHEALTH OUTCOMES.
YOU CAN MAKE AN ARGUMENT THAT
CULTURE COVERS EVERY SINGLE ONE
OF THOSE PROCESSES.
LEVELS EVER INFLUENZAS AND
DOMAINS OF INFLUENZAS.
EVERY ONE OF THOSE BOXES WILL
HAVE AN ASPECT EVER CULTURE IN
THERE.
ASPECT OF CULTURE IN THERE.
KOHL NSZ WENT THROUGH THISCOLLIS
NICELY.
HOWAL IS CULTURE INFLUENCING
THIS?
BUT I ENCOURAGE YOU TO VISIT US
AND SEE THE REST OF THE VISION
FOR TOMORROW.
FOR EXAMPLE, HOW M METABOLISM AD
HOW CULTURE INFLUENCE THAT.
HOW EVERY ONE OF THE BOXES IS
SHAPED BY CULTURE.
NEXT SLIDE.
IN ANOTHER ASPECT THAT I THINK
IS REALLY IMPORTANT TO KEEP IN
MIND AS WE'RE THINKING OF
CULTURE IS THAT CULTURE IS AN
ICEBERG.
THIS IS AN EXACTLY WHAT
GITTALSON WAS ADDRESSING IS THAT
USUALLY WITH WITH THE THEME OF
CULTURE, THERE IS WAYER IN THAN
THAT.
THAT IS MANY OF THE ASPECTS AND
DERCHTIDEFINITIONS ADDRESSED.
DIETARY CULTURE, A CULTURE OF
DIDIE OAT, YOU CAN THINK OF THAT
AS THE THINGS YOU CAN SEE IN
FOOD AT A SURFACE LEVEL AND
THINGS YOU CAN'T SEE LIKE THE
HIERARCHIES, THE PREPARATIONS,
THE ATTITUDES AND VALUES THAT
PEOPLE PUT TOWARD FOOD, ALL OF
THOSE THINGS THAT ARE DEEP DOWN
ARE THE DEEP CULTURAL ASPECTS OF
FOOD THAT WE RARELY TAKE INTO
CONSIDERATION.
AND THAT HAS BEEN ONE OF THE
BIGGEST GAPS IN THE
EFFECTIVENESS.
OF REAL LIFE
ADAPTATIONS FOR DIETARY
INTERVENTIONS.
SO I WANT TO TODAY IS SHOW YOU
HOW WE CAN ADOPT DIETARY
INTERVENTIONS TAKING THE FABRIC
OF CULTURE ACROSS DIFFERENT
LEVELS USING THE SAMPLE OF THE
MEDITERRANEAN DIE OAT.
DIET.
THIS HAS STRONG EVIDENCE FOR
HEALTH.
IT'S BEEN SHOWN IN BOTH CLINICAL
TRIALS AS WELL AS OBSERVATIONAL
STUDIES THAT IT CAN REDUCE THE
RISK OF CARDIOVASCULAR DISEASE
AND ME BIOTIC SYNDROME,
MORTALITYOVER ALL BUT IT HAS
VERY LIMITED EVIDENCE COMING
FROM GROUPS EVER DIVERSE ORIGIN.
AND THE PROBLEM IS THAT WHEN THE
EVIDENCE IS USUALLY GENERATED
FROM WHITE OR EUROPEAN
POPULATIONS AND THAT IS THE CASE
FOR THE MEDITERRANEAN DIE OAT,
IT MAY -- DIE O DIET, IT MAY NOT
EXTRAPOLATE TO OTHER SOARTS.
DIFFERENT CULTURES MIGHT EAT THE
SAME FOOD BUT IN DIFFERENT WAYS.
FOOD GROUPS DIFFERENTLY.
AND THE MEDITERRANEAN DIET, THE
WAY WE CURRENTLY MEASURE IS WITH
FOOD GROUPS.
HERE YOU CAN SEE THE WAY WE
TRADITIONALLY DEFINE WHAT THE
MEDITERRANEAN DIE OAT SHOULD BE
PRESCRIBED AS.
EAT MORE VEGETABLES, MORE FRUIT
AND VEGETABLES AND SO FORTH.
WHAT IS A LEGUME?
HERE ARE SOME EXAMPLES.
THE TRIAL THAT STARTED THIS
EVIDENCE, THE TOP LEGUME WERE
LENTILS AND CHICK PASTE.
IF YOU'RE TRYING TO TRANSLATE
THAT INTO OTHER POPULATIONS, YOU
MIGHT ADVOCATE FOR THAT, BUT
THOSE MIGHT NOT BE THE MAIN LE
JEUMS.
LEGUMES.
YOU HAVE A SOUTHERN FOOD MADE
WITH BLACK EYED PEAS OR YOU HAVE
A TYPICAL RED BEANS FROM PUERTO
RICO OR YOU HAVE HERE A BROWNISH
OR BLACK BEAN FROM COSTA RICA.
HERE ON THE RIGHT BOTTOM, YOU
HAVE AN RICE WITH
[INDISCERNIBLE] HAS MORE
RELATION TO ATTITUDES TO OUR
HEALTH PROMOTION AND DISEASE
PREVENTION.
ALL OF THEM HAVE DIFFERENT AT
TIFS WITH PRESENTATIONS AND
DIFFERENT TYPES EVER BEANS THAT
ARE USED.
WHAT EXACTLY IS A MEDITERRANEAN
DIET IS DIFFERENT IN ALL OF
THESE DIFFERENT SEGHTSES.
THAT IS A LIMITATION BUT AN
OPPORTUNITY.
IT'S A LIMITATION BECAUSE YOU
CAN'T EXTRAPOLATE AND YOU NEED
THE RIGHT DIETARY ASSESSMENT
TOOL TO CAPTURE THE RIGHT FOOD
ASK RIGHT FOOD PREPARATIONS BUT
IT'S A GREAT OPPORTUNITY TBHAWS
OPENNESS PROVIDES THE ADOPTION
OF WHAT THE DIET COULD BE LIKE.
THE DIETARY GUIDELINE SAYS WE
SHOULD BE EATING MORE OF THE
MEDITERRANEAN DIE OAT AND THEY
SAY WE SHOULD CUSTOMIZE AND
ENJOY FOODS THAT ARE REFLECT OUR
PERSONAL PREFERENCE AND OUR
CULTURAL TRADITIONS AND OUR
BUDGE INDUSTRY TRADITIONS.
THEY GIVE US THAT MANDATE AND
THAT DIRECTION AND THEY GIVE US
THE ADDRESS AND FINAL
DESTINATION BUT DON'T GIVE US
THE ROAD MAP SO WE DON'T KNOW
HOW TOW DO THAT.
DRUSH HOW TO DO
IS THAT.
WE FIND THESE CHALLENGES IN REAL
LIFE ADAPTATION.
THIS IS A GOOD EXAMPLE OF A
MEDITERRANEAN DIE OAT ADAPTATION
THAT WAS TRIED IN A
NON-MEDITERRANEAN COUNTRY, IN
THIS CASE THE U.K.
IT WAS FOUND SOME AK SEPTEMBER E
AND HAD THE DIFFICULTY OF
FINDING THOSE FOODS AND COSTS
AND PRESSURE -- TIME PRESSURES
THAT ALL UNDERMINE THAT
ADHERENCE.
WITHOUT ADHERENCE, YOU CAN'T
HAVE AN EFFECTIVE INTERVENTION.
SORRY, I MISSED THE NEXT WOULD
SLIDES.
NEXT SLIDE.
SO KR, WITH THAT, WE DECIDED TOO
AN INTERSTLEANGS ADDRESSED ALL
OF THAT.
I'LL ALE HIGHLIGHT A COUPLE OF
POINTS SO YOU CAN SEE HOW YOU
CAN INTEGRATE THE SAME
ADAPTATIONS.
IN THE REST OF THE PANELS TODAY
AND TOMORROW, YOU'LL SEE SEVERAL
EXAMPLES OF THESE.
WE HAVE A STUDY RIGHT NOW GOING
ON FOR CULTURAL-INFORMED
INTERVENTION.
WE'RE GIVING OLIVE OIL OR
VEGETABLE OILS, BEANS AND
PEANUTS AND FRESH PRODUCE FOR
ABOUT A MONTH.
THE CONTROL IS JUST GETTING A
VOUCHER TO PURCHASE THEIR OWN
FOODS FOR THE SAME VALUE OF
THAT.
THIS IS AN 18-MONTH INTERVENTION
AND DIVIDING IS IT INTO SIX
MONTH PARTS.
THE FIRST SIX MONTHS GETTING THE
ACCESS PART AND ENABLING ACCESS
OF GETTING THE FOOD.
THE NEXT SIX MONTHS ADDING AND
STACKING ON KNOWLEDGE COMPONENT
AND THE NEXT SIX MONTHS
PRACTICING THE BOO HAIFIER SO
THEY WILL BE RECEIVING TEXT
MESSAGES THAT WILL CONTINUE THE
BEHAVIOR THAT THEY LEARNED IN
THE PREVIOUS SIX MONTHS AND A
MAINTENANCE BEHAVIOR WHERE THEY
ARE GOING TO KEEP UP WITH THE
BEHAVIOR WITH JUST SMALL PROMPTS
BUT WITH THE PREVIOUS
INTERVENTION.
HOW DO WE INTEGRATE SEVERAL
STRATEGIES?
FIRST, WE MADE IT PRAGMATIC AND
YOU CAN DO THE SAME THING TOO IF
YOU'RE CREATING AN INTERVENTION.
MAKE IT REAL LIFE.
HAVE CLINICAL BEHAVIORAL AND
SOCIAL METRICS THAT YOU CAN SUES
AND HAVE PRACTICAL THINGS THAT
PEOPLE CAN USE.
SOCIAL AND BEHAVIORAL METRICS
CAN THIS HELP WITH SOCIAL
SUPPORT?
CAN IT HELP FOOD INSECURITY AND
HELP PEOPLE TO CHANGE TO A
MAINTENANCE BEHAVIOR.
THESE ARE IMPORTANT AND IT'S
GOOD TO ADD THESE INTO YOUR
METRICS.
THE OTHER THING WE NEED WAS TO
START WITH SOLID EVIDENCE.
BEFORE WE DID THIS, WE SPENT
SEVERAL YEARS LOOKING WHAT A
MEDITERRANEAN DIET LOOKED LIKE
IN PUERTO RICO AND THEY WERE
DIFFERENT THAN A MEDITERRANEAN
DIET IN OTHER COUNTRIES.
WE IDENTIFIED THE OIL AND LEDGE
ILEJELEGUMES AND FRUITS AND VEGE
VEGETABLES.
WE STUDIED THE CARDIOMETABOLIC
OUTCOMES WE OBSERVED.
SOMETHING THAT IS COMMON ACROSS
ALL THE ADAPTATIONS IS THAT I
READ AND DISPIEND HAD MOST OF MY
COLLEAGUES HAVE DESIGNED IS
FORMATIVE RESEARCH.
YOU'LL SEE THIS CLEARLY IN
PANELS TODAY.
FORMATIVE RESEARCH INFORMS
CULTURAL FOODWAYS AND THE
CHANGES YOU NEED TO MAKE IN YOUR
ADAPTATION.
WE NEED SURVEYS AND INTEREXPREUS
FOCUS GROUPS.
THOSE HELP -- INTERVIEWS AND
FOCUS GROUPS.
HOW TO COOK THESE EXPWEENS WHERE
THEY WERE PURCHASED OR HOW TO
SERVE THEM, HOW OFTEN O SERVE
THEM.
WHAT THEY VALUE ABOUT THEM.
AND THAT TOOK SOME TIME BUT
TAILORED THE MESSAGES WE WERE
GIVING.
WE ALSO USED FORMATIVE RESEARCH
FOR THE STRATEGIES.
SHORT TERM GOALS, PERSONAL
GOALS, PEOPLE DIDN'T WANT TO --
AND HEALTH-RELATED GOALS.
THEY WANTED TO FOCUS ON OVERALL
HEALTH.
WE MADE SURE THAT 5U ALL OF THEE
RELATED TO THE CULTURE AND WE
PUT INTO OUR MESSAGES.
CULTURAL ADOPTED PROGRAMS ON AND
INTERVENTIONS SHOULD ADDRESS
STRUCTURAL BARRIERS.
THAT IS SOMETHING WE HAVE WITH
STAPLE FOODS LESS EXPENSIVE.
THE OILS AND BEANS ARE LESS
EXPENSIVE THAN THE OIL AND LE
JEUMS GIVEN IN THE TRADITION --
LEGUMES GIVEN IN THE TRADITIONAL
MEDITERRANEAN DIET.
ALL OF THE BOXES OF PRODUCE THAT
WE ARE GIVING COME FROM LOCAL,
SMALL FARMERS IN PUERTO RICO.
SO WE ARE HELPING THE CULTURE,
THE COMMUNITY AND FARMERS IN
PUERTO RICO AND BRINGING IN
FAMILIAR FOODS TO THE COMMUNITY.
NEXT.
SO LASTLY, THIS IS AN EXAMPLE OF
HOW WE TAILOR THE INTERVENTION
WITH THESE CULTURAL MESSAGES.
THIS IS AN EXAMPLE OF A TEXT
MESSAGE IN THE INTERVENTION.
HERE WE ADDRESS THE TRADITIONAL
CONCEPT, APPEALING TO TRADITION
AND CULTURAL PART OF EATING
BEANS BECAUSE THEY ARE PART OF
YOUR CULTURE.
THE COOKING PART, HOW TO COOK IT
AND HOW TO DO SUBSTITUTIONS AND
WITH WHAT.
AND ALSO THE RECIPE.
THESE RECIPES THAT WE'RE
PROVIDING WERE ALL TESTED.
THEY'RE GRANDMA APPROVED AS WE
CALL THEM.
AND FINALLY SOMETHING THAT IS
REALLY IMPORTANT AND THAT I
ALWAYS MENTION IS THAT ALL OF
THESE ADAPTATIONS HAVE SOB
GUIDED BY A FRAMEWORK.
WE USE THE FRAMEWORK TO GUIDE
WHEN OR WHO OR WHAT OR WHERE OFL
MOST IMPORTANTLY WHY REASONS WHY
WE'RE DOING THESE ADAPTATIONS.
I USE THIS ONE IN PARTICULAR,
WILL ARE MANY FRAMEWORKS OUT
THERE.
I HAVE TO MENTION THE HEALTH
EQUITY FRAMEWORK WHICH IS VERY
HELPFUL AND THE SCOL
CONSOLIDATED FRAMEWORK FOR
RESEARCH AND ROLE MODEL FROM THE
AMERICAN HEART ASSOCIATION,
THEY'RE GOOD WAYS FOR YOU TO
CONCEPTUALIZE WHAT YOU NEED TO
DO AS YOU ADOPT AN INTERVENTION.
LASTLY, I HAVE TO MENTION THAT
EAR DIETARY PATTERNS.
I USE THE MEDITERRANEAN DIET
BECAUSE IT'S POPULAR AND
EVERYONE KNOWS IT.
BUT WE HAVE TO REMEMBER THAT ALL
OF THESE -- CULTURE IS A LAYER
AND WE HAVE MULTIPLE DIFFERENT
CULTURES NOT JUST BY COUNTRY BUT
DIFFERENT ASPECTS.
THERE ARE MANY PATTERNS
CULTURALLY DIVERSE.
IF YOU LOOK GLOBALLY, WE HAVE SO
MANY GUIDELINES THAT WE HAVE TO
FIGURE OUT HOW DO WE ADAPT ALL
OF THESE MESSAGES THAT SPEAK TO
A PARTICULAR GROUP INTO THEIR
DIFFERENT POPULATIONS.
WITH THAT, I'M GOING TO CLOSE
WITH A COUPLE OF RESEARCH GAPS
AND OPPORTUNITIES.
GAPS THAT WE HAVE TO KEEP IN
MIND IS THAT WE STILL HAVE
LIMITATION NOTICE EVIDENCE FROM
DIVERSE POPULATIONS.
BUT WITH THAT, IT OPENS AN
OPPORTUNITY THAT WE HAVE GOOD
COHORTS OUT THERE THAT YOU CAN
FIND OUT THE TRADITIONAL FOODS
THAT MAY BE PREVENTING CHRONIC
DISEASES IN POPULATIONS OF
DIVERSE CHARACTERISTICS.
THERE IS NO CONSENSUS WITH
HEALTH BUT WE HAVE DERCHTIONS.
THE OTHER THING THAT I WANT TO
SEE WITH GAPS AND OPPORTUNITIES,
THIS IS A WARNING, WHEN WE TALK
ABOUT CULTURE, WE MIGHT BE
TALKING ABOUT SOME STEREOTYPES
OR BIASES OR JUDGMENTS.
THAT'S NOT THE PURPOSE OF
INCORPORATING CULTURE INTO OUR
EVIDENCE BASE, BUT RATHER IT'S
BEEN VALIDATING AND VALUING
CULTURE IN OUR NUTRITION
SCIENCE.
THANK YOU VERY MUCH AND ENJOY
THE REST OF THE PANEL.
>> THANK YOU SO MUCH.
THAT HELPS SET THE STAGE FOR THE
REST EVER OF OUR PANELS TODAY.
I'LL TURN IT OVER TO MODERATING
FOR PANEL ONE.
>> THANK YOU.
GOOD AFTERNOON.
I WANT TO SAY WE'RE RUNNING A
LITTLE BEHIND SO WE'RE GOING TO
SKIP THE BREAK AND GO STRAIGHT
INTO THE PANEL.
I'M KIBBE BROWN THE ULT
CONSULTANT FOR INDIAN EXPWHEALT
PREVENTION.
IT'S BEEN A PLEASURE TO SERVE ON
THIS CAN COMMITTEE.
I WANTED TO SAY A COUPLE OF
THINGS ABOUT MYSELF.
I AM A MEMBER OF THE TRIBE IN
SOUTH DAKOTA.
IT'S BEEN INTERESTING TO WATCH
THE FOOD SOVEREIGNTY MOVEMENT.
ALL THE ACTIVITY HAPPENING
ACROSS INDIA COUNTRY.
OUR PANELISTS WILL TOUCH ON SOME
EXAMPLES.
IF YOU CAN TELL ON THE SLIDE
THAT WE HAVE A GREAT LINE-UP OF
SPEAKERS FOR THIS PANEL WHICH
HIGHLIGHTS THE SOCIOCULTURAL CAN
FACTORS HIGHLIGHTING FOOD
SOVEREIGNTY IN NATIVE MERCH
COMMUNITIES.
WE'LL BEGIN WITH THE
PRESENTATION BY ENTITLED FOOD
SOVEREIGNTY AND FOOD WITHIN
INDIGENOUS COMMUNITIES.
DURING THE Q&A DISCUSSION,
PLEASE SEND YOUR QUESTIONS USING
THE LIVE FEEDBACK.
PLEASE STATE WHICH PANELIST
YOU'RE DIRECTING YOUR QUESTION
TO.
LET ME INTRODUCE OUR FIRST
SPEAKER.
THE DIRECTOR OF THE CENTER FOR
INDIGENOUS RESEARCH POLICY AND A
PROFESSOR WITHIN THE CENTER OF
HEALTH SCIENCES AT OKLAHOMA
STATE UNIVERSITY.
WELCOME DR. JEMIGAN.
>> THANK YOU DR. BROWN.
NEXT SLIDE PLEASE.
I WILL BE TALKING ABOUT FOOD
SOVEREIGNTY AS A PATH TO
INDIGENOUS HEALTH EQUITY.
NEXT SLIDE.
I WANT TO SAY THANK YOU TO THE
NIH CONFERENCE ORGANIZING
COMMITTEE AND I WANT TO THANK
THE CENTER FOR INDIGENOUS
INNOVATION AND HEALTH PARTNERING
COMMUNITIES.
WE HAVE EXCELLENT PARTNERS FROM
OSAGE NATION, CENTER FOR ALASKAN
NATIVE HEALTH RESEARCH
UNIVERSITY OF ALASKA FAIR BANKS.
DENAKKANAAGA INK AND SOUTH
CENTRAL IN ALASKA.
HERE I TOUCH ON NUTRITION AND
DIET DISPARITIES IN NATIVE
AMERICAN AND ALASKAN
COMMUNITIES.
FOOD INSECURITY IS LINKED WITH
HIGH HEALTH CARE COSTS AND
PREMATURE DEATH.
I LOOKED AT THIS IN THE EARLIEST
PARTS OF MY CAREER.
THE PREFER LENS OF FOOD
INSECURITY IS HIGH IN NATIVE
COMMUNITIES.
MY COLLEAGUES AND I RECENTLY
CONDUCTED A SCOPING REVIEW TO
EXAMINE THE REV LENS OF FOOD
INSECURITY ACROSS THE UNIVERSITY
IN AMERICAN INDIA AND ALASKAN
NATIVE COMMUNITIES.
WE LOOKED AT STUDIES PUBLISHED
AFTER 1990 THROUGH 2021 AND
FOUND AN AVERAGE PREVALENCE EVER
458.7% ALTHOUGH THEY VARIED FROM
60 TO 80% IN OTHER COMMUNITIES.
YOU CAN SEE THIS IS A DIG
DISPARITY.
IN OKLAHOMA WE FOUND 60% OF
NATIVE AMERICANS FOR FOOD
INSECURE.
THEY WERE MSH LIKELY TO HAVE
DIABETES, OBESITY AND
HYPERTENSION COMPARED TO
INDIVIDUALS WHO WERE FOOD
SECURE.
WE KNOW FROM DATA COLLECTED AS
PART OF THE NATIONAL INTERVIEW
SURVEY WHICH INCLUDES NATIVES
THAT NATIVES ARE THREE TIMES
MORE LIKELY TO HAVE DIABETES
COMPARED TO WHITES AND MUCH MORE
LIKELY TO DIE FROM
DIABETES-RELATED COMPLICATIONS.
HAS TO CHALLENGES REQUIRE US TO
DIRECTLY INTERVENE AS STRUCTURAL
AND ENVIRONMENTAL LEVELS AND
CREATE LONG-TERM ACCESS TO
HEALTHY FOODS THAT IS CULTURALLY
CENTERED AND RELIABLE.
AND IN THIS NEXT SLIDE HERE, STT
SHOWS GARDENING INTERVENTIONS
WITH THE OSAGE NATION.
THAT'S PART OF INDIGENOUS FOOD
SOVEREIGNTY WHICH IS THIS
GRASSROOTS SOCIAL MOVEMENT THAT
ADDRESSES SOME OF THE MANY
BARRIERS TO HEALTHY FOOD ACCESS
AND TRADITION IN NATIVE
COMMUNITIES.
IT'S DEFINED AS THE RIGHT AND
RESPONSIBILITY OF INDIGENOUS
COMMUNITIES TO HELP HAVE
CULTURALLY APPROPRIATE FOODS
PRODUCED THROUGH INDIGENOUS
PRACTICES AND EMERGED AS AN
IMPORTANT STRATEGY TO SUPPORT
INDIGENOUS COMMUNITIES IN TAKING
GREATER CONTROL OVER OUR LAND
AND FOOD SYSTEMS BY INCREASING
AND PROTECTING TRA DECISIONAL
HEALTHY FOODS AND REDUCING
DEPENDENCE ON PACKAGED AND FAST
FOODS.
THE FOOD SOVEREIGNTY MOVEMENT
CENTERS INDIGENOUS WORLD VIEWS
AND CULTURAL PRACTICES AND
KNOWLEDGE WHICH ARE NOT INCLUDED
IN THE PUBLIC HEALTH OR MEDICAL
LITERATURE AND FOOD SOVEREIGNTY
IS A BROAD TERM THAT DESCRIBES
MANY TYPES EVER ACTIVITIES
RELATED TO TRADITION THE
FOODWAYS BUT A COMMON VALUE
WITHIN THE FOOD SORCHTSY
MOVEMENT I -- FOOD SOVEREIGNTY
MOVEMENT RESTORE EFFORTS AS THE
ORIGINAL LAW OR GREAT LAW
INCLUDING THE ORIGINAL
AGREEMENTS THAT OUR ANCESTORS
MADE WITH OUR PLANT AND ANIMAL
RELATIVES WHICH IS THAT WE'LL
CARE FOR THEM AND THEY IN TURN
WILL CARE FOR US.
IT'S THIS RESTORATION OF
RELATIONAL RESPONSIBILITIES THAT
WE BELIEVE IS THE KEY TO LEADING
BALANCES AND HEALTHY LIVES AND
THAT IS ULTIMATELY WHAT WILL
IMPROVE HEALTH AND WELLNESS IN
OUR COMMUNITIES.
THIS IS A PICTURE OF OUR OSAGE
AND ALASKAN NATIVE PARTNERS IN
ANCHORAGE TAINDING A FOOD
GATHERS WHICH.
THE PURPOSE OF THIS CENTER FOR
INDIGENOUS INVASION AND HEALTH
EQUITY IS TO SUPPORT THE
COMMUNITIES ACROSS THE U.S. AND
EVALUATE THEIR IMPACT ON HEALTH
OUTCOMES.
THIS WILL ADDRESS THE GAP IN
SCIENTIFIC LITERATURE FOR HEALTH
AND WELLNESS AS WELL AS
DEMONSTRATE THE CLEAR
RELATIONSHIP BETWEEN FOOD
SOVEREIGNTY AND IMPROVED HEALTH
WHICH WE KNOW EXISTS BUT HASN'T
BEEN WELL-DOCUMENTED OR
DOCUMENTED AT ALL WITHIN THE
SCIENTIFIC LITERATURE.
I WANT TO SHOW YOU SOME SPECIFIC
EXAMPLES OF WHAT FOOD
SOVEREIGNTY INITIATIVES LOOK
LIKE FOR INDIGENOUS COMMUNITIES.
HERE ASK T IS THE GROWING HOPE M
OF THE CHOCTAW NATION.
THEY DISTRIBUTE HEIRLOOM SEEDS
BROUGHT FROM THE ORIGINAL HOME
LANDS IN THE EASTERN PART OF THE
UNITED STATES.
WE SEWED THEM INTO OUR CLOTHING
AND CARRIED THEM TO NOW WHAT IS
PRESENT-DAY OKLAHOMA AS PART OF
THE TRAIL OF TIRES.
TARYS.
THEY WERE KEPT BY CHOCTAW
FAMILIES AND SNARED THIS PROGRAM
WHO ARE PROVIDED SEEDS TO
SUPPORT AND MAINTAIN A
TRADITIONAL CHOCTAW GARDEN.
IT INCLUDES TRADITIONAL PLANTING
METHODS SUCH AS THREE SISTERS
AND PLANTING OF CORN BEANS AND
SWASH.
COOKING TRADITIONAL FOODS AND
FOOD PRESERVATION.
WE AS PART OF THIS WILL ARE
ASSESSING HEALTH OUTCOMES
INCLUDING FOOD SECURITY, CHANGES
IN DIETARY INTAKE, BLOOD
PRESSURE AND SELF-REPORTED
HEALTH.
ANOTHER EXAMPLE IS THE
INTERVENTION OUT OF FAIRBANKS
WITH OUR PARTNERS THERE --
>> YOU HAVE TWO MINUTES
REMAINING.
>> THIS IS ELDERS MENTORING
ELDERS IS WHAT IT'S CALLED.
IT'S LED BY ALASKAN NAIT ELDERS
THAT TEACH TRADITIONAL FOOD
PRACTICES WITH RESIDENTIAL
SCHOOL SURVIVORS AND FAMILIES.
NATIVE PEOPLE WERE TAKEN AS PART
OF THE ASSIMILATION PROCESS IN
THIS COUNTRY AND MY OWN
GRANDMOTHER, FOR EXAMPLE, WAS
PLACED IN A RESIDENTIAL SCHOOL.
MANY OF US DID NOT HAVE A CHANCE
TO LEARN OUR CULTURAL WAYS OR AS
THE PROJECT LEAD IN THIS
PARTICULAR PROJECT STATES IT,
THIS IS HOW WE LEARN OUR
TRADITIONS.
THAT'S HOW WE BECOME A HUMAN
BEING IN OUR CULTURE.
IN IS LOOKING TO RESTORE THAT
PROCESS AND THE TRANSMISSION OF
CULTURAL KNOWLEDGE.
WE'RE EVALUATING THE IMPACT OF
THESE CULTURE CAMPS OF SOCIAL
AND CULTURAL WELL-BEING,
SELF-REPORTED HEALTH AND DIETARY
INTAKE.
MY COLLEAGUES AND I -- NEXT
SLIDE.
MY EXPLEETION I C COLLEAGUES ANA
COMMUNITY PARTNERSHIP DEVELOPED
TO MEND THE RELATE BETWEEN FOOD
SOVEREIGNTY AND HEALTH.
IT'S MEANT TO BE READ FROM LEFT
TO RIGHT.
WE HAVE GATHERING AND FORAGING,
AND GARDENING AND WE HAVE THE
EFFECTS OF THIS.
THIS IS FLFERRED BY
COMMUNITY-BASED PRACTICE AS WELL
AS SCIENTIFIC LITERATURE.
IT'S BASED ON A COUPLE MUCH
THEORIES EVER CHANGE, THE
CONNECTIVENESS MODEL WHICH
PAUSES THAT BE CONNECTIVES IN
AND INDIVIDUALNESS LEADS TO
HEALING AND THE DISCONNECTION
LEADS TO POOR HEALTH AS WELL AS
SELF-DETERMINATION AND CULTURAL
CONTINUITY.
WE PUBLISHED THIS AS PASSIONATE
OF A 12 HRT SERIES 12-PART SERIT
IN NOVEMBER.
NEXT SLIDE, I'LL CONCLUDE WITH
TH LAST SLIDE A BEAUTIFUL QUOTE
BY OUR LAGUNA WRITER WHO SO
BUFFBEAUTIFULLY WROTE IN HER BO.
THIS IS ALL WE HAVE TO FIGHT OFF
ILLNESS AND DEATH.
THIS IS WHAT THE FOOD
SOVEREIGNTY INITIATIVES ARE
DOING, IS RESTORING
CONNECTIVENESS AND OUR CULTURAL
FOODWAYS ARE STORIES AND THE
RESTORATION OF OUR ORIGINAL
AGREEMENTS.
AND LAST SLIDE, THIS IS A
PICTURE OF SOME OF OUR PARTNERS
YAKOKE.
THANK YOU.
>> THANK YOU FOR THAT EXCELLENT
PRESENTATION.
OUR NEXT PRESENTER IS DR. FORETZ
THE SHEYENNE RIVER SIOUX TRIBE
FOR HEALTH STUDY ADAPTATION FOR
INDIGENOUS COMMUNITY.
SHE'S A CARDIOVASCULAR
EPIDEMIOLOGIST AIMED AT
IMPROVING CASHEDIO METABOLIC
HEALTH IN UNDERSERVED IS
COMMUNITIES.
>> GOOD MORNING, EVERYONE.
AS WAY OF BACKGROUND, THE
PROBLEMS OF OBESITY AND DIABETES
AND CORONARY HEART DISEASE ARE
HIGH AMONG AMERICAN INDIANS.
ACCORDING TO STATISTICS ABOUT
48% OF AMERICAN INDIANS HAVE
OBESITY.
24% HAVE DIABETES AND 9% HAVE
CORONARY HEART DISEASE.
IT'S HYPOTHETICALLIZED THAT THE
BUSHED CAN BE BE AN TRIBUTED TO
RECENT CHANGES IN LIFESTYLE.
THE ADOPTION OF SEDENTARY
LIFESTYLE INCLUDING INCREASED
CONSUMPTION OF PROCESSED FOODS
AND CHANGES IN RESERVATIONS MAY
BE RESPONSIBLE FOR THE STRIKING
PREVALENCE OF HEALTH OUTCOMES IN
AMERICAN INDIAN COMMUNITIES.
MOST OF WHAT WE KNOW ABOUT
QUARDIO METAMETABOLIC SEIZES COE
STUDY.
I DON'T HAVE TIME TO GO FLOOT
STUDY IN DETAIL, BUT WORK FROM
THE STRONG HEART STUDY INFORMS
THE WORK I WILL STRIE TODAY.
THIS SHOWS THE ACHIEVEMENT OF
THE LIFE'S SIMPLE 7 DIE OAT
GOALS.
THE GENERAL POPULATION IS SHOWN
IN PURPLE.
IN THE INDIANS SNOAN GOALS.
THE STRONG HEART PARTICIPANTS
ARE MEETING THE GUIDELINES FOR
MOST FOODS.
SO BASED ON FINDINGS FROM THE
STRONG HEART STAWDY, WE KNOW
THERE IS NEED FOR CAN
IMPROVEMENT IN DIET QUALITY IN
SUSTAINABLE, DIETARY
INTERVENTIONS ARE NEEDED.
WE KNOW THERE ARE MANY EXAMPLES
OF DIET INTERVENTIONS CONDUCTED
IN DIVERSE POPULATIONS, BUT MOST
OF THE INTERVENTIONS ARE NOT
POSSIBLE TO IMPLEMENT FROM
RESOURCE-LIMITED COMMUNITIES
LIKE MANY RURAL AND REZ RAILROAD
VAITION COMMUNITIES.
THERE IS NO TEACHING KITCHENS,
THERE ARE FEW CENTRALLY MEETING
LOCATIONS THAT ARE CONVENIENT TO
MOST.
THERE IS LIMITED OR NO PUBLIC
TRANSPORTATION AND ONLY A
HANDFUL OF GROCERY STORES.
MOST EXISTING COMMUNITY DIE OAT
FOCUS ON PREVENTION OF DIABETES
AND HEART DISEASE.
WITH POPULATIONS WITH A HIGH
BURDEN, WE NEED TO FOCUS ON
OPTIMIZING HEALTH AMONG THOSE
WITH EXISTING MORBIDITY.
THE STRONG HEART STUDY INCLUDES
PARTICIPANTS FROM 12 TRIBES
THROUGHOUT THE UNITED STATES AND
INTERVENTION FOCUSES ON ONE
COMMUNITY TO DATE, THE SHEYENNE
RIVER SIOUX TRIBE.
THE RESERVATION IS THE FOURTH
LARGEST RESERVATION IN THE
UNITED STATES.
IT EXPRIEZS 4200 SQUARE MILES
WHICH IS THE SIEFERS THE STATE
EVER CONNECTICUT.
8,000 PEOPLE LIVE ON THE
RESERVATION AND IT'S IF ONE OF
THE LOWEST INCOME COUNTIES IN
THE USA OUR JOURNEY TO DEVELOP
AND IMPLEMENT A CULTURALLY
TAILORED DIE OAT INTERVENTION
REQUIRES WORK.
WE STARTED WITH PILOT WORK IN
2016.
WE BEGAN THE EARLY STEPS OF A
TRIAL DESIGN?
2DESIGN IN 2018 AND HOPE TOHAVE.
FIRST I'LL TALK ABOUT OUR PILOT
STUDY.
IT HAS SEVERAL COMPONENTS
PARTICULARLY THE ADMINISTRATION
OF THE USDA COMMUNITY FOOD STORE
SURVEY AT OUTLETS ON THE
RESERVATION.
TO BETTER TRAIRK ADVERTISE THE
FOOD ENVIRONMENT.
WE DRUSH BETTER CHARACTERIZE THE
FOOD ENVIRONMENT.
WE WORKED TO BETTER UNDERSTAND
RESOURRESOURCES AND BEE BARRIERD
FACILITATORS TO EATING HEALTHY
FOODS.
WE SET THE GROUNDWORK TO PROMOTE
HEALTHY FOOD CHOICE.
THE COMPONENT OF OUR PILOT WORK
HIGHLIGHTED FIVE MAJOR TOPICS TO
HEALTHY EATING.
EXTERNAL FACTORS WERE COST,
AVAILABILITY AND QUALITY.
INTERNAL FACTORS WERE TASTE AND
KNOWLEDGE.
IN THE USDA COMMUNITY SURVEY
DEMONSTRATED MORE THAN 90% OF
FOODS ON THE SURVEY WERE
AVAILABLE AT LOCAL STORRS BUT
THERE WAS A HUGE RANGE OF PRICES
ACROSS THE STORES.
NEXT SLIDE.
BASED ON OUR FINDINGS, WE
DETERMINED THAT THE COOKING
MATTERS PROGRAM WHICH IS SHARE
OUR STRENGTH CAMPAIGN THAT
OFFERS COOKING CLASSES TO
FAMILIES PARTLY FILLED MANY OF
THE NEEDS FOR DIET INTERVENTION.
HOWEVER, THE INTERVENTION NEEDED
MAJOR ADAPTATIONS TO WORK WELL
WITH THE TRIBAL COMMUNITY.
THE TRIBE WANTED TO FOCUS ON
DIABETES MANAGEMENT RATHER THAN
HEALTHY FOODS PROMOTION IN
GENERAL.
WE NEEDED TO INCORPORATE A NEW
DIDIMENSION.
THE AIMS OFFER OUR COOKING
FORRAL HEALTH STUDY WERE TO WORK
IN PARTNERSHIP WITH THE TRIBAL
DIABETES PROGRAM TO CONDUCT A
RANDOMIZED CONTROL PANEL TO
DPERM THE BUDGETING,
PARTICIPATING AND COOKING
INFLUENCES HEALTH.
WE LOOKED AT DIFFERENT IN DIET
SPECIFICALLY SUGAR-SWEETENED
BENCHES AND PROCESSED FOODS.
AND ALSO TO LOOK AT DIFFERENCES
IN DIABETES CONTROL AND BMI AT
MONTHS 6 AND 12.
WE HAD A MIXED METHODS PROCESS
TO LOOK AT EFFECTIVENESS.
IN TOTAL, 176 PARNTS ENROLLED IN
THE TRIAL, HALF WERE
INTERVENTION AND HALF WERE IN
THE CONTROL ARM.
AT THE START OF THE STUDY,
INTERVENTION PARTICIPANTS
RECEIVED TOOLS TO PREPARE
HEALTHY MEALS.
IN THE INTERVENTION ARM THEY
RECEIVED 12 MONTHS OF ACTIVITIES
TO IMPROVING DIET FOR DIABETES
MANAGEMENT.
PARTICIPANTS ARE OW ENGAGING WIH
FOLKS THAT LIVE IN THE COMMUNITY
THAT FOCUS ON COOKING, AND
BUDGETING FOR FOODS, INCREASING
LITERACY HAD SHOPPING FOR FOODS.
WE HAVE LOTS OF CONTESTS WITH
MONTHLY RAFFLES AND GIFT
CERTIFICATES TO INCENTIVIZE
PARTICIPATION.
IF EFFECTIVE, THE DIABETES
PROGRAMS HOPE TO USE THIS
INTERVENTION AS PART OF THEIR
PROGRAMMING FOR DIABETES
MANAGEMENT.
NEXT SLIDE, PLEASE.
HERE IS A SNAPSHOT OF THE TOPICS
COVERED.
THONE SMALL GOAL CAN MAKE
MEANINGFUL CHANGES IN HEALTH.
IT'S DISTANCE-BASE SOD MAINLY
DONE BY TABLETS WITH VIDEOS AND
ACTIVITIES THAT DON'T REQUIRE
INTERNET DUE TO LIMITED PLACES
TO HOLD COOKING CLASSES AND
BECAUSE MOST OF THIS
INTERVENTION WAS OCCURRING
DURING THE PANDEMIC.
PARTICIPANTS COME IN FOR THREE
VISITS OVER 12 MONTHS AND HAVE
MONTHLY PHONE CALLS.
INTERVENTION IS REALLY GROUNDED
IN LAKOT LAKOTAA VALUES TO MAKE
HEALTHY FOOD CHOILSES.
NEXT SLIDE -- FOOD CHOILSES.
WE USE FOODS OBTAINED LOCALLY AS
WELL AS LAKOTAA FOODS.
HERE IS AN EXAMPLE OFFER THE USE
EVER HEALTHY TRADITIONAL FOODS
AND NON-TRADITIONAL ALTERNATIVES
SUCH AS PROTEIN SUCH A BUFFALO
OR DEER AND NON-TRADITION ARE
TURKEY OR CHICKEN.
HERE ARE THE BASELINE
CHARACTERISTICS.
EVERYONE HAD DIABETES.
IT'S COMMON AMONG INDIVIDUALS IS
OBESITY WERE COMMON AND THERE
WERE HIGH LEVELS EVER FOOD
INSECURITY.
70% OF FOOD PARTICIPANTS
REPORTED FOOD INSECURITY.
THIS IS JUST ONE EXAMPLE OF ON
GOING WORK IN THE SIOUX TRIBE.
THIS INCLUDES A PROJECT FOR DEEP
ASSESSMENT FOR MULTI-LEVEL
COMPONENTS OF THE FOOD
ENVIRONMENT IN ALL 12
COMMUNITIES AND WE WERE FUNDED
TO HAVE A PRESCRIPTION PROGRAM.
WE'LL CONTINUE TO BUILD
PARTNERSHIPS WITH LOCAL
ORGANIZATIONS THAT FOCUS ON
FOOD.
IF EFFECTIVE, WE WANT TO
DEPARTMADAPTTHE STUDY FOR OTHERL
NATIONS.
I WOULD LIKE TO ACKNOWLEDGE NRCH
EVERYONE INVOLVED IN THIS
RESEARCH.
>> OUR NEXT PRESENTER IS BY
CHRISTINE HA FOR
INTERGENERATIONAL 2350D
PRACTICES.
MRS. HA IS A PhD. CANDIDATE IS
WITH THE MCGILL UNIVERSITY IN
KAND.
SHE JOINED THE DELORIMER LAB TO
FOCUS ON FOOD LITERACY AND
CLIMATE CHANGE AND INDIGENOUS
HEALTH PARTICULARLY AMONG
INDIGENOUS YOUTH.
WELCOME.
CHRISTINE HA.
>> THANK YOU FOR HAVING ME.
FIRST SLIDE, PLEASE.
POSITIONALITY IS AN IMPORTANTLY
CONCEPT FOR RESEARCHERS
PARTICULARLY HOSE LIKE ME WHO
ARE NON-INDIGENOUS AND ENGAGE IN
RESEARCH WITH THE INDIGENOUS
POPULATION.
WITH YOUTH, I ACKNOWLEDGED MY
POSITION AS A RESEARCHER OFFER
CHINESE AND VIET NAMESE DESCENT
MAY HAVE AN IMPACT ON MY ROLE.
THERE MAY BE CONCERN PRIVILEGES
ASSOCIATED WITH BEING A
NON-INDIGENOUS RESEARCHER.
I'M AWARE OF THE BALANCES
BETWEEN MY SOFA AND THE
POPULATION THAT I WORK WITH AND
TO ADDRESS THESE IMBALANCES, I
ENGAGE IN MEANINGFUL
COLLABORATIONS WITH THE
COMMUNITY.
I ENSURE THEIR RESEARCH BENEFITS
THEM TO RESPECT MUTUAL INTEREST.
I CAN NAVIGATE MY ROLE WITHIN
THE RESEARCH PROCESS MORE
EFFECTIVELY WHILE FOST SHALLING
STRONGER RELATIONSHIPS WITHIN
THE COMMUNITY.
IT'S IMPORTANT TO NOTE THAT THE
PRINCIPLES OF POSITIONALITY ARE
NOT LIMITED TO ACADEMIA BUT CAN
BE APPLIED IN PRACTICAL CONCEPTS
SUCH AS DEVELOPING INTERVENTION.
LET'S TALK A LITTLE BIT ABOUT
REFLEXITY.
I'M CONSTANTLY CHECK E CHECKING
IN WITH MYSELF AND RECOGNIZING
MY OWN BIASES AND ASSUMPTIONS
AND WHERE I STAND IN RELATION
WITH THE RESEARCH AND PEOPLE
INVOLVED.
BEING A NON-INDIGENOUS
RESEARCHER MEANS I HAVE TO OWN
UP TO MY CULTURAL BACKGROUND AND
MANY BIASES I CARRY DUE TO WHO I
AM.
WHEN I'M GOING THROUGH THE DATA,
I HAVE TO MAKE SURE THAT WHAT I
FIND ACTUALLY REPRESENTS THE
STHAWTS AND WAYS OF THE
INDIGENOUS COMMUNITY THAT I'M
WORKING WITH.
COMING FROM A PRETTY DIFFERENT
CULTURAL AND EDUCATIONAL
BACKGROUND, THE WAY I INTERPRET
THE RESEARCH FINDING MAKE ME
DIFFERENT FROM THE COMMUNITY
MEMBERS.
TO MAKE SURE I'M IN SYNC WITH
THE COMMUNITY, THE PROCESS COLED
BY MYSELF AND COMMUNITY MEMBERS.
YOU CAN SEE IN THIS GRAPH, AFTER
AN INTERVIEW IS BEING CONDUCTED
WITH A PARTICIPANT, WHICH KEEP
IN MIND IS DONE WITH AN
INDIGENOUS RESEARCH ASSISTANCE,
IT'S A COCONDUCTED INTERVIEW, WE
REFLECT ON THE FINDINGS TOGETHER
AND I TAKE NOTES OF MY
REFLECTIONS OF HOW I WAS FEELING
AT THE TIME AND MY REFLECTIONS
DURING THE INTERVIEW AND ACH.
WE DISCUSS ABOUT MY ASSUMPTIONS
AND HOW THAT MIGHT IMPACT THE
ANALYSIS OF THE DATA.
I FURTHER REFLECT ON THE
FINDINGS AND WE REEVALUATE OUR
RESEARCH FINDINGS TO MAKE SURE
WHAT WE'RE REPORTING IS
REFLECTIVE OF THE WAYS OF
KNOWING.
OVER THE PAST FIVE YEARS -- NEXT
SLIDE, PLEASE.
OVER THE PAST FIVE YEARS, I'VE
NURTURED AND BUILT STRONG
RELATIONSHIPS WITH THE
COMMUNITY.
THESE RELATIONSHIPS HAVE PLAYED
AN IMPORTANT ROLE IN THE SUCCESS
OF CODEVELOPED RESEARCH PROJECT.
MY JOURNEY BEGAN DURING MY
PhD. PROGRAM WHEN I FIRST
INTERNED WITH THE KREE NATION
GOVERNMENT WHICH LOOKS AT
CLIMATE CHANGE ON COMMUNITIES.
WE ACTIVELY INVOLVE YOUTH AS
RESEARCH ASSISTANCE OFFERING
THEM TRAINING AND OPPORTUNITIES
TO CREATE A STRATEGY AND ACTION
PLAN FOR THE KREE COMMUNITY.
THIS INITIAL -- KREE COMMUNITY.
-- CREE COMMUNITY.
HAVING AN INDIGENOUS RESEARCHER
AS MY MENTOR AT THE UNIVERSITY
HAD A DI SIGNIFICANT IMPACT.
MY MENTOR PLAYED A ROLE IN
UNDERSTANDING AND HAVING SELF
REFLECTION DURING MY TRAINING.
I HIGHLY RECOMMEND BUILDING
RELATIONSHIPS WITH COMMUNITIES
TO BEST UNDERSTAND THEIR
DISMEEDZ HOW TO MOST EFFECTIVELY
ADDRESS THEIR -- NEEDS AND HOW
TO MOST EFFECTIVELY ADDRESS
THEIR NEEDS.
WE CREATE AN INCLUSIVE
ENVIRONMENT INVITING PEOPLE TO
SHAPE THE RESEARCH PROCESS WITH
ME.
MY WORK IS TO EXPAND THE
EXISTING NOTION FOR THE
PARTICIPATE RESEARCH APPROACH
AND EXISTING RESEARCH WITHIN THE
NORTHERN REGIONS EVER QUEBEC.
WE EXPECT THAT THIS PROJECT WILL
SUPPORT THE COMMUNITY'S EFFORTS
TO ENGAGE MORE YOUTH IN FOOD
PRACTICES AND ADDRESS THEIR
CONCERNS WITH RESEARCH IN A
POSITIVE RELATIONSHIP WITH
RESEARCHERS.
IN CLINICAL PRACTICE, THIS COULD
BE APPLIED TO COCREATE
INTERVENTIONS.
NEXT SLIDE, PLEASE.
IN MY -- AS I PREVIOUSLY
MERCHTIONED, MY RESEARCH IS
MOSTLY FOCUSED IN THE COMMUNITY
IN NORTHERN QUEBEC AND I
RECOGNIZE THAT THEIR FOOD SYSTEM
IS DIFFERENT THAN WHAT I'M
ACCUSTOMED TO IN MONTREAL.
I WOULD EXPECT AN INTERVENTION
IN CLINICAL PRACTICE AND
RESEARCH IF LOCATED IN MONTREAL
WOULD LOOK DIFFERENT THAN AN
INTERVENTION FOR A COMMUNITY IN
NORTHERN QUEBEC.
TO DO SO, I NEED TOE FIRST
CONSULT AND WORK WITH THE
COMMUNITY TO UNDERSTAND THAT TO
THE CREE, THE NORTHERN
TRADITIONAL FOOD SYSTEM IS
FOUNDATIONAL TO THEIR GOOD
HEALTH AND WELL-BEING.
IT'S WHERE THEY GAINT SKILLS AND
IS COMPOSED OFFER ALL THE
ANIMALS AND PLANT SPECIES
HARVESTED FROM THE LAND TO HAVE
HIGHLY NUTRITIONAL FOODS.
THESE ARE EXPRESSED THROUGH OLD
TRADITIONS, STORY TELLING AND
PRACTICING THEIR CULTURE ON THE
LAND WITH KNOWLEDGE-HOLDERS.
IT PROVIDES VALUABLE GUIDANCE TO
BOTH MYSELF AS A RESEARCHER AND
TO OTHER HEALTHCARE
PROFESSIONALS ON HOW TO CREATE
AN INTERVENTION TO HAVE
INDIGENOUS PRACTICES AND ENHANCE
IT'S BENEFITS TO THE COMMUNITY.
IT IS CLEAR BY NOW THE
TRADITIONAL FOODS AND PRACTICES
HOLD SIGNIFICANCE IMPORTANCE.
IN A COMMUNITY ACTING TO
STRENGTH AND THEN PRESERVE THEM.
BUT THERE HAS BEEN A SHIFT IN
DIETARY PATTERN.
TODAY THE TRADITIONAL FOODS IS
ON THE DECLINE WHILE THE
INCREASE OF MARKET-BASED IS ON
THE RISE SO MORE PROCESSED
FOODS.
THIS IS PARTICULARLY NOTICEABLE
AMONG THE YOUNGER GENERATIONS OF
INDIGENOUS YOUTH.
IT'S WORTH EMPHASIZING THAT
STUDIES FOUND IS THAT DIETS
INCORPORATING TRADITIONAL FOODS
ARE SUPERIOR COMPARED TO
MARKET-BASED FOODS WITHIN THE
SAME POPULATION.
ALTHOUGH WE ACKNOWLEDGE THAT THE
CREE WORLD VIEW DOES NOT
ENCOMPASS FOOD LITERACY, WE'LL
USE THIS AS A BRIDGE TO EX-POUR
THE PERSPECTIVE ON HOW
INDIGENOUS COMMUNITIES A KRIER
TRADITIONAL FOOD PRACTICES,
SKILLS AND KNOWLEDGE THROUGH
THEIR INTERACTIONS BETWEEN THE
ENVIRONMENT AND TRADITIONAL
KNOWLEDGE HOLDERS.
THE COMMUNITY I WORK IN
OBSERVATION PRESSINGED AN
INTEREST IN FOCUSING ON ENGAGING
THE YOUTH IN FOOD PRACTICES.
WE WANT TO BETTER UNDERSTAND THE
PROCESS EVER TRADITIONAL FOOD
PRACTICES AND HOPE THIS WILL
CONTRIBUTE TO FOOD SECURITY,
COMMUNITY RESILIENCE AND THE
OVERALL WELL-BEING OF INDIGENOUS
COMMUNITIES.
OVERALL IT IS TO IMPROVE THE
HEALTH OF THE OVERALL YOUTH.
IN SOME CASES THEY MAY HAVE
ACCESS TO GET FOOD BECAUSE EVER
COST.
FOR INSTANCE, ACQUIRING THE SAME
GROCERIES UP NORTH WHERE I WORK
CAN COST NEARLY TWO OR THREE
TIMES THE COST OF LIVING IN
MONTREAL.
IF WE PROMOTE FOOD SECURITY
INCLUDING IMPROVING FOOD ACCESS
TO PARTICIPATE IN THEIR
TRADITIONAL FOOD PRACTICES,
WE'RE SUPPORTING OVERALL FOOD
SECURITY IF THE STORE BOUGHT
FOODS ARE NOT AS ACCESSIBLE.
I WANTED TO WRAP UP WITH A FEW
QUESTIONS FOR YOU ALL TO REFLECT
ON.
THIS COULD BE FOR HEALTH CARE
PRACTITIONERS OUR RESEARCH ARSE
LIKE.
SOME QUESTIONS THAT ARE
IMPORTANT TO THINK ABOUT ARE DO
YOU THINK THAT YOUR PERSONAL
TRAINING AND EXPERIENCES ARE
INFLUENCING YOUR APPROACH AND
THE TYPES OF INVENTIONS YOU
RECOMMEND.
WHO IS THIS INTERVENTION YOU'RE
DEVELOPING DIRECTED TO.
HOW TO DOES IT HELP OUTCOMES IN
THE POPULATIONING AND IS THE
INTERVENTION YOU'RE SUGGESTING
THE MOST SUITABLE APPROACH TO
ADDRESS THE HEALTH ISSUE WITHIN
THAT PARTICULAR POPULATION?
THERE IS ONE MORE SLIDE, BUT --
>> EXCELLENT.
THANK YOU.
MRS. LA.
MRS. HA.I WILL START WITH DISCUN
QUESTIONS.
WE'RE EXCITED TO FOLLOW YOUR
RESEARCH IN THE FUTURE.
AS A REMINDER, PLEASE SUBMIT ANY
QUESTIONS USING THE SUBMIT LIVE
FEEDBACK BUTTON.
PLEASE STATE WHICH PANELIST
YOU'RE DIRECTING YOUR QUESTION
TO.
LESS' LIVE INTO SOME QUESTIONS.
WOULD I LIKE TO ADDRESS THE
FIRST QUESTION TO DR. FRETTS.
IT'S CONTROLLING THE GROUP FOR
HEALTHY COOKING PRACTICES.
COULD YOU SHARE MORE ON WHAT THE
CONTROL GROUP RECEIVED.
>> THE CONTROL GROUP IS
ESSENTIALLY A DELAYED
INTERVENTION GROUP.
AT THE END OF THE STUDY WHICH IS
NEXT MONTH, EVERYONE IN THE
CONTROL GROUP WILL BE INVITED TO
PARTAKE IN THE INTERVENTION AND
HAVE ACCESS TO ALL THE
MATERIALS.
SO IT'S ESSENTIALLY A CONTROL
GROUP IN THE SENSE THAT THEY
DIDN'T RECEIVE THE INTERVENTION
RIGHT AWAY.
IN THE END, EVERYONE IN THE
COMMUNITY WILL HAVE THE
OPPORTUNITY TO BENEFIT FROM THE
MATERIALS.
>> THERE IS LIKE A PART B.
WHAT STRATEGIES ARE USED TO
ENSURE THE COMPLIANCE WITHIN THE
CONTROL GROUP?
>> THIS IS A CHALLENGING
QUESTION AS WELL.
THE COMMUNITY THAT WE'RE WORKING
WITH IS VERY SMALL AND
CLOSE-KNIT.
THERE IS POTENTIAL FOR SHARING
OF INFORMATION AMONG -- ACROSS
INDIVIDUALS WHO WERE RANDOMIZED
TO THE INTERVENTION GROUP AND
INDIVIDUALS WHO ARE RANDOMIZED
TO THE CONTROL GROUP.
THERE IS NOT MUCH WE CAN DO
ABOUT THAT.
THE WAY WE HAVE CONTROLLED FOR
IT IS FOR THE INTERVENTION,
WE'RE ONLY ALLOWING ONE
INDIVIDUAL PER HOUSEHOLD TO BE
ABLE TO PARTICIPATE IN THE
INTERVENTION.
WHEN THE CONTROL GROUP AND THE
INTERVENTION GROUP COME IN, WE
ASK THEM, HAVE YOU SHARED ANY OF
THE INFORMATION OR THE VIDEOS
WITH OTHER PEOPLE?
AND WHEN WE DO OUR ANALYSIS,
WE'LL CONSIDER THAT TO SEE IF
THAT IMPACTED ANYTHING.
IT'S JUST THE REALITY OF WORKING
IN A SMALL COMMUNITY.
>> THANK YOU.
NEXT QUESTION IS DR. JEMER
RMIGAN.
WHAT ARE THE WHAT DO YOU THINK
WE CAN LEARN AS THE NUTRITIONAL
COMMUNITY THIN THINKS ABOUT MOSS
FOR FOOD INTERSECURITY?
>> GREAT QUESTION.
THE FOCUS ON NUTRITION SECURITY
HAS GAINED A LOT OF EXCITEMENT
AND ENTHUSIASM IN NATIVE
RESEARCH CIRCLES BECAUSE WE SEE
IT AS A PROAMP APPROACHING A MOE
HOLISTIC VIEW OF FOOD.
WE THINK OF FOOD SOVEREIGNTY AS
A PATHWAY TO FOOD SECURITY.
IT IS, YOU KNOW, NUTRITION
SECURITY AND THAT CONCEPT OF
NUTRITION BEING WHOLE HEALTH AND
ACCESS TO YOUR FISHING AND
HUNTING RIGHTS.
AND FORGING RIGHTS.
FORAGING RIGHTS AND
SOVEREIGNTY OF YOUR OWN LAND
BASE.
VERY HOLISTIC VIEWPOINT ASK
NUTRITION SECURITY IS A RIGHT
DIRECTION IN HOW WE ACCESS THAT.
>> NEXT QUESTION ASKS, CAN YOU
TALK ABOUT ANY CHALLENGES
SCREENING FOR FOOD INSECURITY IN
AMERICAN INDIAN OR ALASKAN IJ
DIJ NEWS COMMUNITY?
COMMUNITY -- ALASKAN
NATIVE COMMUNITY?
>> WE HAVE A SMALL PILOT GRANT
RIGHT NOW THAT IS I'M WORKING
WITH INDIVIDUALS AT THE
UNIVERSITY OF CALIFORNIA DAVIS
IN THE NAVAJO NATION.
THE INSEN INTENTION WAS TO DEVEA
STRENGTH-BASED SCREENER AS
OPPOSED TO A DEFICIT-BASED
SCREENER.
RIGHT NOW WE USE USDA
INSTRUMENTS.
SOMETIMES THE QUESTIONS ARE A
LITTLE BIT CONFUSING FOR
INDIVIDUALS.
SO WHEN INDIVIDUALS TALK
ABOUT -- THESE QUESTIONS WERE
DEVELOPED FOR THE GENERAL US
POPULATION AND NONE HAVE BEEN
VALIDATED OR THOAN TO BE
RELIABLE.
SOME OF THE QUESTIONS ARE JUST
CONFUSING.
FOR INSTANCE, ONE OF THE
QUESTIONS ASKED ABOUT DO YOU RUN
OUT OF FOOD BY THE END EVER
PLONT?
-- END OFFER THE MONTH.
IN MANY COMMUNITIES THERE ARE
SOCIAL NETWORKS THAT PREVENT
INDIVIDUALS FROM RUNNING OUT OF
FOOD.
INDIVIDUALS MAY NOT NECESSARILY
HAVE INCOME IN THEIR HOUSE TO
PURCHASE FOOD, BUT THEY WON'T
RUN OUT BECAUSE THEY HAVE FAMILY
AND FRIENDS AND OTHER SOCIAL
NETWORKS TO HELP SUPPORT THEM.
I THINK IT IS CHALLENGING TO
ASSESS FOOD INSECURITY AND A LOT
OF PEOPLE AT LEAST THAT WE
REALIZE THROUGH THIS PILOT
PROJECT DON'T LIKE THE
QUESTIONNAIRES.
THEY FEEL STIGMATIZED.
I THINK IT'S CHALLENGING TO
MEASURE FOOD INSECURITY AND WE
NEED BETTER INSTRUMENT 20S TO DO
SO.
>> ANYONE ELSE?
OR SHOULD YOU MOVE ON?
>> I WOULD ADD THAT WHAT I HAVE
SEEN IS THAT THE FOOD SECURITY
SCREENING, UNFORTUNATELY, IS NOT
ADMINISTERED VERY REGULARLY AS
PART OF ANY KIND MUCH ROUTINE
MEDICAL CARE.
IT'S SIMPLY FOR THE FACT THAT
IHS IS SO UNDERFUNDED THAT THERE
IS NOT A LOT OF TIME IN THOSE
PATIENT PROVIDER INTERACTIONS
WHICH WOULD BE ONE OF THE
FRONTLINES WHERE THAT WOULD
OCCUR.
AND SO A LOT OF PEOPLE ARE NEVER
ASKED ABOUT FOOD SECURITY.
WHEN THEY ARE ASKED, LIKE MANDY
WAS SAYING, SOME OF THE
QUESTIONS REALLY DON'T GET AT
THE CULTURAL CONTEXT.
>> SCREENING IS DEFINITELY ON
THE RISE AND THAT'S A GOOD
THING.
BUT I WOULD LIKE TO MOVE ON WITH
OUR FINAL QUESTION.
THAT IS WHAT STRUCTURAL BEAR
YORES EXIST IN THE INDIGENOUS
COMMUNITIES TO REESTABLISH FOOD
SOVEREIGNTY AND WHAT SOLUTIONS
CAN BE USED TO OVERCOME THOSE
STRUCTURAL BARRIERS?
THIS IS TO ANYONE OF THE
PANELISTS.
>> I CAN SPEAK A LITTLE BIT.
ONE OF THE MAIN BEAR YORES IN
THE COMMUNITIES I WORK WITH
BECAUSE I'M WITH THE YOUTH, IS
THE -- A LOT OF THE YOUTH DON'T
HAVE ACCESS TO THE LAND.
THAT'S ONE OF THE MAJOR BEAR
YORES AS WELL AS HAVING THE
KNOWLEDGE AND SKILL FOS ACCESS
THEIR TRADITIONAL FOOD SYSTEM.
AT LEAST IN MY WORK, THE KNOW
CUSS IS HOW TO ENGAGE INDIGENOUS
YOUTH IN EXCHANGES AND SPINDING
MORE TIME ON THE LAND TO LEARN.
IF THEY HAVE MORE KNOWLEDGE
ABOUT INTEREST EDITIONAL FOOD
PRACTICES AND THE CAPACITY TO
PRACTICE THEIR CULTURAL -- IN
THEIR INDIGENOUS FOOD SYSTEM, IT
COULD SUPPORT FOOD SECURITY.
AS I MENTIONED EARLIER, FOOD
SECURITY APPLIES ON BOTH FRONTS
FOR THIS COMMUNITY WHERE
STORE-BOUGHT FOODS IS NOT THE
MOST ACCESSIBLE NOR IS IT ON THE
LAND.
>> WE DID HAVE A COUPLE MORE
QUESTIONS COME IN.
SO MANY INTERVENTIONS FOR
INDIGENOUS FOOD SECURITY ARE
DONE ON A LOCAL OR GRASSROOTS
LEVEL.
DO YOU KNOW OF ANY INTERVENTIONS
ON A LARGER SCALE SUCH AS GLOBAL
HEALTH?
IF NOT, WHY IS THIS NOT LOOKED
AT OR IS IT EVEN POSSIBLE?
>> YES, THEY ARE DONE AT A LOCAL
LEVEL AND THAT'S THE BEAUTY OF
THEM.
THEY ARE DEEPLY LOCALIZED.
KNOWLEDGE IS PART OF THE REASON
WHY THAT OCCURS.
TAKING THE UNIQUE KNOWLEDGE OF A
SPECIFIC PLACE AND BROADENING
THAT KNOWLEDGE OUT IS VERY, VERY
CHALLENGING.
SO THAT'S PROBABLY ONE REASON
WHY THAT DOESN'T OCCUR.
BUT I THINK ALSO YOU KNOW, THESE
INTERVENTIONS ARE NOT WHAT YOU
WOULD CONSIDER THE TYPICAL RCT
SORT OF MATERIAL.
SO IF YOU KEEP THEM INTACT, IT'S
HARD TO KIND OF OPERATIONALIZE
THEM IN THE RTC MODEL.
WE ARE EXPANDING SOME OF THIS AS
PASSIONATE OF OUR CENTER FOR
INDIGENOUS INNOVATION AND HEALTH
EQUITY.
WE LOOK AT SIMULATOR IN THE
DIFFERENT POPULATIONS.
BUT WE HAVE TO BE THOUGHTFUL
ABOUT KEEPING THAT CASE-BASED
KNOWLEDGE LOCALIZED.
THE EMERGENCE CAME FROM A CROSS
CULTURAL INTERNATIONAL LEARNING
EXCHANGE WHICH IS THE LAST
PICTURE IN MY SLIDE WHERE POKES
FROM HAWAII, OSAGE, CHOCTAW,
CHEROKEE CAME TOGETHER IN HAWAII
AND IMAGINED WHAT THE CCISCOS
LOOKEDS LIKE.
IT'S NOT IN THE BOOKS YET BUT
IT'S EMERGING.
>> HOW DO WE ADDRESS NATIVE
ELDERS AND E ON FOOD KNOWLEDGE,
HOW DO YOU LEVERAGE THEIR
INFLUENCE AND INSIGHT?
>> I CAN SPEAK TO THIS A LITTLE
BIT.
FOR MY RESEARCH, WE HAVE AN
INDIGENOUS NOOJ CIRCLE WHICH IS
A LOT OF OLDERS AND CAN
COUNCILMEMBERS THAT GUIDE MY
RESEARCH.
BASICALLY, I OFTEN REFER TO THEM
TO GUIDE MY RESEARCH.
THEY'RE THE ONE WHOSE GIVE ME
CONNECTIONS OF WHO I SHOULD
REACH OUT TO, WHO ARE THE KEY
KNOWLEDGE HOLDERS IN THE
COMMUNITY.
I THINK IT'S CENTRAL TO HAVE
THAT O LEVERAGE THEIR KNOWLEDGE,
THEIR EXPERIENCES AND THEIR
CONNECTIONS WITHIN THE
COMMUNITY.
THROUGHOUT MY RESEARCH, WE HAVE
INDIGENOUS RESEARCH ASSISTANTS
THAT ARE PART OF THE RESEARCH AT
EVERY STAGE.
THEY'RE PART OF DATA ANALYSIS,
CODEVELOPMENT, ANALYSES AND
WRITING AS WELL.
NOW THAT I'M WORKING ON WRITING
AND PUBLISHING, IT'S HOW QUOWO
DO YOU -- HOW DO I GIVE THEM
AUTHORIZESHIP AND RECOGNITION
FOR ALL OF THEIR CONTRIBUTION TO
THE WORK.
THAT'S HOW I LEVERAGE IT.
>> THANK YOU.
I WANT TO THANK THE PANEL
MEMBERS FOR SHARING YOUR
INSIGHTS IN THIS TOPIC.
THANK YOU TO THE AUDIENCE.
THINK WE NEED TO MOVE ON TO OUR
COOKING DEMONSTRATION.
WE NOW HAVE A BRIEF COOKING
DEMONSTRATION VIDEO FROM OUR
FINAL PRESENTER BRETT O 'TIS.
HE'S A COMMUNICATION PROJECT
MANAGER IN HARVARD, SCOOFL
PUBLIC HEALTH CONSIDER HE LENDS
STRATEGIC SUPPORT TO
INTERVENTIONS INCLUDING THE
WEBSITE NUTRITIONSOURCE.
>> HI, I'M BRETT, I'M A CITIZEN
OF THE OKUNA TRIBE.
THIS I'M HERE WITH MY DAD WHO
TAUGHT ME HOW TO LISTEN FOR THE
PARTICULAR SOUND TO RAKE SCAPE
ALONG A SHELL.
HE IS BETTER THAN I AM.
SOMETIMES WE PULL UP ONES THAT
ARE TOO SMALL.
WE PUT THEM BACK IN.
WE DON'T LIVE ON THE ISLAND.
IT'S BEEN A SPECIAL PLACE OF
CONNECTION FOR ME.
WHEN I LEARNED OUR LANGUAGE'S
WORDS FOR LAND, WATER AND FOOD
CAME FULL CIRCLE.
MY LAND IS ME AND FOOD IS ME.
BACK FROM THE BEACH AND FLOOT
KITCHEN ALTHOUGH TRADITIONALLY
THESE QUAHOGS WOULD HAVE BEEN
COOKED NOT TOO FAR AWAY FROM THE
WATER, STONES WOULD HAVE BEEN
HEATED SO THEY'RE HOTTE.
THERE IS HOCK WOOD SEE WEED AND
STEAM THE QUOHOGS.
WE'RE GOING TO USE A STEAMING
METHOD ON THE STOVE TOP.
I'M USING CORN BEING THE SQUASH
KNOWN AS THE THREE SISTERS THAT
CORN GROWS IN THE CENTER, SQUASH
AROUND THE BASE AND BEANS IN A
SYMBIOTIC RELATIONSHIP WITH EACH
OTHER.
TIME TO GET COOKING.
FIRST THING TO DO IS WASH THE
QUAHOGS.
THEN HE LET THEM SOAK TO RELEASE
THE SAND WHILE PREPARING THE
OTHER INGREDIENTS.
HERE I TAKE THE FRESH CORN ON
THE COB AND SLIPPING OFF THE
KERNELS AND I WILL SAY IT A IT N
ALIVE OIL.
GIVE THEM A STIR IN THE PAN AND
ONCE THE GARLIC IS FRAGRANT, I
ADD THE CORN, BLEND OF SEAWEED
AND OTHER HERBS AND SPICES AND
ADD THE QUOHOGS AND PLACE THEM
ON TOP SO THEY'RE NOD CROWDED.
I SNEAK IN A LITTLE BIT OF WHITE
WINE FOR MORE FLAVOR AND ADDING
VOLUME TO THE STEAMING LIQUID
AND LOATHE IT DO ITS THING.
GIVING EVERYTHING A STIR TO BE
SURE ALL THE SHELLS HAVE OPENED.
ALWAYS BE SURE TO DISCARD ANY
THAT DON'T OPEN.
IT'S LOOKING GOOD.
FOR A FINAL TOUCH, I ADDED FRESH
BASIL SINCE IT'S DOING SO WELL
IN THE GARDEN THIS SUMMER.
NOW TIME TO GIVE IT A TASTE.
DELICIOUS.
SUPER SIMPLE.
YOU CAN TASTE THE OCEAN FROM THE
CLAMS AND CORN IS NICE AND SWEET
AND JUST A SIMPLE QUICK
PREPARATION.
IT CAN BE SERVED OVER PASTA AND
DIPPING BREAD IN IT BUT I'LL
PROBABLY DRINK ARE THE BROTH UP
AFTER I'M DONE WITH THE CLAMS.
THE OTHER COOL THING ABOUT
QUAHOGS IS ONCE THEY'RE DONE,
YOU HAVE A BEAUTIFUL SHELL LEFT
OVER.
YOU ARE SEEK THE PURPLE INSIDE.
WE HAVE A LOT EVER TALENTED
ARTISANS WHO CRAFT BEADS AND
OTHER JEWELRY OUT OF THIS
WAMPUM.
THANK YOU FOR JOINING ME FROM
GETTING THE QUAHOGS.
I ENJOYED SHARING A GLIMPSE OF
THIS PRACTICE THAT IS A
CONNECTION POINT FOR ME AND MY
FAMILY AS WELL AS MY OWN
PERSONAL CONNECTION TO THE LAND
AND GETTING TO ENJOY A FOOD THAT
HAS BEEN CONSUMED FOR AS LONG AS
ANYONE CAN REMEMBER.
SO THAT'S ALL FOR ME.
THTHEINDIGENOUS PEOPLE ARE STIL
HERE.
IT'S GREAT TO SHARE THIS WITH
YOU.
>> HOW INSPIRING.
I WOULD LIKE TO THANK EACH OF
OUR PANELISTS AND TO ALL OF YOU
WHO JOINED OUR FIRST PANEL OF
THE DAY.
I THINK WE ARE A LITTLE BEHIND
TIME AND WE'RE GOING STRAIGHT ON
TO PANEL 2.
AND SO, DR. BLACKMAN CARR, YOU
ARE OUR NEXT MODERATOR.
>> GOOD AFTERNOON AND THANK YOU.
I HOPE EVERYBODY ENJOYED PANEL
1.
I AM DR. BLACKMAN CARR, I'M AN
ASSISTANT PROFESSOR AT THE
UNIVERSITY OF CONNECTICUT WITHIN
THE DEPARTMENT OF HEALTH
SCIENCES.
I FOCUS ON WEIGHT CONTROL
AMONGST BLACK WOMEN BUT I'M ALSO
A REGISTERED DIETICIAN AS WELL
FOR A PASSION FOR EATING WELL,
COOKING AND CERTAINLY A FOCUS ON
HEALTH DISPARITIES AND CULTURE
WITHIN MY WORK.
AS WE -- AS A MODERATE PANEL 2,
WE HAVE A WONDERFUL LINE-UP OF
SPEAKERS WHO WILL HIGHLIGHT
DIETARY INTERVENTIONS TAILORED
TO BLACKS OF DIVERSE
SOCIOCULTURAL EXPERIENCES WITHIN
THE UNITED STATES.
BEFORE WE START, A COUPLE OF
HOUSE KEEG NOTES.
THROUGHOUT THE PRESENTATION FOR
PANEL 2, CERTAINLY THERE WILL BE
A Q&A DISCUSSION PORTION THAT
WILL COME, BUT PLEASE SEND ANY
QUESTION TOTS LIVE FEEDBACK
BUTTON IN THE NIH VIDEO
AND PLEASE TELL US WHO YOU'RE
DIRECTING YOUR QUESTION TO.
I WOULD LIKE TO INTRODUCE DR.
STERLING IS A NUTRITION
SCIENTIST AND FOUNDER AND
DIRECTOR OF VEGGIE AND SOUL.
AND SERVES AS A DIRECTOR FOR THE
PEANUT INSTITUTE.
SHE IS IN THE PREVENTION AND
TREATMENT OF CHRONIC DISEASES.
DR. STERLING WILL START US OFF
WITH PLANT-BASED SOUL FOOD
NUTRITION AND LIFESTYLE
INTERVENTIONS TO IMPROVE
LIFESTYLE RISKS.
>> THANK YOU SO MUCH.
I APPRECIATE THE ORGANIZERS FOR
THE OPPORTUNITY TO BE PART OF
SUCH AN IMPORTANT DISCUSSION.
I'LL BE TALKING ABOUT THE VEGGIE
AND SOUL STUDY?
IS A PLANT-PLACED LIFESTYLE
INTERVENTION TO IMPROVE
CARDIOVASCULAR RISK TO BLACKS
LIVING IN THE DEEP SOUTH.
IN 2019 WHETHER WE STARTED TO
PREPARE FOR THIS WORK, ONE OF
THE THINGS WE QUICKLY RECOGNIZED
WAS THERE IS A WEALTH OF DATA ON
THE HEALTH BENEFITS OF DIETARY
PATTERNS IN THE GENERAL
POPULATION BUT LIMITED RESEARCH
THAT HAD BEEN DONE AMONG BLACK
ADULTS IN A RURAL BLACK BELT
SETTING.
WE SAW THE STUDY WHICH WAS ONE
OF THE PIONEERS OF THE STUDY BUT
WE WANTED TO FOCUS ON THE DEEP
SOUTH BECAUSE THERE WERE HIGHING
RATES OF CHRONIC DISEASES AMONG
BLACKS IN THIS REGION.
ALTHOUGH THERE ARE DIETARY
SHIFTS THAT ARE NEEDED, TIE TRIY
INCLUDED PLANT FOODS.
ONE OF THE THINGS THAT WAS
INTERESTING IS THAT WE SAW THE
TRENTD AMONG BLACK AMERICANS
MOVING TOWARDS MORE
PLANT-CENTERED DIETS AND THAT IS
INCREASING ACROSS THE COUNTRY.
SO WE THOUGHT HOW DO WE
INTERVENE IN A WAY THAT HONOR
CULTURE.
WE CONSIDERED THE CONCEPT I LIKE
TO CALL CULTURAL PALT BILITY.
BEFORE WE GET TO THE THIRD STEP
IN GREEN THAT YOU SEE THERE QUR
WE START TEACHING BEST PRACTICES
RELATED TO PRESERVING AND
ENHANCING THE NUTRIENT DESITY OF
EACH MEAL, WE HAVE TO FIRST
HIGHLIGHT AND SOLE BRAIT THE
RICH FOODS OF THE CULTURE AND
CONSIDER WAYS TO INCORPORATE
THEM WITHIN THE INTERVENTION
WE'RE SEEKING TO DO.
THE VEGGIE AND SOUL WAS A ARE
GRASS ROADS 12 VEHICLE
INTERVENTION TO EMPHASIZE SOUL
FOOD FLAVORS.
IT DID RELY ON ELEMENTS OF
COMMUNITY-BASED FOR RESEARCH AND
FOCUSED ON THESE FOUR ELEMENTS
YOU SEE THERE.
PLANT-BASED NUTRITION, 23EUS PHL
ACTIVITY AND WELLNESS AND
CULTURAL ADAPTABILITY.
NEXT SLIDE, PLEASE.
THE INTERVENTION WAS SET IN
ALBANY GEORGIA WHICH IS
CONSIDERED PART OF THE BLACK
BELT REGION IN THE UNITED
STATES.
WHAT THAT MEANS IS THAT GREATER
THAN 50% OF THE POPULATION
IDENTIFIES AS EITHER BLACK OR
AFRICAN-AMERICAN.
73% OF THE POPULATION IS BLACK,
ONLY 23 IS WHITE.
THE DISPARITIES HERE ARE
PALPABLE BECAUSE WE SEE THE HIGH
RATES OF CHRONIC DISEASE AS
AMONG BLACKS AND LIMITED ACCESS
TO MEDICAL CARE BUT NUTRITION
FOODS IN MANY NEIGHBORHOODS.
THAT'S ONE OF THE REASONS WE
WERE GRATEFUL TO HAVE THE
SUPPORT OF THE SPONSORS LISTED
BELOW.
SO, THE INTERVENTION INCLUDED
WEEKLY VIRTUAL EDUCATIONAL
CLASSES, SUPPORT GROUPS THAT
CAME IN THE SUPPORT OF HEALTH
LEADERS IN THE COMMUNITY AND
Facebook GROUPS WHERE PEOPLE
COULD SHARE WITH EACH OTHER.
THAT WAS A KEY PART OF THE
INTERVENTION.
PARTICIPANTS RECEIVED WEEKLY
PLANT-BASED MEALS FROM A LOCAL
RESTAURANT START-UP, PRODUCE
BOXES FROM A LOCAL GARDEN AND
MEAL PLANS.
WE DID CONDUCT SURVEYS.
THIS WAS A GRASSROOTS MODEL.
HERE YOU CAN SEE IF YOU GO BACK
ONE SLIDE, SO HERE YOU CAN SEE A
FEW SNIPPETS OF ONE EVER OUR
WEEKLY CLASSES.
A LOCAL COMMUNITY PASTOR DR. THE
DEMONSTRATIONS FOR THE LESSONS
AND THERE WAS EXERCISE
DEMONSTRATION WITH PARTICIPANT
ENGAGEMENT TOE END EVER THE
CLASS.
ONE THING THAT IS NOT SHOWN HERE
IS ONE OF THE HEALTH LEADERS HAS
A PRODUCTIVE FARM IN THE AREA
AND WHAT HE DID WAS HE TAUGHT
PARTICIPANTS HOW TO PLANT FOODS
LIKE BLUEBERRIES IN THEIR OWN
SPACES.
HERE IS A LOOK AT WHAT OUR CHEF
TAUGHT COOKING CLASSES LOOKED
LIKE.
ON THE TOP LEFT YOU'LL SEE A
RECIPE FOR CRAB CAKES.
ON THE BOMB OM RIGHT IS A RECIPE
FOR BUFFALO.
IT WAS ONE OF OUR PARTICIPANTS
FAVORITES.
HERE YOU CAN SEE A PICTURE MUCH
WEEKLY FOOD BOXES AND RECIPES
THAT PARTICIPANTS RECEIVED.
WE TRIED TO COORDINATE THE
RECIPE CARDS THEY GOT WITH THE
KIND OF PRODUCE WE GOT.
ON THE WEEK THEY GO COLLARD GRES
THEY COULD REPLACE IT WITH
SOMETHING ELSE.
LET'S TALK ABOUT THE RESULTS.
THERE WERE 24TH PARTICIPANTS IN
THE HIGHLIGHT AND 92% WERE
WOMEN.
THE AVERAGE AGE WAS 43.
WE DID SEE ANG EVEN SPREAD AMONG
INCOME AND EDUCATIONAL LEVELS.
A THIRD OF ALL PARTICIPANTS
DEMONSTRATED SOME LEVEL EVER
FOOD INSECURITY ADDS MEASURED BY
THE SURVEY.
IN TERMS OF DIETARY BEHAVIORS,
WE FOUND THAT SELF-REPORTED FOOD
AND WHOLE GRAIN CONSUMPTION
DOUBLED BY 12 WEEKS AND
VEGETABLE CONSUMPTION INCREASED
BY 90% AND A SIGNIFICANT
REDUCTION IN LIMITS TO LIMIT
SUCH AS CHOLESTEROL AND ADDED
SUGARS.
PARTICIPANTS REDUCED THEIR
CAFFEINE INTAKE.
WE THINK IT MAY HAVE A
CORRELATION WITH ADDED SUGARS IN
THE COULD HOTTER.
COHORT.
THERE WAS IMPROVEMENT IN TERMS
OF CONFIDENCE TO PREPARE AND
SHOP FOR NUTRITION FOOD ITEMS IN
THE GROCERY STORE.
BODY MASS INDISPEKS WAIST
CIRCUMFERENCE WERE DECREASED AND
LDL REDUCED AND INFLAMMATORY
MARKERS WAS REDUCED BY 25%.
AT THE BEGINNING OF THE
INTERVENTION, WHAT YOU SEE HERE
IS WE USE A VALIDATED
QUESTIONNAIRE TO ASK PEOPLE TO
AGREE OR EXPWREE TO THE
FOLLOWING STATEMENT.
AT BASELINE THERE WAS AN EVEN
SPREAD ON AGREEING OR
DISAGREEING.
ED .AT THE END, YOU'LL SEE THAT%
OF PARTICIPANTS AGREED OR
STRONGLY AGREED WITH THE
STATEMENT BY THE END OF THE
PROGRAM.
THE PROGRAM WAS HIGHLY RATE ADD
AMONG PARTICIPANTS AND HAD AN
AVERAGE EVER 93 PANE DANCE.
93 ATTENDANCE.
THEY SAID THAT THE TOP
MOTIVATORS WERE THE EDUCATIONAL
LESSONS AND FOOD BOXES AND THEY
HIGHLY RATED THE MEALS AND
RECIPES THEMSELVES.
WE ACKNOWLEDGE THAT THERE WERE
SOME LIMITATIONS WITHIN THE
CONTEXT OF THIS PILOT.
IN TERMS OF NOT HAVING A
RANDOMIZED SAMPLE AND USING
24-HOUR DIETARY RECALLS.
SOME UNIQUE CHALLENGES INCLUDED
THE ENVIRONMENTAL CONDITIONS.
THAT
WAY HINDER THE ADOPTION OF
HEALTHY DIETARY PATTERNS.
ONE OF THE THINGS WE THINK IS A
UNIQUE STRENGTH OF THIS PROGRAM
IS BEING ABLE TO LIVE IN THE
COMMUNITY THAT WE SERVE ON LOCAL
LEVEL.
I CAN'T EMPHASIZE HOW POWERFUL
THAT WAS BECAUSE IT HELPED US TO
FOSTER TRUST NOT ONLY AMONG THE
PARTICIPANTS THEMSELVES, BUT IT
HELPED US BUILD AN INTEGRAL
NETWORK ACROSS VARIOUS COMMUNITY
PARTNERS.
AND THESE NETWORKS HAVE ALLOWED
US TO CONTINUE OUR WORK IN
VARIOUS WAYS THROUGH MONTH-LONG
COOKING CLASSES, LIFESTYLE 34ED
SIN HEALTH CARES AND OTHER
EVENTS DESIGNED TO NOT ONLY
RAISE AWARENESS BUT TEACH
HEALTHY LIFESTYLE HABITS AND
SKILLS AND WE HOPE TO HAVE MORE
TO BUILD UPON THE WORK THAT
WE'VE BEEN ABLE TO DO.
I WANTED TO END BY ACKNOWLEDGING
THE VJY AND SOUL STAFF, THE
STUDENTS, INTERNS, THE COMMUNITY
LEADERS, SPONSORS AND ALL THE
PARTICIPANTS WHO MADE THIS WORK
POSSIBLE.
>> THANK YOU SO MUCH DR.
STERLING FOR A REALLY EXCELLENT
PRESENTATION.
THOSE RESULTS ARE VERY
ENCOURAGING.
I LOOK FORWARD TO THE Q&A AND
THE QUESTIONS THAT WILL COME
REGARDING YOUR WORK.
NOW I WOULD LIKE TOTION
TRANSITION TO THE SECOND
PANELIST.
NEXT PRESENTATION IS BY NICOLE.
COMMUNITY-BASED PARTICIPATORY
APPROACH TO IDENTIFY FACTORS
AFFECTING DIET FOLLOWING
MIGRATION FROM AFRICA.
SHE'S A STUDENT IN PUBLIC HEALTH
AT THE UNIVERSITY OF CALIFORNIA
SAN DIEGO.
AND SAN DIEGO STATE UNIVERSITY
WHERE SHE WORKED WITH DR. SHERYL
ANDERSON.
IN HER WORK, SHOO CLAB -- SHE
COLLABORATES TO CATER TO UNDER
SERVED AND UNDERREPRESENTED
COMMUNITIES.
>> THANK YOU.
HI, EVERYONE.
LIKE SHE MENTION, I'M 234EU COAL
A PhD. STUDENT, THE PRIMARY
VECTOR FOR THE STUDY.
MY P MY APOLOGIES FOR THE SOUND
OF MY VOICE.
SO, THE OBJECTIVE OF THIS STUDY
WHICH IS THE HAWASH PILOT STUDY
FOCUSING ON VEGETABLES AND HERBS
FOR HYPERTENSION USED TO PROVIDE
KEY INSIGHTS FROM COMMUNITY
MEMBERS AS WELL AS KEY
INFORMANTS FOR THE BARRIERS AND
OPPORTUNITIES FOR IMPROVEMENT OF
DIETARY QUALITY FOR THIS
POPULATION.
OUR POPULATION OF INTEREST IS
EAST AFRICAN AND SUBSAHARAN
IMMIGRANTS LIVING IN SAN DIEGO.
WE CREATED A IMPACT AND DECREASF
SALT, SUGAR, DIETARY FAT AND
OTHER FACTORS.
I QUO LIKE TO START BY
ACKNOWLEDGING AND GIVING A BOIG
SHOUT OUT TO OUR EXCELLENT
COMMUNITY PARTNER, UNITED WOMEN
OF EAST AFRICA.
WE WOULD NOT BE ABLE TO DO THIS
WITHOUT THEM.
THE BACKGROUND OF THIS WORK
COMES FROM UNDERSTANDING THE
ROLE OF ACCULTURATION AND
NUTRITION TRANSITION FOR MANY
IMMIGRANTS, SNOT ONLY SUB SA
WHAT HAREN AND EAST AFRICAN
IMMIGRANTS COMING TO THE UNITED
STATES BUT PEOPLE MAY LEAVE
THEIR COUNTRY WHERE THEY HAVE A
HIGH FRUIT AND VEGETABLE INTAKE
AS WELL AS WHOLE AND UNREFINED
GRAINS.
AS THEY COME TO THE UNITED
STATES, WE SEE A SHIFT IN
DIETARY QUALITY AND
CARDIOMETABOLIC FACTORS.
SO MAYBE THE SHIFT TO WESTERN
DIET AND SOME OF THE LIMITED
ACCESS TO THEIR FOODS MIGHT
RESULT IN FRUITS AND VEGETABLES
TO THE FORM THEY'RE USED TO.
THEY'RE MORE EXPENSIVE THAN
BEING ABLE TO ACCESS SOMETHING
MORE AFFORDABLE TO END UP BEING
HIGH ENERGY AS WELL AS
PROCESSED.
OFTEN WE SEE THE IMPACT OF THE
NUTRITION TRANSITION ON
IMMIGRANTS ALL OVER WHO COME TO
THE U.S. THAT THERE IS AN IMPACT
ON THEIR CARDIOMETABOLIC HEALTH
FOR THIS REASON.
WHAT WE AIM TO DO IS INCREASING
THE WAYS THAT WE'RE -- WHAT WE
AIM TO DO IS ACTUALLY MITIGATE
THE IMPACT OF THE NUTRITION
TRANSITION BY BEING ABLE TO
PROVIDE AN INTERVENTION TO ALLOW
CONTINUED HEALTH AFTER
IMMIGRATION TO THE UNITED
STATES.
AS WE KNOW, IMMIGRATION IS THE
CONTINUED PARTICIPANT OF LIFE IN
THE UNITED STATES AND THIS GROUP
OF IMMIGRANTS, PARTICULARLY
SUBSAHARAN AND EAST AFRICAN
IMMIGRANTS ARE INCREASING BY AS
MUCH AS 200 PERCENT WITHIN THE
LAST DECADE.
WE SEE AN INCREASE IN THIS
GROUP.
IT'S IMPORTANT TO DESIGN
INTERVENTIONS THAT WOULD BE ABLE
TO IMPROVE THOSE DIETARY
OUTCOMES AS THEY COME TO THE
UNITED STATES.
OUR MECHANISM OF ACTION THAT
WE'VE CHOSEN IS THE USE OF
SPICES AND HERBS.
MY ADVISER STARTED BY CONDUCTING
A TRIAL STARTING AT JOHNS
HOPKINS AS WELL AS CONTINUING
THE WORK HERE AT UC SAN DIEGO
THAT AIMED AN EFFICACY APPROACH
TO PARTICIPANTS BEING PROVIDED
WITH A CONTROLLED AMOUNT OF FOOD
THAT SHOWED THE RECOMMENDATIONS
THAT WE'RE SUPPOSED TO HAVE.
IT WAS LOW IN SE SODIUM AND
MIMICKED WHAT WE WANTED PEOPLE
TO BE ABLE TO EAT AND THE AMOUNT
OF SODIUM WE WOULD WANT THEM TO
EAT.
AFTER THAT, THE PARTICIPANTS
WERE SPLIT INTO THE INTERVENTION
AND CONTROL WHERE THE
INTERVENTION WAS PROVIDED WITH
GROUP COUNSELING AS WELL AS THIS
EMPHASIS ON SPICES AND HERBS
WHILE THE CONTROL WAS GIVEN
GROUP COUNSELING AND TOLD TO
STAY IN A LOW SODIUM DIET.
THEY FOUND A DRASTIC INCREASE
FOR URINARY SODIUM.
THIS WAS A WESTERN POPULATION.
THE QUESTION IS, WHAT LESSONS
CAN WE LEARN FOR A GROUP THAT
ALREADY HAS HIGH SPICE USE?
NEXT SLIDE.
SO SOME OF THE WORK THAT WE
BEGAN TO CONDUCT WITH
ORGANIZATIONS LIKE UNITED WOMEN
OF EAST AFRICA IS ASKING THE
COMMUNITY WHAT WOULD YOU NEED IN
AN INTERVENTION IN ORDER TO HELP
YOU START TO FOLLOW THE
RECOMMENDATIONS AS WELL AS
INCREASE THE A. KNOWLEDGE THAT
COULD CHANGE THE LEVEL OF ACCESS
THAT YOU HAVE?
SO WE DESIGNED AN ITERATIVE
APPROACH.
STARTING FROM THE LEFT SIDE OF
THE SLIDE, WHERE WE'RE DOING THE
FORMATIVE EVALUATION AND
ACTUALLY CONTINUING FROM WHAT
WAS ALREADY DONE IN 2016 HERE IN
SAN DIEGO WITH THIS POPULATION
ALREADY.
WE'LL CONDUCT FOCUS GROUP AND
GROUP INTERVIEWS INTERVIEWS ANDY
INFORMANTS AS WELL AS USING THE
LEARNINGS DIRECTLY INTO THE
INTERVENTION DESIGN.
AFTER THAT, AS YOU MOVE TO THE
RIGHT SIDE OF THE SLIDE, WE'LL
BE DOING AN ELIGIBILITY
SCREENING AND TESTING THAT
INTERVENTION THAT WE WOULD HAVE
CREATED USING THE LEARNINGS THAT
WE GET FROM THE FOCUS GROUP.
IT WILL BE A SIX-WEEK
INTERVENTION O TRY IT.
SEE ANY AREAS OF ADAPTATION AND
FOUR WEEKS LATER DO A FOLLOW-UP.
OUR OUTCOMES ARE RANGING FROM
EVERYTHING TO DO WITH
HYPERTENSION, AND BLOOD PRESSURE
AND YOU' URINARY SODIUM AND OTHR
FACTORS SUCH AS OVERWEIGHT, TYPE
II DIABETES AND HIGH
CHOLESTEROL.
OUR STUDY POPULATION INCLUDES
KEY INFORMANTS, PEOPLE WHO
WORKING WITH THIS POPULATION
WHETHER IT'S IN THE HEALTHCARE
SECTOR, COMMUNITY ORGANIZERS AND
GRASSROOTS ORGANIZERS AS WELL AS
PEOPLE IN THE FOOD INDUSTRY
MAYBE RESTAURANT OWNERS AND
GROCERY STORE OWNERS, SMALL
STORE OWNERS THAT INTERFACE WITH
THIS POPULATION STARTING TO SEE
WHAT TRENDS WE CAN FIND FROM
TRENDS.
AND THEN OF COURSE, THE
POPULATION ITSELF WHERE IF
YOU'LL NOTICE, WE'RE INCLUDING
PEOPLE WHO HAVE HYPERTENSION AND
PREHYPERTENSION AS WELL AS
PEOPLE IMHOF A FAMILY EVER
HYPERTENSION.
SOME OF THE BEAUTY OF THIS
DESIGN IS WE ARE ALLOWING THE
COMMUNITY TO ACTUALLY INFORM
WHAT EXACTLY IS GOING TO BE PART
OF THIS INTERVENTION.
SOME OF THE KEY THINGS THAT
WE'RE FOCUSING ON SU CULTURAL
RELEVANCE.
HOW IS THIS RELEVANT TO YOU.
HOW IS THIS ADAPTABLE FOR YOU?
WHAT CAN WE HELP WITH.
IT'S HIE HIGH POT TH HYPOTHESIS.
WE KNOW THEY ARE HIGHLY
INTERESTED IN HOME COOKING.
IT'S ALSO AN ITERATIVE DESIGN
WHERE WE AIM TO ADAPT AND ADJUST
AS WE GO AND OFFERING DIFFERENT
LANGUAGES AND PROVIDING CULTURAL
HUMILITY TRAIN TRAINING AND BEIE
TO FOR OUR TEAM TO EVER A
PROCESS PIECE WHERE WE'RE
MEETING THE COMMUNITY WHERE THEY
ARE.
VARIOUS OPPORTUNITIES COME OUT
IN THIS WORK.
OUR METHODOLOGY IS BOTH WHERE IT
IS UNDER-STUDIED BUT IN ADDITION
THAT PROVIDES US THE OPPORTUNITY
TO ADJUST AND ADAPT AS WE WORK
WITH ORGANIZATIONS AS WELL AS
THIS COMMUNITY.
ON A NATIONAL LEVEL, WE'RE
STARTING TO RUN INTO DATABASES S
THAT DO NOT INCLUDE FOODS FROM
THE POPULATION OF INTEREST AND
HOW DO WE CREATE A BODY OF WORK
THAT WOULD END UP INFORMING
SYSTEMS SO THEY CHANGE THIS AND
THEY'RE ALSO CHANGING MORE
FREQUENTLY HOW MANY FOODS ARE IN
THESE DATABASES AS WELL AS
BUILDING CAPACITY FOR RESEARCH.
LOCALLY OF COURSE WE HAVE
LANGUAGE AND CULTURAL TAILORING
AS WELL AS THIS A HETEROGENOUS
GROUP.
IF YOU HAVE RESOURCES, THAT'S
GREAT BUT IF YOU DON'T, WHAT CAN
YOU DO TO MEET THE POPULATION
WHERE THEY ARE AND WHAT GAPS
EXIST WHEN PEOPLE ARE NOT ABLE
TO DO THIS WORK EFFECTIVELY.
THAT'S THE WORK THAT WE'RE DOING
AT LEAST IN SAN DIEGO SCLD THANK
YOU VERY MUCH -- AT LEAST FROM
SAN DIEGO, THANK YOU VERY MUCH
FOR HAVING ME.
>> THANK YOU, NICOLE FOR YOUR
PRESENTATION.
I LOOK FORWARD TO THE
DISCUSSION.
I WOULD LIKE TO TRANSITION TO
OUR NENGS PRESENTATION BY DR.
CARMEN SAMUEL HODGE SPEAKING ON
THE INTERVENTION AND
MEDITERRANEAN DIE OAT ADAPTED
FOR SOUTH EASTERN UNITED STATES
POPULATION.
DR. HODGES SERVES FOR DISEASE
PREVENTION AND SERVES IN A RURAL
ACADEMIC HEALTH DEPARTMENT.
>> THANK YOU.
GOOD AFTERNOON, EVERYONE.
IN THE NEXT 10 MINUTES, I WILL
TELL YOU ABOUT THE MED-SOUTH
PROGRAM WHICH PROMOTES A
MEDITERRANEAN PATTERN ADAPTED
FOR THE SOUTHEASTERN POPULATION.
MY MAIN ROLES HAVE BEEN IN
CONDUCTING COMMUNITY-BASED
REARCH AND TRAINING COUNSELORS
TO DELIVER THE FINDINGS TO ADULT
AND CHANGING EATING HABITS.
THE MED-SOUTH PROGRAM AND
SOUTHERN STYLE CULTURAL
ADAPTATIONS THAT BLEND THE
MEDITERRANEAN DIET AND I'LL
SUMMARIZE OUR FINDINGS FROM
THREE STUDIES DEVELOPED IN NORTH
CAROLINA.
MED-SOUTH IS A FOUR MONTH
PROGRAM WITH SENGSES FOCUSED ON
DIETARY CHANGES.
IT INCLUDES BRIEF PHONE CALL
THOSE CHECK IN WITH PARTICIPANTS
ON THE PROGRESS.
THE PROGRAM MATERIALS INCLUDE A
PARTICIPANT MANUAL THAT COVERS
INFORMATION, RECOMMENDATIONS AND
PRACTICAL STRATEGIES OR TIPS FOR
MAKING CHANGES IN DIETARY AND
PHYSICAL ACTIVITY BEHAVIORS.
THE MANUAL HIGHLIGHTS DIETARY
HABITS IN THE SOUTHWEST AND
TAILORED TO THOSE PEOPLE WHO
LACK ACCESS TO EXERCISE
FACILITIES.
MED-SOUTH INCLUDES A MAJOR
DIETARY FOCUS TO IMPROVE FAT AND
CARBOHYDRATE QUALITY AND IS
CLOSE TO THE MEDITERRANEAN DIE
OAT.
THERE IS A COOKBOOK THAT
INCLUDES RECIPES FROM THE
SOUTHEASTERN U.S.
PARTICIPATE MANUAL AND COOKBOOKS
ARE AVAILABLE IN ENGLISH AND
SPANISH AND WE HAVE A MED SOUTH
CHECKLIST WHICH IS A FULL
LISTING OF THE RECOMMENDATIONS
FROM ALL FOUR SESSIONS TO BE
USED AS A REMINDER FO PARTICIPAS
TO PUT ON THEIR REFRAIJ RAIRTS.
RAIRTS -- REFRIGERATES.
THIS IS WRITTEN IN A
CONVERSATIONAL TONE, THE READING
LEVEL IS BETWEEN THE 5TH AND 6TH
GRADE.
THERE IS AN ASSESSMENT OF
CURRENT EATING HABITS FOLLOWED
BY BACKGROUND INFORMATION AND
TIPS AND GOALS.
BRIEF ASSESSMENT ALLOWS THE
COUNSELOR TO TAILOR THE
COUNSELOR AND THE TIPS GIVE
PARNTS IDEAS ON HOW TO MAKE
IMPROVEMENTS IN EACH OF THE
ASSESSMENT AREAS.
NO MORE THAN TWO GOALS ARE SET
AT EACH SESSION AND TRACKING OF
PROGRESS HAPPENS BETWEEN
SESSIONS.
THE FOUR LESSONS ARE IN THE
ORDER EVER THE GREATEST
POTENTIAL TO REDUCE RISK FOR
CHRONIC DISEASES.
LESSON ONE STARTS WITH NUTS,
OILS, DRESSINGS AND SPREADS.
IT PROVIDES HEALTHY FATS.
LESSON TWO TARGETS VEGETABLES,
FRUITS, WHOLE GRAINS AND GREEN
BEANS.
HEALTHY CASHES NEEDS THE MOST
WORK AMONG AMERICANS.
LESSON THREE IS DRINKS, DESSERTS
AND SNACKS AND INTAKES NEED TO
BE REDUCED TO MEET DIETARY
RECOMMENDATIONS.
LESSON FOUR IS FISH AND POULTRY
AND EGGS AND WE FOCUS ON
INCREASING THE INTAKE OF FISH
AND REDUCING PROCESSED MEATSES.
DR. ALICE ZELLERMAN HAS LED THE
PARTICIPATION.
THE APPROACH TO ADAPTATIONS IS
TO ENCOURAGE THE MEDITERRANEAN
PATTERN TO THE CULTURALLY FOODS
OF THE POPULATION EVER INTEREST.
IT EMPHASIZES REGIONAL BEVERAGES
AND LOCAL FAVORINGS.
ADDING VEGETABLES TO DISHES LIKE
HUSHPUPPIES AND BARBECUE AND
INCLUDING SMALLER AMOUNTS OF
PROTEINS OR MEATS IN MIXED
DISHES.
IMPORTANT TO ALL ADAPTATIONS IS
HAVING THE ADAPTIVE RECIPES,
TASTE TESTED FOR AK
SEPTEMBERABLE BY COMMUNITY
MEMBERS.
THE AIM FOR THE RECIPES IN THE
COOKBOOK IS TO KEEP THE RECIPES
SIMPLE AND USE COMMONLY
AVAILABLE FOODS THAT ARE NOT
EXPENSIVE.
MED-SOUTH CAN BE DELIVERED IN
MANY FORMATS, INDIVIDUALLY,
GROUP KF PHONE, WEB-BASED AND
COMBINATION MORE MATS.
OUR APPROACH TO COUNSELING IS TO
HAVE CONVERSATIONS GROUNDED IN
ADULT LEARNING THEORY AND
MOTIVATIONAL INTERVIEWING
PRINCE.
THE BRIEF ASSESSMENT AT EACH
SESSION ALLOWS THE TAILOR OF THE
COUNSELING TO HIGHLIGHT THE
RECOMMENDED LEVEL AND WORK ON
WHAT COULD OR SHOULD BE
IMPROFFERRED.
BEHAVIORAL CHANGE STRATEGIES ARE
USED IN GOAL SETTING, ACTION
PLANNING, SELF MONITORING OF
BEHAVIORS AND PROVIDING FEEDBACK
ON PROGRESS.
THESE ARE SOME OF OUR RESEARCH
FINDINGS.
THE HEART TO HEALTH TESTED THE
MED-SOUTH PROGRAM.
IT SHOVED 385 PRIMARY PATIENTS
WITH THE MEAN AGE OF 63 YEARS.
HALF WERE FEMALE AND 24% WERE
ARCKEN AMERICANS.
AFRICAN-AMERICANS.
ONE GROUP RECEIVED ACCOUNT
PROGRAM BY COUNSELOR, IN-PERSON
OR BY PHONE EXT OTHER GROUP
WEB-BASED.
IT INCLUDES FOUR MONTHLY
SESSIONS AND THREE SHORT
SESSIONS FOR A 12 MONTH STUDY
PERIOD.
AT FOUR AND 12 NONTS, THERE WERE
SIGNIFICANT -- MONTHS THERE WERE
SUSTAINED RESULTS IN THE CSD
RISK.
WITH GREATER REDUCTION NOTICE
COUNSELOR ARM AT FOUR MONTHS.
BLOOD PRESSURE AND CHOLESTEROL
LEVELS ALL IMPROVED IN BOTH
GROUPS.
NEXT SLIDE, PLEASE.
FOLLOWING THE H THE HEART TO HEH
STUDY, WE STUDIED IN COMMUNITY
HEALTH EXPERNTS LOCAL HEALTH
DEPARTMENT IN MORE RURAL AND
UNDER-SERVED POPULATIONS.
HEART HEALTHY WAS CONDUCTED IN
LLENORE COUNTY.
WE ENROLLED 339 PARTICIPANTS.
6 OF 767% WERE FEMALE, 65% WERE
AFRICAN-AMERICAN AND THE
MED-SOUTH PROGRAM WAS DELIVEREDS
IN-PERSON, INDIVIDUAL, OR GROUP
SESSIONS AND FOLLOW-UP MEASURES
WERE COLLECTED AT SIX MONTHS.
WE SAW IMPROVEMENTS IN BLOOD
PRESSURE, DIETARY AND PHYSICAL
ACTIVITIES AND BEHAVIORS IN THIS
STUDY.
NEXT STUDY IS CHANGE WHICH
STANDS FOR CAROLINA, HEART LINES
FOR GREATER EQUITY.
THIS WAS DELIVERED BY COMMUNITY
HEALTH WOU WORKERS AND LOCAL HEH
DEPARTMENTS IN TWO
AFRICAN-AMERICAN COUNTIES WITH
HIGH RATES EVER POVERTY.
IN THIS STUDY WE HAD 360 PARNTS
AND WE OBSERVED MEANINGFUL
REDUCTIONS IN BLOOD PRESSURE AND
IMPROVEMENTS IN DIETARY AND
PHYSICAL ACTIVITY BEHAVIORS.
CURRENTLY WE'RE LOOKING TO STUDY
MED-SOUTH IN TERMS OF LOOKING AT
SCALING UP THE PROGRAM BY
FOCUSING ON IMPLEMENTATION AND
DELIVERY EFFECTIVENESS.
WE'VE INVOLVED 19 SITES, 300
PARTICIPANTS AND TRAINED THE
STAFF SITE FOR THE PROGRAM.
WE HAVE A SMALL SUBSAMPLE OF
SPANISH SPEAKING PARTICIPANTS.
THESE ARE THE GAPS AND
OPPORTUNITIES.
WHAT WE KNOW IS NEARLY 60% OF
ADULT AMERICANS HAVE AT LEAST
ONE CHRONIC DISEASE AND
TREATMENT OF CHRONIC DISEASES IS
A SIGNIFICANT DRIVER EVER
HEALTHCARE COSTS.
WHILE INVESTMENTS IN CHRONIC
DISEASE PREVENTION AND CONTROL
CAN SAVE LIVES AND DOLLARS, ONLY
A SMALL FRACTION SUPPORTS
PREVENTION AND HELP APPROXIMATES
PROMOTION.
MORE RESEARCH IS NEEDED ON
SYSTEM -- NEEDED AT THE SYSTEM
LEVEL TO IDENTIFY HOW PREVENTION
AND HEALTH PROMOTION PROGRAMS
FIT INTO THE SYSTEM AND HOW TO
INFLUENCE POLICYMAKERS TO INVEST
MORE IN STATE AND NATIONAL
ORGANIZATIONS TO ADDRESS CHRONIC
DISEASE PREVENTION.
IN TERMS OF OPPORTUNITIES, THERE
IS NOW AN INTEREST IN TESTING
AND USE OF FOOD AS MEDICINE SUCH
AS HEALTHY FOOD PRESCRIPTIONS.
IN APPROACH, THE IDEA IS TO SEEK
INTERVENTIONS INTO HEALTHCARE
WITH THE UNDERSTANDING THAT
THESE EFFORTS SHOULD BE
PARTNERED WITH A LARGER MOVEMENT
TO IMPROVE HEALTH AND FOOD
SYSTEMS.
AND THEN FINALLY, ANOTHER AVENUE
FOR IMPROVING THE USE EVER
PROGRAMS LIKE MED-SOUTH TARGETS
COMMUNITY CONNECTIONS.
HERE THE FOCUS IS ON SUPPORTS
FOR PRIME DISEASE MANAGEMENT
WHERE THERE IS MISTRUST OF THE
HEALTHCARE SYSTEM.
THANK YOU.
>> MANY THANKS TO ALL OF YOU FOR
YOUR PRESENTATIONS TODAY.
WE NOW ARE INTO OUR Q&A PORTION
WHERE I INVITE QUESTIONS FROM
THE AUDIENCE.
AS A REMINDER, IF YOU HAVE
WHICHS, INDICATE WHO YOUR
QUESTION MIGHT BE FOR AND YOU
CAN SUBMIT THAT FEEDBACK VIA THE
LIVE FEEDBACK BUTTON IN THE NIH
VIDEO CAST.
I WOULD LIKE TO KICK OFF A FIRST
QUESTION DIRECTED TO ALL SPECIAL
IF YOUR RESEARCH HAS INCLUDED
SOME SOCIAL MEDIA ASPECT.
WHAT WILL ARE YOUR THOUGHTS AND
ANYBODY CAN HAND THIS WILL
QUESTION.
WHAT WERE YOUR THOUGHTS ABOUT
THE USE OF SOCIAL MEDIA DURING
INTERVENTION TO INCREASE
COMPLIANCE TO THE INTERVENTION?
>> I GUESS I CAN START.
SO WE DID USE SOCIAL MEDIA QUITE
A BIT.
AND IT WAS ONE OF THE ELEMENTS
THAT OUR PARTICIPANTS NOTED AS
ONE MUCH THEIR TOP MOTIVATORS TO
REMAIN ENGAGED.
ONE OF THE REASON NARS IT WAS
ORGANIC.
IT WAS -- WE EVEN HAD SOME
FRIENDLY COMPETITION WITHIN THE
SOCIAL MEDIA SPACE WHERE PEOPLE
WANTED TO KIND OF SHOW WHAT THEY
WERE MAKING AND HOW MUCH THEY
WERE ENGAGING IN PHYSICAL
ACTIVITY AND OTHER LIFESTYLE
MEASURES.
I THINK IN TERMS OF COMPLIANCE,
IT WAS DEFINITELY KEY AND ALSO
BECAUSE COMMUNITY IS SUCH AN
INTEGRAL PART OF BLACK CULTURE
SPECIFICALLY WITHIN THE SOUTH, I
THINK THAT SOCIAL MEDIA PROVIDED
THAT SPACE FOR THE SUPPORT.
>> FOR MY SOFA, WE HAVE NOT
ENTERTAINED USING SOCIAL MEDIA
YET.
THATHAT WOULD ALLOW US TO TARGEA
YOUNGER POPULATION.
RIGHT NOW MUCH OF OUR
PARTICIPANTS ARE MID AGE OR
OLDER.
BUT WE KNOW FROM SOME OF OUR
SEPTEMBER BACCEPTABILITY YOU ARS
THAT PEOPLE ARE ASKING FOR ON
LINE TYPE ENGAGEMENT AND APPS.
>> AND WE'VE BEEN USING SOCIAL
MEDIA RIGHT NOW IN THE CAPACITY
OF RECRUITMENT.
WE'VE BEEN USING BOTH WATTS APP
AND RECRUITMENT.
WHAT WE DO HERE FROM AW SEAS
THAT THEY'RE CONNECTED AND THERE
IS AN OPPORTUNITY FOR CONTINUING
TO CONNECT WITH PARTICIPANTS
THROUGH WATTS APP AS THE
INTERVENTION IS GOING.
>> I HAVE A POINTED QUESTION FOR
DR. STERLING.
ONE OF THE QUESTIONS WAS
REGARDING THE SAMPLE THAT YOU
WORKED WITH FOR YOUR
INTERVENTION.
WERE THE PARTICIPANTS LIVING
WITH DIABETES OR PREDIABETES
THINKING ABOUT WHAT THEIR BODY
MASS INDEX MAY HAVE BEEN AT THE
OUT SET OF STUDY.
>> GREAT QUESTION AND WITHIN 10
MINUTES I DIDN'T HAVE THE CHANCE
TO GO THROUGH THAT.
70% OF PARNTS WERE EITHER
PREDIABETIC OR DEBETTIC.
WE DID SEE RESULTS TRENDING
TOWARDS A DECREASE IN HEEM
GLOBEN A-1-C BUT WE HAD A SMALL
START-UP SAMPLE.
>> NEXT QUESTION FOR YOU DR.
STERLING, HAVE YOU FOLLOWED UP
WITH PARTICIPANTS POST STUDY AND
WHAT WERE THE RESULTS?
>> WE FOLLOWED UP AT SIX MONTHS
AND DID A SURVEY AND
ENCOURAGINGLY -- SURPRISINGLY --
WHAT WE SAW WAS THAT THEIR
SELF-REPORTED FRUIT AND
VEGETABLE INTAKE REMAINED
CONSISTENT IN 12 WEEKS.
SEESAW THAT THEIR CONCEPTIONS
WERE PLANT-BASED PATTERNS
APPEARED TO REMAIN AND 94% SAID
THEY WERE STILL HAVING MORE OF A
PLANT-CENTERED APPROACH.
THE MOATCATION CONTINUED TO BE
THERE.
I WILL SAY EVEN FOLLOWING UP
BEYOND IS THAT, BECAUSE WE LIVE
WITHIN THE COMMUNITY, ONE OF THE
THINGS WE HEAR IS THAT PEOPLE
WANT MORE SOCIAL SUPPORT.
I THINK THAT'S ONE OF THE MAIN
BARRIERS AND CHALLENGES THAT WE
HAVE.
>> SOCIAL SUPPORT CONTINUES TO
BE A REL VANTD TOPIC WITHIN THIS
SPACE AND OTHER RESEARCH
INTERESTS.
THANK YOU FOR THAT.
SAMUEL HODGE, ONE OF THE
QUESTIONS FROM THE AUDIENCE IS
REGARDING FOLLOW-UP.
WERE THERE ANY FOLLOW-UP STUDIES
TO MED-SOUTH WHERE YOU WERE ABLE
TO OBSERVE LONG TERM CHANGES
WITH PARTICIPANTS LIFESTYLE
CHANGES?
>> SO TO DATE WE ONLY HAD ONE
STUDY OF THE TWO-YEAR PERIOD.
THAT STUDY HAD MULTIPLE PROGRAMS
INVOLVED IN IT.
IT STARTED OUT WITH LIFESTYLE
AND A WEIGHT LOSS PROGRAM
INTEGRATED, THEN THERE WAS THE
HYPERTENSION CONTROLLED PROGRAM.
ALL OF THOSE MERGED TOGETHER
AMONG SOME PARTICIPANTS.
BUT WE SEE THAT THE BEHAVIORS
HOLD OVER TIME AND THE REASON
FOR THAT IS WE -- PARTICIPANTS
CHOOSE WHAT THEY FEEL THEY CAN
SUCCESSFULLY CHANGE.
THE THINGS THAT WE'RE SUGGESTING
ARE FAMILIAR WITH THEM AND THEY
FEEL COMFORTABLE MAKING THOSE
CHANGES BECAUSE THEY PRACTICED
DOING THEM OVER TIME.
WE FOUND THAT THE BEHAVIORS
HOLD.
>> THANK YOU FOR THAT.
THAT IS AN ENCOURAGING SIGN.
IN THINKING ABOUT INTERVENTIONS,
FOR YOU, STILL, DR. SAMUEL
HODGE, CAN YOU TALK ABOUT
CHALLENGES IN IMPLEMENTS
MED-SOUTH AND SIMILAR PROGRAMS
WITHIN COMMUNITY HEALTH CENTERS?
>> YES.
HOW WELL I KNOW THE CHALLENGES!
OUR PRIMARY HEALTH DELIVERY
SYSTEMS, THE WORK FLOWS THAT ARE
PRESENT DON'T REALLY ALLOW FOR
PREVENTION AND PROMOTION
PROGRAMS TO FIT VERY NEATLY.
IN ADDITION TO THE FUNDING
ISSUE, IT IS -- SITES TALK ABOUT
HOW TO GET PARTICIPANTS TO SHOW
UP WITHOUT INCENTIVIZING THEM
AND THEY TALK ABOUT STAFF TO BE
ABLE TO ACTUALLY DELIVER THESE
PROGRAMS.
AND MANY OF OUR HEALTHCARE
ORGANIZATIONS DON'T HAVE STRONG
PARTNERSHIPS WITH
COMMUNITY-BASED ORGANIZATIONS
THAT CAN HELP WITH DELIVERING
SOME OF THESE INTERVENTIONS.
THIS COMES DOWN TO WHO WILL PAY
FOR IT.
THAT'S THE BOTTOM, THE CORE OF A
LOT OF THE CHALLENGES TO
IMPLEMENTATION.
ALL OF THE SITES THAT WE LOVE
THIS PROGRAM AND WOULD LOVE TO
BE DOING IT, WE DON'T HAVE THE
WHEREWITHAL TO DO IT.
THERE IS A LOSS OF STAFF THROUGH
THE COVID PERIOD AND WE HAVE A
LOT OF FOLKS LEAVING PUBLIC
HEALTH.
THERE ARE CHALLENGES IN THE
WORKFORCE OF HEALTH.
>> THANK YOU FOR THAT.
I THINK THIS NEXT QUESTION THAT
CAME IN CERTAINLY SPEAKS TO YOUR
INTERVENTION, BUT I THINK IT'S
APPLICABLE ACROSS O OUR
PANELISTS CURIOUS OF CHALLENGES
IN TERMS OF ACCESSIBILITY OF THE
MED TRAIN CABBIAN OR OTHER
PLANT-BASED DIE OATS.
WHAT CHALLENGES HAVE YOU
ENCOUNTERED IN TERMS OF
ACCESSIBILITY IN THE DIETARY
PATTERNS THAT ARE BEING PROMOTED
THROUGH YOUR WORK?
>> I THINK THE WORK THAT WENT
INTO DEVELOPING THE ADAPTATIONS
INVOLVES COMMUNITY MEMBERS ALL
LONG THE WAY.
WHEN WE TEST ACCEPTABLE, WE FIND
IT'S HIGH.
WHAT IS MORE IMPORTANT THAN THE
FOOD ITSELF IS THE ENGAGEMENT
WITH THE COUNSELORS BECAUSE WE
REALLY EMPHASIZE BUILDING A
RELATIONSHIP WITH THE
PARTICIPANT NOT TEACHING THEM,
KRVETION AROUND BEHAVIOR
CHANGES.
THAT MAKES THEM FEEL MORE
COMFORTABLE IN MAKING CHANGES.
THE OTHER PIECES MANY OF THEM
HAVE HEARD ABOUT A MEDITERRANEAN
DIET, BUT WHEN THEY SEE
MED-SOUTH, THEY CAN SEE
THEMSELVES IN IT.
SO THAT'S THE COMMENTS THAT
WE'VE GOTTEN BACK FROM PARNTS IN
PARTICIPANT, BEFORE THEY DIDN'T
THINK THE PROGRAM WAS FOR THEM,
ESPECIALLY RURAL PARNTS.
PARTICIPANTS.
BUT THEY FEEL COMFORTABLE WITH
IT AND THEY FIND, OKAY, I FEEL
MORE H EFFICACIOUS AND I CAN DO
THIS.
THAT'S THE RESPONSES WE'VE
GOTTEN.
>> AND I WOULD ECHO THAT.
I THINK THAT'S SORT OF WHAT WE
FOUND AS WELL.
I THINK YOU SAID IT SO WELL.
PEOPLE HAVE HEARD ABOUT IT SO
WE'RE -- ALBANY GEORGIA IS
SOUTHWEST, IT'S CLOSER TO
FLORIDA BUT NOT TOO FAR FROM
ATLANTA AND THERE WERE
PLANT-BASED RESTAURANTS POPPING
UP THERE.
PEOPLE HAVE HEARD ABOUT PLANT
BASE AND WANT TO TRY IT.
WHEN THEY SEE THE WAYS IN WHICH
WE ARE TEACHING IT OR THE
CONVERSATIONS THAT WE'RE HAVING
AROUND IT JUST LIKE WE SAID
BEFORE, THEY SEE THEMSELVES IN
IT AND THEY'RE WILLING TO TRY
IT.
>> I FEEL THIS AL PLIES TO YOU
DR. KRANGO.
HOW IS ACCESSIBILITY IN TERMS OF
YOUR POPULATION?
>> WITH OUR TARGET POPULATION,
WHICH IS PEOPLE EAST AFRICAN --
FROM THE EAST AFRICAN REGION,
THERE HAS BEEN FROM THE
QUALITATIVE DESIGNS FROM BEFORE
AND WITH DISCUSSION NOW, THERE
IS HIGH SOAPT BILITIES OF
PLANT-BASED FOODS BECAUSE THAT
IS OFTEN PART OF THEIR
TRADITIONAL DIE OAT.
WHEN YOU THINK OF EVEN THE
VARIOUS SIDE DISHES THAWR
INCLUDE -- DISHES THAT ARE
INCLUDED, IT'S EASY IN THIS
POPULATION TO HAVE A DISCUSSION
ABOUT PLANT BASED FOODS BUT WE
WANT TO HAVE A DISCUSSION ABOUT
THE WAYS THAT PROTEIN CAN BE,
WHY THOSE PLANT-BASED FOODS ARE
STILL IMPORTANT IN A DIE OAT AND
TALKING ABOUT PROTEIN AND THERE
IS PROTEIN IN VEGETABLES AS
WELL.
IT MIGHT BE MORE OF A KRCHTION
ABOUT THE FUNCTIONALITY AS WELL
OF PLANTS AND PLANT-BASED DIET
OUTSIDE FOR FLAVOR OR ESTHETIC
OR THE CRUNCH THAT THERE IS ALSO
ADDITIONAL FUNCTIONAL PROPERTIES
THAT WE CAN TALK THROUGH MANY,
MANY WAYS.
AT LEAST IN OUR POPULATION OF
INTEREST, AND THERE IS HIGH
SEPTEMBER BILITY FOR THE
PLANT-BASED -- SOAP BIL ACCEPTAR
THE PLANT-BASED DIE OAT.
>> WHAT KIND OF STRATEGIES ARE
HELPFUL IN TERMS OF RECRUITING
YOUR TARGET POPULATION.
SOMETIMES WORKING IN HEALTH
DISPARITIES, MANY OF THE
COMMUNITIES WE WORK WITH ARE
CHARACTERIZED AS HARD TO REACH.
WHAT ARE YOUR SUCCESSFUL
STRATEGIES?
>> WHEN I HIGHLIGHTED UNITED
WOMEN OF EAST AFRICA, IT WAS
UNDERSTATED AS OUR STAR IN BEING
ABLE TO CONNECTS TO THE
COMMUNITY.
WHAT WE'VE DONE IS DONE SORT OF
A RANDOMIZED POPULATION IN THAT
UNITED WOMEN OF EAST AFRICA,
THERE ARE PEOPLE THAT COME AND
ATTEND SERVICES THERE, BUT
THEY'RE ALSO A FACET OF THE
COMMUNITY THAT PEOPLE FOLLOW AND
GET NEWS FROM OR UPDATES ON WHAT
IS HAPPENING IN THE COMMUNITY OR
AND WHAT PROGRAMS ARE AVAILABLE.
IT'S NOT A CONVENIENT SAMPLE IN
THAT WE'RE MEETING PEOPLE WHO
ARE ACTUALLY INSIDE, BUT THROUGH
SOCIAL MEDIA WE'RE MEETING WITH
PEOPLE WHO DON'T NECESSARILY
INTERACT DIRECTLY WITH UNITED
WOMEN OF EAST AFRICA.
WE HAVE A SEMI-CONVENIENT SAMPLE
BASED ON THE FACT THAT EVERYONE
IS CONNECTED TO THIS
ORGANIZATION AND IT'S BRINGING
THE COMMUNITY TOGETHER.
THAT'S HOW WE'VE BEEN ABLE TO
RECRUIT FOR OUR STUDY.
WE'RE ALSO LOOKING INTO
ADDITIONAL WAYS THAT WE CAN
FURTHER REACH OUTSIDE OF THE
PEOPLE WHO ARE NOT ATTACHED TO
UW EAST IN ANY WAY AS WELL AS
CHURCHES AND OTHER COMMUNITY
ORGANIZATIONS WHERE WE GATHER
AND ARE IN COMMUNITY WITH EACH
OTHER.
WE'RE REALLY GOING AS FAR AS WE
CAN.
ALSO UNDERSTANDING THAT THIS IS
A PART OF POPULATION IN SAN
DIEGO.
SO OUR REACH IS NOT GOING TO BE
SUPER HIGH, BUT THE IMPACT WILL
BE THERE.
>> THANK YOU SO MUCH AND FOR
LANDING ON IMPACT AS A KNOW ALL
OF YOUR RESEARCH HAS THAT.
AGAIN, I WANT TO THANK ALL OF
YOU PANEL MEMBERS FOR SHARING
YOUR INSIGHTS ON THIS IMPORTANT
TOPIC.
FOR THE NEXT VIDEO, WE'LL HAVE A
COOKING DEMONSTRATION.
SHE IS FAMOUS FOR HER COOKING
CLASSES.
IN THIS VIDEO, SHE'LL HIGHLIGHT
HER ORGANIZATION SOUL FOOD MY
PLATE AND DEMONSTRATE A COOKING
DEMONSTRATION.
37 WELCOME TO ADVANCE BEING
HEALTH WE CANITY TO ADDRESS --
>> WELCOME TO ADVANCE HEALTH.
THE IMPORTANCE EVER CULTURALLY
AND LINGUISTICALLY WELLNESS
MESSAGES CANNOT BE OVERSTATED
ESPECIALLY WHEN IT COMES TO
COMBATING CHRONIC DISEASES.
THESE DISEASES ARE OFTEN FUELED
BY LIFESTYLE FACTORS HAVE
REACHED ALARMING LEVELS
GLOBALLY.
IMAGINE A SOCIETY THAT HEALTH
MESSAGES ARE TAILORED TO
RESONATE WITH EVERY COMMUNITIER
AND EMPOWERMENT TRANSCENDS BEAR
YORES.
THOUGH BECOME RELATABLE AND
COMPELLING.
PEOPLE ARE MORE LIKELY TO
LISTEN, ABSORB AND ACT UPON
INFORMATION THAT ACKNOWLEDGE
THEIR HERITAGE AND SPREECT AND
IDENTITY.
THAT'S IMPORTANT.
A NUTRITION PLAN INSPIRED BY
TRADITIONAL DIETS AND EXERCISE
ROUTINES THAT HONOR CULTURAL
PRACTICES.
THEY'RE NOT ONLY EFFECTIVE BUT
CELEBRATE THE BEAUTY OF
DIVERSITY.
THIS IS WHY WE CREATED OUR CULT
LCONSULTANTS, WE DEVELOP HEALTH
INFORMATION IN PEOPLE'S NATIVE
LANGUAGES AND ENSURE THAT VITAL
INSIGHTS IS ACCESSIBLE TO
EVERYONE.
THIS PAVES THE WAY FOR INFORMED
DECISIONS, HEALTHIER CHOICES AND
ULTIMATELY A REDUCED BURDEN OF
CHRONIC DISEASES.
WE DEVELOPED THE SOUL FOOD PLATE
IN OUR PRACTICE IN ORDER FOR
DIETICIANS TO MEET PEOPLE WHERE
THEY ARE.
EMBRACING CULTURAL AND
LINGUISTIC DIVERSITY ISN'T JUST
AN OPTION, IT'S A NECESSITY.
IT'S A PATH TO FOST SHALLING A
HEALTHIER SOCIETY WHERE HEALTH
KNOWS NO CULTURAL BOUNDS AND
KNOWLEDGE TRANSFORMS LIVES.
LET'S HAVE THIS OPPORTUNITY TO
PURSUE WELL-BEING AND LEAD THE
CHANGE TOWARDS A FUTURE WITH
FEWER CHRONIC DISEASES.
ANY 2011, I IMMEDIATELY WENT TO
OUR TEAM AND SAID WE REALLY NEED
TO FOCUS ON THE SOUL FOOD
PYRAMID TRANSITIONS OVER TO A
SOUL FOOD PLATE.
IT HAS WORKED REALLY WELL BALLS
THEY SEE THEMSELVES IN THIS
PARTICULAR HANDOUT.
WE FOCUS ON LABEL READING AND WE
TEACH PORTION CONTROL ALONG WITH
THE PLATE AND A SPOON SO THEY
CAN GET IT RIGHT NOT ONLY HERE
IN FRONT OF ME, BUT REPEAT THE
MESSAGES EVEN AT HOME.
LET'S GO IN THE KITCHEN AND
COOK.
>> WONDERFUL.
THANK YOU ALL AGAIN FOR JOINING
OUR PANEL AND I HOPE YOU FOUND
THAT VIDEO ENJOYABLE.
THANK YOU TO OUR EXPEERKS
AUDIENCE MEMBERS FOR THE GREAT
QUESTIONS.
AND THOUGHT PROVOKING QUESTIONS
AS WELL.
WE'LL NOW MOVE TO PANEL THREE
AND I WILL TURN IT OVER TO DR.
HEATHER GREENLY, THE MODERATOR
FOR THIS NEXT SECTION.
THANK YOU.
>> HELLO EVERYBODY AND THANK YOU
RONIECE.
I WANT TO THANK THE ORGANIZERS
AT NHLBI AND NCI FOR THIS
WORKSHOP.
IT'S A TRUE HONOR TO PARTICIPATE
HERE.
I'M WITH THE FRED HUTCHISON
CANCER CENTER AND HEAD DIRECTOR
WITH WITH THE CLINICAL PROGRAM
HERE.
I HAVE A BILINGUAL WEBSITE TO
PROVIDE EVIDENCE-BASED
NUTRITIONAL INFORMATION TO
CANCER PATIENTS AND CAREGIVERS
ACROSS THE GLOBE AND SERVES AS A
PLATFORM FOR INTERVENTION FOR
CANCER PATIENTS.
WE'LL HIGHLIGHT MIGRATION AND
ACCULTURATION AMONG DIVERSE
HISPANIC AND LATINX COMMUNITIES.
THROUGHOUT THE PRESENTATION AND
THROUGHOUT THE Q&A DISCUSSION
SEND QUESTIONS AND LET US KNOW
WHICH PANELIST YOU'RE DIRECTING
YOUR QUESTION TO.
TODAY WE'LL BEGIN WITH THE FIRST
PRESENTATION ENTITLED CULTURE
FOOD FACTORS.
DR. FEUSER IS AT TULANE SCHOOL
AND HAS A PhD. IN FOOD POLICY
AND HER RESEARCH EXAMINES THE
CONTEXTUAL FOCUS ON LATIN
AMERICAN COMMUNITIES AND
DIASPORA.
WELCOME DR. FUFUSTER.
>> THANK YOU.
NEXT SLIDE.
THANK YOU FOR THE INTRODUCTION
AND FOR THE INVITATION.
IT'S AN HONOR TO BE HERE.
MY AIM FOR THIS TALK IT IS TO
OPEN THE SESSION BY UNDERSCORING
THE DIVERSITY WITHIN LATIN BE
AMERICAN COMMUNITIES AND PROVIDE
INSIGHTS ON HOW TO APPROACH SUCH
DIVERSITY WHEN DESIGNING
INTERVENTIONS BASED ON MY
RESEARCH.
MY GOAL IS TO PUSH US TO MOVE
BEYOND JUST CULTURE TO CONSIDER
STRUCTURAL FACTORS SUMP AS RACE,
GENDER, INCOME AND OTHERS AND
MOVER TO INDIVIDUAL BEHAVIOR
CHANGE TO THINK MORE ABOUT
ENVIRONMENTAL BASED CHANGES.
I WILL END MY PRESENTATION BY
PRESENTING SOME OF MY WORK.
WORK
AIMING TO DO THAT.
ECHOING OUR OPENING SESSION, I
WANT TO START BY REMINDING US
THAT LATIN AMERICA AS A REGION
IS QUITE DIVERSE WITH SUCH
DIVERSITY STELLING FROM UNIQUE
HISTORIES AND GEOPOLITICAL
SITUATIONS.
THIS RESULTS IN NOT ONLY
DISTINCT PRACTICES BUT DIFFERENT
MIGRATORY TRAJECTORIES AND
HEALTH OUTCOMES IN THE STATES.
THE STUDY OF LATINOS PROVIDE
EVIDENCE OF THIS.
HERE YOU CAN SEE THAT FOR
EXAMPLE THOSE OF HISPANIC
CARIBBEAN ANCESTRY, PARTICULARLY
PUERTO RICANS IN THE BLUE DOTTED
LINE, LEAD THE CHARTS WHEN IT
COMES TO MANY PRESSING HEALTH
DISPARITY SUCH AS HEART DISEASE,
OBESITY, DIABETES AND
DEPRESSION.
THESE FINDINGS, I BELIEVE, MERIT
FURTHER EXPLANATION.
I WANT TO REMIND YOU PUERTO
RICANS ARE U.S. CITIZENS, IN
THEORY, THESE CITIZENSHIP
PROVIDE ADVANTAGES TO LIFE IN
THE STATES.
AS WE -- I AM PUERTO RICAN, WE
DO NOT HAVE TO CONTEND WITH THE
LEGAL ASPECTS OF BEING AN
IMMIGRANT.
BUT AS YOU BE SEE THIS IS NOT
RESULTING IN BOATER HEALTH
OUTCOMES.
IN MY RECENT WORK, I SOUGHT TO
DIG DEEPER AS TO WHY THIS WAS
THE CASE.
THIS WORK IS SUMMARIZED IN MY
BOOK WHERE I EXAMINED THE CASE
EVER PUERTO RICANS IN NEW YORK
CITY ALONGSIDE FELLOW CUBANS.
THIS IS RESEARCH ALONGSIDE
PUBLIC HEALTH, NUTRITION,
HISTORY, MIGRATION STUDIES AND
SOCIAL SCIENCE TO EXAMINING HOW
LOCAL AND GLOBAL CIRCUMSTANCES
HAVE SHAPED AND PRESENTING
RESULTS IN DISIRCHG THE U.S.
THIS IS IN NEW YORK CITY BUT
CONCLUDES WITH A LOOK AT
COMMUNITIES IN OTHER LOCATIONS
IN THE STATES.
THE CONTEMPORARY SITUATION IN
CARIBBEAN AND IMPLICATION FOR
OTHER GROUPS.
I ALSO WANTED TO HIGHLIGHT THAT
THE BOOK INCLUDES COMMON FOODS
AND SPANISH TERMS USED FOR THE
FOODS TO BENEFIT YOU WORKING
WITH THE COMMUNITIES.
HERE ARE SOME BRIEF ACHE AWAYS
FROM THIS WORK.
FIRST, I THINK THAT WE NEED A
BETTER UNDERSTANDING OF CULTURE.
WHEN I EXAMINE HOW OUR FIELD,
PUBLIC HEALTH, NUTRITION ADDRESS
LATIN AMERICAN COMMUNITIES, I
SHOWED HOW THERE IS CONTRASTING
THE CULTURE AS BOTH THE COST AND
SOLUTION FOR DIETARY PROBLEMS.
THAT IS, THERE WAS A PERCEPTION
OF CULTURAL PRACTICES BEING
DESCRIBED SOMETIMES AS UNHEALTHY
AND ON THE OTHER HAND, THERE WAS
A VIEW THAT WE NEED TO PRESERVE
THE TRADITIONAL PATTERNS AS
SOLUTIONS FRPT PROBLEM.
SOLUTIONS FOR THE PROBLEM.
I UNDERSCORE TRADITIONAL FOOD
PRACTICES AND I SEE AN IDEAL OIK
VIEW OF FOOD WASTE IN THE
CARIBBEAN.
OUR FOOD WASTES ARE BECOMING
MORE PROCESSED AND COMPLEX
INCLUDING ADDITIONS FROM OTHER
CULTURAL FOOD WASTE.
THEREFORE, WE NEED TO RE-THINK
VIEWS OF DIETARY ENCU CULL TRAI.
CULTURATION.
WE NEED TO ADDRESS THE INFLUENCE
OF STRUCTURAL FACTORS NAMELY
RACE, CLASS, GENDER ANDING MY
ANDMIGRATION.
THESE CAN FACILITATE AND HINDER
ACCESS TO FOOD AND BOATER LIVING
CONDITIONS.
THESE ARE INFLUENCED BY BROAD,
POLITICAL, ENVIRONMENTAL
CONDITIONS INCLUDING BACK TO THE
BIG VIEW ABOUT GLOBAL FORCES
THAT INFLUENCE THE MIGRATORY
FLOWS.
A SECOND TAKE AWAY IS THAT
HERITAGE FOODS ARE NOT ALWAYS
HEALTHY OR PREFERRED.
SOME I INTERVIEWED PERCEIVED
TRADITIONAL DIETS AS UNHEALTHY
AND DISANSD THEMSELVES FROM
THEIR HERITAGE SCHOOLS.
THESE WERE REFLECTED IN
DESCRIBING HE THEIR MEALS AS TOO
STARCHY AND POOR PEOPLE FOODS.
THIS WAS MOSTLY THE CASE AMONG
HUMANS AND I LEAN TO THE
NONEXISTENT RELATIONSHIP MOAMS
OF THE COMMUNITY HAVE WITH CUBA.
WE CANNOT ASSUME FOOD PREFERENCE
BASED ON ANCESTRY.
HOW WE EAT IS INFLUENCED BY HOW
WE LEFT OUR HOME COUNTRY NOTICE
FIRST PLACE AND THE RESULTING
SITUATION THAT WOVE BACK TO THAT
COUNTRY OF ORIGIN OR HERITAGE.
WE NEED TO EVER STRUCTURAL
FOCUS.
AS PART OF THIS, WE NEED TO
THINK ABOUT FOOD ENVIRONMENTS
AND SOCIAL NORMS AS IMPORTANT IN
SHAPING PERCEPTIONS OF DIETS AND
THE RESULTING FOOD PRACTICES.
NEXT SLIDE, PLEASE.
WITH THIS, FOLLOWING THIS TAKE
AWAY, I WANTED TO BRIEFLY SHARE
MY CURRENT FOCUS HOW IT MASS
SHIFTED FROM THAT INDIVIDUAL
FOCUS TO ADDRESSING MORE FOOD
ENVIRONMENT WORK.
AND SPECIFICALLY THROUGH LATIN
AMERICAN RESTAURANTS AS PART OF
MY INITIAL CAREER DEVELOPMENT
AWARD.
WHY RESTAURANTS?
ASIDE FROM THE INCREASING
IMPORTANCE OF FOODS AWAY FROM
HOME, MY EMPHASIS ON RESTAURANT
IS INSPIRED BY A RECOGNITION OF
THESE ESTABLISHMENTS AS AGENTS
TO MAKE A HEALTHIER CHOICE NOT
ONLY THE EASY ONE THAT PEOPLE
HAVE ACCESS TO, BUT ALSO THE
DESIRED ONE WHICH ARE TWO
DIFFERENT THINGS.
IN ADDITION, RESTAURANTS CAN
SERVE AS THE ECONOMIC POINT TO
MANY IMMIGRANT COMMUNITIES
MAKING FOOD BUSINESSES KEY FOR
ECONOMIC DEVELOPMENT EFFORTS AND
CONTRIBUTING TO FOOD ACCESS.
IN THIS WORK, I HAVE BEEN USING
THE DESIGNED THINKING TO TURN
CHALLENGES INTO OPPORTUNITIES
FOR COMMUNICATION.
WE NEED TO HAVE EMPATHY AND USER
EXPERIENCE AT THE CENTER.
FOCUSING ON INNOVATION AND
CREATIVITY TO DEVISE NEW
SOLUTIONS TO WHAT IS COMPLEX
PROBLEMS SUCH AS HEALTHIER
EATING IN RESTAURANTS AS PLACES
THAT ARE ORPHAN ASSOCIATED WITH
INDULGENCE AND NOT LEGALITY.
HERE I SHOW TWO CH TWO EXAMPLESE
CHALLENGES PRESENTED.
WE HAVE TWO OTHER CHALLENGES AT
THE RESTAURANT LEVEL AND WE ARE
NOW MOVING IN NEW ORLEANS TO SEE
HOW WE CAN ENGAGE LOCAL
RESTAURANTS AND RELATED TAKE
HOLDERS TO FIND INNOVATIVE
POLICY-LEVEL SOLUTIONS TO
FACILITATE CHANGE.
NEXT SLIDE.
BACK TO TODAY'S TOPIC, I WANT TO
BRING IT BACK TO MY MAIN
TAKE-AWAYS.
LET AS ENGAGE WITH CULTURE AND
THE COMPLEXITY.
THINK OF NOT JUST PLACE EVER
ANCESTRY BUT EVERYTHING ELSE
THAT MAKES YIDITE.
IDENTITY.
BASED ON AGE, JENTER INCOME AND
RACE.
WE ENCOUNTER THAT HERE IN THE
STATES AND FOLLOW FOLLOWING UP Y
CURRENT WORK, LETS' LEARN MORE
YOJTD THE INDIVIDUAL.
FINDING NEW WAYS TO ADDRESS
CHANGES AND RESEARCH AT THE
COMMUNITY OR ORGANIZATIONAL
POLICY AND ALSO CONTEXTUAL
LEVEL.
AND NEXT SLIDE, FINAL SLIDE, AND
WITH THIS, I WANT TO CLOSE.
I'M INCLUDING MY e-MAIL AND
YOU CAN REACH OUT.
THANK YOU SO MUCH FOR LISTENING.
I LOOK FORWARD TO THE NEXT
PRESENTATION AND DISCUSSION.
>> WONDERFUL.
THANK YOU FOR THAT PRESENTATION.
NEXT PRESENTATION IS BY DR.
SONYA VEGA LOPEZ FOR SOCIALLY
ACCEPTABLE SOLUTIONS.
SHE'S A MEMBER OF ARIZONA STATE
UNIVERSITY.
SHE'S A BILINGUAL AND BI
CULTURAL RESEARCHER.
>> THANK YOU VERY MUCH.
I'M HONORED TO BE PART OF THIS
PANEL.
NEXT SLIDE, PLEASE.
I WOULD LIKE TO ACKNOWLEDGE THAT
I'M ON THE INTIJ NEWSPEOPLE THAT
ALLOWS FOR THIS WORK TO BE
CONDUCT.
THIS WAS FUNDED BY THE NATIONAL
INSTITUTE FOR HEALTH DISPARITIES
AND NATIONAL INSTITUTE OF AGING
AND HEART ASSOCIATION AND.
OUR CENTER IS LOCATED IN THE
SOUTHWESTERN UNITED STATES AND
TO THE SOUTH BORDER OF MEXICO.
OUR LOCATION BRINGS UNIQUE
CHARACTERISTICS UNIQUE FOR
DIETARY INTERVENTION WORK.
IT IS CONCENTRATED IN THE
SOUTHERN PART OF THE STATE
INCLUDING THE TOWN ASKS
METROPOLITAN AREAS.
ACCORDING TO THE RECENT U.S. SEN
TELL US DATA, 19% OF THE U.S.
POPULATION IS HISPANIC.
BUT IN ARIZONA 32.5% OF THE
POPULATION IS HISPANIC OF WHICH
89% ARE OF MEXICAN ORIGIN.
WITH THE BARS ON THE RIGHT SIDE,
THE PERCENTAGE INCREASES WITH
GREATER ACCESS TO THE BORDER.
THEY HAVE DISADVANTAGED
SOCIOECONOMIC CONDITIONS WITH
LOWER LEVELS OF EDUCATION, HOME
OWNERSHIP AND HEALTH INSURANCE.
THEY'RE MORE LIKELY TO LIVE IN
OVERCROWDED HOUSEHOLDS.
20% OF HAS PANIC HOUSEHOLDS IN
ARIZONA LIVE BELOW THE POVERTY
LINE AND 27% ARE CONSIDERED LOW
INCOME.
WHEN THINKING ABOUT DIETARY
INTERVENTION AMONG HISPANICS WE
START WITH THE NOTION OF
MIGRATION PEOPLE ADOPT DIETARIAL
HABITS ALIGNING WITH THE
MIGRATION.
BUT IT'S NOT AS MARKED AS IT WAS
WHEN THIS STUDY EMERGED.
EVEN OUR PROXIMITY NOT ONLY TO
THE BORED WELCH MEXICO BUT
ARGUMOTHERAREAS LIKE CALIFORNIA.
NEXT SLIDE.
HOWEVER, IT'S ALSO IMPORTANT TO
CONSIDER THAT POLITICS WITHIN
MEXICO NOW HAS [INDISCERNIBLE]
AND ALSO SOME OF WHAT ARE
CONSIDERED AMERICAN FOODS HAVE
BEEN CULTURALLY ADOPTED TO
MEXICAN STYLE.
THE EU8 STRAITS THAT THE FOOD
CONTEXT IS MORE FLUID STHAN IT
EVER IT WAS.
THIS SLIGHT ILLUSTRATES THE
TRADITIONAL FOOD IN THE AREA.
HISPANICS IN ARIZONA AR --
HISPANICS LIVE WITH LESS ACCESS
TO SUPERMARKETS AND THE ONE ON
THE RIGHT SUGGEST THAT THESE
HAVE GREATER ACCESS O
RESTAURANTS.
THIS ILLUSTRATES THE BARRIERS TO
HEALTHY EATING IN ARIZONA.
THE FOOD ENVIRONMENT AND
CONDITIONS WHICH ARE TIED WITH
COMPETING PRIORITIES AND HAVING
OTHER RESPONSIBILITIES.
ADDITIONAL CONTEXTUAL FACTORS
ARE PUBLIC TRANSPORTATION IN
AREAS THAT SPAN OVER LONG
DISTANCES AND WEATHER MAKES IT
IMPOSSIBLE TO SHOP OR AFFORD.
WHEN ADOPTING INTERS VENGS WORK,
IT'S IMPORTANT TO CAP STALLIZE
ON FACTORS THAT FUNCTION ON
FACILITATORS INSTEAD EVER
BARRIERS.
ILLINOFOR EXAMPLE, HISPANICS HAE
DISMOJ MOTIVATION TO HAVE A
HEALTHY DIE OAT.
THIS IS AN EXAMPLE OF A
DESCRIPTION OFFER A 7TH GRADE
GIRL THAT EMPHASIZED EATING WELL
TO AVOID HEALTH ISSUES SHE SEES
IN HER FAMILY.
NOT ALL TRADITIONAL FOODS MAY BE
PERCEIVED AS HEALTHY OPTIONS,
BUT IT'S IMPORTANT TO
ACKNOWLEDGE THAT MEMBERS OF THE
HISPANIC COMMUNITY RECOGNIZE
THERE ARE MANY TRADITIONAL
CUISINES ARE HEALTHY.
NEXT SLIDE.
THEIR ROLE AND IMPORTANCE OF
HAVING THE FAMILY STRUCTURE IS
AN IMPORTANT MECHANISM FOR
HEALTHY EATING.
A MIDDLE-AGED MAN SHARED
LEARNING FROM HIS DAUGHTER AND A
7TH GRADE BOY RECOGNIZED HIS
PARENTS AS ROLE MODELS FOR
HEALTHY EATING.
GIVEN THE MULTI-LEMRIN THE NEXTL
BRIEFLY PROVIDE EXAMPLES OF
INTERVENTION THAT HAS INCLUDED
SOME OF THESE MULTI-LEVEL BE
FACTORS.
NEXT SLIDE.
FOR EXAMPLE, THE LEETS FOR LIFE
PROGRAM, THIS WAS A PHYSICAL
ACTIVITY FOR FAMILIES WITH
MIDDLE SCHOOL AGED CHILDREN.
MOST EVER THE NUTRITION CONTENT
WAS PROVIDED TO THE PARENTS
TRYING TO FOCUS ON HOME FOOD
ENVIRONMENT.
NOT ONLY BEHAVIORS.
WE OBSERVED FAVORABLE AND
AVAILABILITY OF FRUIT AND SUGAR
ITEMS AFTER INTERVENTION.
THEY ARE FROM RANDOMIZED TRIALS
SHOW COMPARABLE RESULTS.
NEXT SLIDE.
ANOTHER APPROACH WE HAVE USED
FOCUSES ON TARGETING PARENTING
SKILLS AS A MEANS TO PROMOTE
HEALTHY EATING.
WE ADOPTED A 10-WEEK
INTERVENTION DESIGNED TO TARGET
SUBSTANCE ABUSE PREVENTION IN
MIDDLE SCHOOL STUDENTS AND
TARGETED THIS TO BEHAVIORS.
THESE OPERATED THE PLAZA
INTERVENTION WAS IN TRIAL
COMPARED AGAINST TRADITIONAL
INTERVENTION.
A AND IN ADDITION TO THE
PARENTING SKILLINGS AND PROBLEM
SOLUTIONS ADOPTED VERSION FOR
INFORMATION AND CONSENT RELATED
AROUND HEALTH.
THESE ARE JUST SOME OF THE
RELEVANT FINDINGS THAT INCLUDES
BOTH PARENTS ASK THEIR CHILDREN
IN THE GROUPS TO INCREASE FRUIT
INTAKE, VEGETABLE INTAKE.
PARENTS ALSO INCREASED THEIR
WHOLE GAINS INTAKE.
WHOLE GRAINS INTAKE.
I WANT TO SPEND THE FINAL COUPLE
OF MINUTES FOR INTERVENTION.
IT'S IMPORTANT TO GO BEYOND JUST
TRANSLATING INTO SPANISH TO MAKE
HERE IS IT'S TARGETING THE
POPULATION.
THIS MEANS HAVING RELATABLE
SAMPLES AND USING THE CORRECT
TERMINOLOGY.
RECOMMENDATIONS MUST BE KEPT
SIMPLE.
IT INCLUDES TO INCLUDE LANGUAGE
AND EDUCATION AND NOT MAKING
COMPLICATED SUGGESTION.
PREACHING FOOLDIT'S IMPORTANT FS
EXISTING POSITIVE TRAITS DIETARY
BEHAVIORS INCLUDING TRADITIONAL
FOODS.
WE NEED TO ENGAGE MULTIPLE
FAMILY MEMBERS AND OTHER SOURCES
EVER SOCIAL SUPPORT.
FINALLY INTEGRATE
RECOMMENDATIONS THAT INCLUDE THE
BROADER CONTEXT OF THE TARGETED
SOCIETY.
FINALLY RESEARCH GAPS.
WE SHOULD CONTINUE TO HAVE
EDUCATION AND INTERVENTION.
I WILL EMPHASIZE THAT THE
CONTEXTUAL FACTORS SHOULD BE
INTEGRATED IN THE INTERVENTION
PROGRAMS.
THEY CAN INCLUDE FAMILY MEMBERS
SUPPORT FOR DIETARY CHANGE.
THE RESEARCH INVOLVES
UNDERSTANDING HOW PEOPLE BREAK
CULTURAL CONSIDERATIONS IN
NUTRITION AND HOW TO ENSURE THAT
ACCESS TO POSITION-HELD
STRATEGIES ARE ATTAINABLE AND
WHAT ARE THE COMPONENTS TO
EXISTING INTERVENTIONS TO
CONTRIBUTE TO INTERVENTION.
WITH THAT, I THANK YOU FOR YOUR
ATTENTION AND I'M HERE IF THERE
ARE ANY QUESTIONS.
THANK YOU SO MUCH.
>> WONDERFUL.
THANK YOU DR. VEGA LOPEZ.
THAT WAS TERRIFIC.
NEXT PRESENTATION IS ENTITLED
BEE YAIF I DON'T RECALL DISEASES
IN LATINX COMMUNITIES.
DRSHE LESSONS HER EXPERTISE FROM
ENGAGEMENT AND BEHAVIORAL
SCIENCE TO ADDRESS DIABETES,
DEPRESSION AND CANCER.
>> THANK YOU SO MUCH FOR THAT
INTRODUCTION AND THANK YOU FOR
THE ORGANIZERS FOR INCLUDING ME
IN THIS WONDERFUL WORKSHOP.
I'VE BEEN LEARNING SO MUCH.
THANK YOU O MY COPRESENTERS ON
THIS PANEL WHO HAVE DONE SUMP A
TREMENDOUS JOB EVER DESCRIBING
THE IMPORTANT ISSUES TO CONSIDER
IN DIETARY PREVENTIONS IN THE
LATINX COMMUNITY HERE IN THE
UNITED STATES.
I'LL START WITH THE BRIEFEST OF
BACKGROUNDS BECAUSE I KNOW WE
SHARE AN UNDERSTANDING OF THE
IMPORTANCE EVER THIS TYPE OF
RESEARCH.
I'VE DECIDED TO FOCUS ON DIETARY
INTERVENTIONS FOR PREVENTION OF
CHRONIC DISEASE BECAUSE OF THE
DISPROPORTIONATE OCCURRENCE
RATES.
THE TRIAL DEMONSTRATED THAT A
BEHAVIORAL LIFESTYLE
INTERVENTION WAS MORE EFFECTIVE
THAN MODECATIONS OR TRADITIONAL
CARE.
NEVERTHELESS, EVEN THOUGH THE
U.S. PREVENT IR SERVICES TASK
FORCE RECOMMENDS THESE
INTERVENTIONS BE IMPLEMENTS IN
PRIMARY CARE, WE HAVE A LACK OF
CULTURALLY CENTERED
INTERVENTIONS THAT ARE EFFECTIVE
IN THIS POPULATION.
FOR MY TALK, I'LL FOCUS ON
LESSONS LESH LEARNED THAT MY TED
FROM IMPLEMENTING THE TRIALS.
THEN I'LL SPEND TIME TALKING
ABOUT OUR CURRENT WORK WHERE
WE'RE LEVERAGING OUR LEARNINGS
FROM THESE THREE TRIALS INTO TWO
NEW TRIALS INCORPORATING GREATER
FOCUS ON SOCIAL DETERMINANTS FL
HEALTH AND CONCLUDE WITH
RESEARCH GAPS.
ALL OF THE TRIALS I'M ABOUT TO
DESCRIBE USE A COMMUNITY-BASED
PARTICIPATORY APPROACH OR
PATIENT-CENTEREDOUT COMES.
THIS WAS A PARTICIPATE WITH A
HEALTH CENTER IN OUR AREA.
IN THIS STUDY, WE RECRUITED
LATINO ADULTS AT RISK OR
MANAGING A CHRONIC CONDITION AND
RANDOMIZED THEM TO THREE ARMS,
USUAL CARE, CASE MANAGEMENT
INTERVENTION PLUS HOME VISITS
FROM A COMMUNITY HEALTH WORKER
AND WE HAD 4 MONTHS OF FOLLOW UP
AND WEIGHT LOSS INTERVOANGS.
THE CASE MANAGEMENT COMPONENT
INCLUDED GROUP SESSIONS LED MY A
CASE MANAGER THAT WAS FROM THE
FEDERALLY QUALIFIED HEALTH
CENTER INCLUDING 12 MONTHLY
SESSIONS IN THE FIRST YEAR AND
THREE IN THE SECOND YEAR FOR
MAINTENANCE.
IN ADDITION TO 1-ON-1 MEETINGS
WITH THE CASE MANAGER TO ADDRESS
ANY PARTICULAR ISSUES THAT A
PATIENT WAS DEALING WITH.
THE HOME VISITS WERE CONDUCTED
BY A COMMUNITY HEALTH WORKER
FROM A COMMUNITY BEEN BASED
CENTER.
THERE WERE FIVE VISITS IN THE
FIRST YEAR AND TWO IN THE SECOND
YEAR AND FOCUSED ON HELPING
PATIENTS TO LEARN WHAT THEY DID
IN THE CLINIC AND BRING IT TO
THEIR FAMILY.
DESPITE SOME EXCITING CHANGES
FOR MANY OF THE PARNTS IN OUR
TRIAL, WE WERE ABLE TO
DEMONSTRATE SHORT-TERM GAINS OR
WEIGHT FLOSS THIS CASE OVER SIX
MONTHS PARTICULARLY DPL THE
PARTICIPANTS THAT WERE
RANDOMIZED TO GET THE HOME
VISITS FLADZ TO THE GROUP
SESSIONS.
THESE CHANGES WERE NOT SUSTAINED
OVER 12 OR 24 MONTHS.
WE TOOCT LEARNINGS FROM THAT
STUDY TO DESIGN OUR NEXT STUDY
THAT WE CALLED THE VIDDA SANNA.
WE HAD A BOARD THAT TO TOOK OVA
YEAR FOR THE GROUP-BASED A DAN
TAITION AND WE CONDUCTED A TYPE
1 HYBRID FILE INCLUDING SOME
PRELIMINARY INFORMATION ON
IMPLEDGES TO COMPARE THAT
CULTURALLY INTERVENTION WITH
USUAL CARE.
AGAIN, 24 MONTHS OF FOLLOW-UP
WITH A PRIMARY OUTKOSM WEIGHT
LOSS AT 12 MOONTS.
WORKIWORK -- 12 MONTHS.
WORK WITH THE DIVERSE GROUP OF
LATINO PATIENTS THAT WE
RECRUITED FROM PRIMARY CARE, WE
WENT THROUGH EACH SESSION TO
DETERMINE WHAT FACTORS WE COULD
IMPROVE OR ADDRESS TO INCREASE
THE CULTURAL RELEVANCE OF THE
INTERVENTION WE WERE
IMPLEMENTING.
THE LATINO PATIENT ADVISORY
BOARD FOCUSED ON A GREATER
INTEGRATION OF FAMILY THROUGHOUT
THE INTERVENTION.
EXAMPLES OF THIS INCLUDED ADDING
A FAMILY ORIENTATION AT THE
BEGINNING OF THE SESSIONS AND
HIGHLIGHTING OR INCLUDING FAMILY
MEMBERS IN SPECIFIC SESSIONS
WHERE IT WAS RELEVANT.
SESSION 6 AND 12.
YOU CAN GO TO THE NEXT SLIDE.
WE SHOWED SOME IMPROVEMENTS OVER
OUR LAST OUTCOMES AND WE WERE
ABLE TO SHOW SIGNIFICANT WEIGHT
LOSS AT 12 MONTHS COMPARED TO
USUAL AREA.
THIS WAS NOT SUSTAINED OVER 24
MONTH.
IN THE THIRD STUDY, CALLED
HOMBRE STUDY.
THAT WAS WITH THE LATINO MEN.
STANDIIN THIS STUDY, WE WERE
ADDRESSING TWO MAIN GAPS, ONE
WAS THE UNDERREPRESENTATION OF
LATINO MEN.
FROM SYSTEMATIC RECREWO VIEWS
RESEARCH THEY FOUND THAT ONLY A
VERY SMALL PERCENTAGE, LESS THAN
5% OF PARTICIPANTS IN THIS
RESEARCH INCLUDED ETHNIC MEN AS
A WHOLE AND EVEN FEWER LATINO
MEN.
WE FOCUSED ON THIS POPULATION
AND SOUGHT TO OVERCOME OFTEN THE
KEY ISSUES THAT PREVIOUS
PRINTERS ADDRESSED INCLUDING KEY
DEMANDS FOR CHRONIC DISEASE IN
LATINO PARTICIPANTS.
THEY WERE ALLOWED TO MAKE A
FACILITATED CHOICE.
THEY COULD DO IN-PERSON GROUPS,
THEY COULD DO VIRTUAL GROUPS ON
ZOOM AND THIS WAS PRE-PANDEMIC.
IT WAS NEWER FOR OUR TEAM AND
CAN COMMUNITY.
OR THEY COULD DO A SELF-DIRECTED
OPTION ENGAGING IN THE
INTERVENTION THROUGH ON LINE
VIDEOS.
I WON'T SPEND A LOT OF TIME
HERE, BUT I WANTED TO HIGHLIGHT
KEY DIFFERENCES BETWEEN THREE.
THOUGH INCLUDED THE SAME CONTENT
BUT HAD PEER SUPPORT, SIMILAR
FREQUENCY OF SESSIONS AND
DIFFERENT LANGUAGE OPTIONS
BETWEEN ENGLISH AND SPANISH.
HERE IN THESE JOWS COMES I'M
SHOWING YOU THIS FOR THE THREE
DIFFERENT OPTIONS.
YOU CAN SEE BY THEIR INITIAL
CHOICE AND THEIR FINAL CHOICE
AND YOU CAN SEE THAT MEN WHO
CHOSE THE VIDEOCONFERENCE AND
IN-PERSON GROUPS LOST
SIGNIFICANTLY MORE WEIGHT THAN
THES WHO CHOSE THE ON LINE
VIDEOS PERHAPS HIGHLIGHTING THE
IMPORTANCE OF MOTIVATION AND
ENGAGEMENT IN THE INTERVENTION.
SOME LESSONS LEARNED FROM THESE
THREE TILES, I WANT 208
HIGHLIGHT THE IMPORTANCE EVER
TAILORING FOR ACCULTURATION AND
I APPRECIATE THE THON LINEAR
CULL TNON-LNONLINEARAPPROACH.
I DID MENTION THE USE OF
TECHNOLOGY, BUT OPPORTUNITIES
FOR PARTICIPANTS TO ENGAGE WITH
EACH OTHER WITH THE HEALTH
COACHES AND COMMUNITY HEALTH
WORKERS WERE FACILITATED THROUGH
TECHNOLOGY LIKE TEXT MESSAGES
AND MONITORS.
WE ADDRESSED THE IMPORTANCE OF
SOARNL DETERMINANTS OF HEALTH
WITH OUR HEALTH COACH SUPPORT
FOR PARTICIPANTS BUT DIDN'T
INCLUDE A SYSTEMATIC WAY TO AND
THEN DIFFERENT STRATEGIES FOR
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH WITHIN THE BEHAVIORAL
INTERVENTIONS.
THAT LEADS TO THE NEXT TRIALS
THAT WE'RE CONDUCTING NOW.
VERY BRIEFLY, WE HAVE TWO ON
GOING STUDIES RIGHT NOW IN
PARTICIPATE WITH THE SAME HEALTH
CENTER IS SYSTEMS AS WELL AS
DIFFERENT FOOD PARTNERS.
AGAIN, THE VIDDA SANNA HAS A
COMPONENT FOR ADDRESSING FOOD
INSECURITY FOR FED CLI SUPPORTED
GROCERIES FROM THE LOCAL FOOD
BANK.
THEY RECEIVED VIDDA SANNA PLUS
THE MEDICALLY GROCERIES.
THIS TRIAL IS ON GOING.
THE SECOND TRIAL IS ADELANTE
FOCUSED ON LATINA ADULTS WITH
DIABETES.
WE HAVE A DIABETES MANAGEMENT
INTERVENTION PLUS PR PRODUCE
PRESCRIPTIONS.
IN PARTICIPATE WITH ONE OF OUR
URBAN FARMS AND WE'LL FOLLOW
PATIENTS OVER 12 MONTHS AND LOOK
AT HEE HEMOGLOBIN CONTROL.
FINALLY IN TERMS OF RESEARCH
GAPS, IT'S IMPORTANT TO CONTINUE
ENGAGING PARTICIPANTS AND
PATIENTS WITH LIVED EXPERIENCE
FOR INTERVENTIONS IN THESE
COMMUNITIES.
FOR OUR INTERVENTIONS, I'M GLAD
THAT MY COPRESENTER MENTIONED
THE IMPORTANCE EVER -- OF FAMILY
FOCUS AND IMPLEMENTING THE
COMMUNITY-BASED SETTINGS AND
CONTINUING TO ADDRESS ADDITIONAL
DETERMINANTS OF HEALTH.
AND THINKING ABOUT ADAPTIVE
INTERVENTIONS AS WELL AS NATURAL
EXPERIMENTS THAT CAN OVERCOME
SOME OF THE CHALLENGES WITH
GENERALIZED ABILITY WITH
CLINICAL TRIALS.
THANK YOU.
>> THANK YOU DR. GOLDMAN AND
THANK YOU TO ALL THE PANELISTS.
NEXT SLIDE, I'M LOOKING FORWARD
TO FOLLOWING EVERYBODY'S
RESEARCH AND TO CONTINUE TO
LEARN FROM ALL OF YOU.
NOW WE'RE GOING TO TURN TO SOME
QUESTIONS FROM THE AUDIENCE.
SO FUR THE FIRST QUESTION, IT'S
FOR DR. FUSTEER.
CAN YOU OFFER INSIGHT ON THE
STRUCTURAL FACTORS ESSENTIAL TO
CONSIDER.
>> THANK YOU FOR THE QUESTION.
I APPRECIATE THE QUESTION BUT I
ALSO WANTING TO ANSWER -- SORT
EVER BY NOT ANSWERING BECAUSE I
DON'T WANT TO BE PRESCRIPTIVE IN
SAYING AGE, GENDER, INCOME, RACE
BECAUSE THEY'RE ALL IMPORTANT.
THE POINT IS NOT TO THINK OF
ESSENTIAL ONES, BUT MORE TO THI
EVER THEM, REALLY.
BECAUSE DRUSH THINK -- THINK OF
THEM REALLY.
WITH GOOD INTENTIONS WE MAY JUST
FOCUS ON CULTURE AND NOT REALIZE
ALL THE OTHER THINGS THAT
MATTER.
WHEN I USED TO TELL MY STUDENTS
IF THEY LEARN PUERTO RICAN,
[INDISCERNIBLE] THAT WAS THE
CASE.
IT MATTERS THAT I HAD THE INCOME
TO EAT AT DIFFERENT RESTAURANTS,
TRY THEIR FOODS AND TRAVEL AND
GO BACK TO PUERTO RICO.
IT'S INDIVIDUAL IT'S NOT A
MATTER OF TAKING DOWN THE WE
VENGS ONES BUT THINKING ABOUT
THE PERSON BEYOND WHERE THEY
COME FROM AND HOW THAT INTERACTS
TO HOW THEY RELATE TO THEIR HOME
CULTURE.
I APOLOGIZE I CAN'T GIVE A
STRAIGHT ANSWER.
>> FOR DR. VEG AFA LOPEZ, DID YU
NOTICE ANY PERCEPTION ON THE
FOODS WHAT DIFFER BY AGE?
>> THAT'S A GREAT QUESTION.
INTERESTINGLY, THE CONCEPT OF
WHETHER TRADITIONAL FOODS ARE
HEALTHY OR PERCEIVED AS SUCH IS
NOT A QUESTION THAT WE COULD ASK
IN OUR FEE CUSS GROUPS.
IT'S A THEME CAME UP MORE WITH
MEN THAN WOMEN.
AND THAT DIDN'T NECESSARILY COME
UP.
I THINK IT'S A FUNCTION OF THE
EXPOSURE THAT THE GROUPS HAVE
DIFFERENT TRADITIONAL CUISINE
AND WHERE THE DIFFERENT
TRADITIONAL FOODS HAVE BEEN
EXPOSED TO ARE FROM IN E IN
MEXICO AS WELL.
I THINK IT'S MORE A FUNCTION OF
WHAT THEY'VE BEEN EXPOSED TO.
>> FOR DR. GOLDMAN ROSAS.
>> SOME I THINK -- CAN YOU HEAR
ME?
THANK YOU SO MUCH FOR THAT
QUESTION.
I THINK MY FELLOW PRERNTS
MENTIONED SOME OF THIS BEFORE
AND IT REALLY RESONATED WITH
WHAT OUR LATINO PATIENT ADVISORY
BOARD WAS SAYING.
SO ONE IS NOT TO THINK OF YOUR
CULTURAL FOODS AS GOOD OR BAD
NECESSARILY.
BUT THINK OF WAYS THAT YOU CAN
MAKE EACH FOOD THAT YOU ENJOY
EATING HEALTHIER.
AND VERY INTERESTINGLY IN THE
LATINO PATIENT ISRAELI BOARD
MEETING, WE TRIED OUT DIFFERENT
FOODS EVERY TIME.
ONE OF THE FIRST THINGS WE SAID
WE DON'T WANT TO EAT MEXICAN
FOOD EVERY WEEK.
WE WANT O LEARN HOW TO MAKE
DIFFERENT FOODS HEALTHIER.
WE DIDN'T OVEREMPHASIZE ANY
PARTICULAR CUISINE.
A SECOND THING WAS HOW TO
PRIORITIZE YOUR OWN HEALTH WHEN
WITH FAMILY AND NOT JUST IN
CELEBRATION TS BUT WS BUT WHEN E
WITH OTHERS THAT ARE NOT ON A
JOURNEY TO PRIORITIZE THEIR
HEALTH.
HOW CAN YOU DO IS THAT AND
MAINTAIN SOCIAL KIKSZS DURING
THOSE TIMES -- SOCIAL
CONNECTIONS DURING THOSE TIMES?
THANK YOU FOR THE QUESTION ABOUT
MEN.
WE LEARNED SO MUCH THROUGH THAT
STUDY.
I THINK ONE OF THE BIGGEST
THINGS WAS OVERCOMING
PRECONCEIVED NOTION BTION WHAT
HEALTHY FOOD WAS -- NOTIONS
ABOUT WHAT HEALTHY FOOD WAS
GOING TO BE.
SOME OF OUR PARTICIPANTS SAID
IT'S FOOD ONLY WOMEN WOULD EAT.
COMING BACK TO THAT IDEA THAT
YOU CAN MAKE HEALTHY CHOICES
WITHIN ALL KINDS OF DIETARY
PREFERENCES AND THAT IS PART OF
THIS INTERVENTION IS HELPING YOU
TO TAILOR IT TO YOUR OWN
PREFERENCES.
WHILE MAKING HEALTHY
CHOICES.
>> THANK YOU.
THIS NEXT QUESTION IS FOR THE
WHOLE PANEL.
TEALINGS A TWO-PRONGED QUESTION.
IT'S A TWO-PRONGED QUESTION.
CAN YOU SPEAK MORE ON HOW TO
TAILOR INTERVENTIONS FO FOR
HISPANIC OR LATINX COMMUNITIES
WITH A VARIETY OF CULTURATION
LIKE URBAN LOCATIONINGS AND
TRANS BORDER AREAS WHERE
DIFFERENT CULTURES ARE
CONVERGING.
HOW DO WE DESIGN INTERVENTIONS
APPROPRIATE FOR THOSE
POPULATIONS?
>> I THINK A GOOD APPROACH IS
FOCUSING BEYOND THE INDIVIDUAL.
IF YOU START ADDRESSING
[INDISCERNIBLE] YOU'LL BE ABLE
TO REACH SEVERAL PEOPLE WHO MAY
HAVE DIFFERENT ACCESS TO -- OR
DIFFERENT [INDISCERNIBLE]
WENGAGING MEMBERS IN DECISION
MAKING FOR WHAT WILL BE
AVAILABLE IN THE HOME AND WHAT
IS PREPARED CAN REACH THE AGENCY
LOAFL.
LEVEL.
>> I WOULD AGREE WITH WHAT DR.
VEGA LOPEZ SAID ENTIRELY.
I THINK HERE IN CALIFORNIA,
ESPECIALLY IN THE SAN FRANCISCO
BAY AREA, WE HAVE A DIVERSE
LATINO COMMUNITY AND PROVIDING
OPPORTUNITIES FOR PEOPLE TO
SHARE THEIR EXPERIENCES WHETHER
THEY'RE U.S.-BORN, ORIGINALLY
BORN OUTSIDE OF THE U.S. AND THE
DIFFERENT COUNTRIES OF ORIGINAL,
AT WHREES IN OUR COMMUNITY
HEALTH WORKER VISITS AND GROUP
SESSIONS HAD A LOT OF WONDERFUL
LEARNINGS FROM EACH OTHER BY
SHARING RECIPES AND IDEAS.
THAT'S BEEN A HUGE STRENGTH FOR
US.
>> AND I'VE BEEN THINKING ABOUT
THIS IN NEW YORK CITY WHY THEY
SET THE TABLE AT WORK, PEOPLE
ARE ALREADY INTERACTING.
RECENTLY I HAD AN EXPERIMENTAL
APPROACH, FROM THE USER
PERSPECTIVE, IT ALLOWS US TO GO
BEYOND COMMUNITY ENGAGED
RESEARCH IN THAT IT INSPIRING
CREATIVITY AND INNOVATION AT ITS
CORE.
THESE PROBLEMS ARE COMPLEX, THEY
REQUIRE JUST TAKING US TO
DIFFERENT WAYS OF ADDRESS THEM
AND GETTING OUT OF OUR COMFORT
ZONE TO REALLY ADDRESS THEM IN
THE COMPLEXITY.
I MIGHT SUGGEST EXPLORING NEW
METHODS TO REALLY ENGAGE THE
COMMUNITY BEYOND JUST ASKING
THEM LIKE MAKING THEM MORE
ACTIVE AND INNOVATE WITH THEM ON
HOW TO ADDRESS IT.
AGAIN, I COMPO EXHORT TO THINK T
THE FACT THIS IS NOT LINEAR,
THERE ARE STUDIES THAT HAVE
COMPLICATED MY VIEW ON
ACCULTURATION.
IF YOU'RED THI YOU'RE INTERESTE,
GET OUT OF YOUR COMFORT ZONE AND
EXPLORE THE OTHER SCHOLARSHIP TO
PROVIDE NEW LENSES TO ADDRESS
THE COMPLEX ISSUES.
>> OKAY, AND THAL IS ALSO
CAPITALIZING ON WHAT IS CAUSING
EITHER WITHIN THE FOOD
ENVIRONMENT OR NEIGHBORHOOD
ENVIRONMENT OR PRACTICES THAT
PEOPLE ARE FOLLOWING,
EMPHASIZING THOSE ARE POSITIVE
AND SHOULD BE MAINTAINED RATHER
THAN WHAT SHOULD YOU NOT EAT AND
STOP EATING.
>> GREAT, SO TO FOLLOW ON THAT
AND MAYBE AN ADDITIONAL LAYER,
DO YOU HAVE ANY SUGGESTIONS ON
HOW TO DETERMINE SOCIAL
DETERMINANTS ON SOCIAL
FACTORRERS ON INTERVENTIONS
WITHIN INTERVENTIONS AND WOULD
THAT DIFFER EITHER FOR THE
SPECIFIC HISPANIC LATINO
COMMUNITIES OR BEE A HAIF I
DON'T RECALL INTERVENTIONS IN
GENERAL?
>> I CAN START.
I TALKED A LITTLE BIT ABOUT THIS
TO MY RESTAURANT WORK IS
INSPIRED TO TRY TO DO THIS
BECAUSE IF YOU THINK OF SOCIAL
DETERMINANTS AS INCOME ACCESS TO
FOOD, FOOD ENVIRONMENTS.
THAT'S WHY AGAIN I FOCUS ON THE
INDIVIDUAL IS IMPORTANT, BUT IF
WE COULD WORK WITH BUSINESSES OR
THINK ABOUT FOOD NOT ONLY AS A
DETERMINANT FOR HEALTH, HEALTH
OUTCOMES BUT THINKING OF FOOD AS
AN ECONOMIC ENGINE FOR
COMMUNITIES AND INDIVIDUALS THAT
WE HAVE SEEN HISTORICALLY IN
IMMIGRANT COMMUNITIES AND MAYBE
MOVING OUR WORK UPSTREAM CAN
HELP.
SOME OF THE WORK I'VE SEEN
INVOLVING THE YOUTH IN
ADVOCATING FOR CHANGES IN THE
LOCAL STORES, INVOLVING THE
YOUTH AND OTHER PEOPLE TO IN
GROWING FOOD IN URBAN AREAS AND
SELLING THE FOOD.
BEING MORE CREATIVE IN HOW WE
ADDRESS THE ISSUES.
>> I WOULD JUST ADD THAT
HOPEFULLY FROM THIS -- THESE
THREE PRESENTATIONS, YOU HAVE
THE TAKE AWAY MESSAGE THAT IT'S
IMPORTANT FOR US TO LOOK AT
UPSTREAM FACTORS AND FOOD
ENVIRONMENTS MORE BRADLEY.
IN ADDITION WITHIN INDIVIDUAL OR
FAMILY FOCUSED INTERVENTIONS TO
ALSO ADDRESS THOSE SOCIAL
DETERMINANTS EVER HEALTH WHILE
WE CONTINUE TO TRY TO SCHAING
THEM.
CHANGE THEM.
SO I THINK WE NEED TO USE BOTH
APPROACHES.
>> SO MANY TIMES WE THINK ABOUT
SOCIAL DETERMINANTS IN HEALTH AS
THE MEDICAL CONNOTATION THAT
PEOPLE THINK OF THEMSELVES AS A
STEREOTYPE.
A LOT OF PEOPLE HAVE BUSINESS --
THE MISCONCEPTION THAT PEOPLE
DON'T KNOW HOW TO CHOOSE HEALTHY
OPTIONS FOR FOOD.
THAT IS NOT THE CASE.
IT'S NOT THE LACK OF KNOWLEDGE
THAT MAY PREVENT FREEDOM BEING
ABLE TO MAKE CHOICE.
I THINK CHANGING THAT PARADIGM
IS ALSO IMPORTANT FROM HOW TO
ADDRESS THE MEANS.
>> I WANT O THANK OUR PANEL FOR
A WONDERFUL PRESENTATIONS AND A
ROBUST DISCUSSION.
THAT WAS TERRIFIC.
I'LL INVITE AUDIENCE MEMBERS TO
REACH OUT INDIVIDUALLY TO THE
PANEL MEMBERS IF YOU SUBMITTED
QUESTIONS THAT WEREN'T ANSWERED.
I THINK THEY WOULD BE HAPPY TO
CONTINUE THE CONVERSATION WITH
YOU.
NEXT WE HAVE A BRIEF VIDEO
PRESENTATION FROM OUR FINAL
PRESENTER DA LEANA SO THEO.
SHE'S AN AFTER ROW BLINK WALL
DIETICIAN THAT CELEBRATES EATING
CULTURAL FOODS WITHOUT GUILT.
SHE TRIES TO INSHIER OTHERS TO
BUILD NARRATIVES THAT DON'T
INCLUDE DEPRIVATION.
WELCOME DA LEANA AND THANK YOU.
>> HELLO.
I'M DALINA SO THEO.
MY FOCUS IS TO EDUCATE MY
PATIENTS, MY CLIENTELE BOTH IN
THE PHILADELPHIA AREA AND ACROSS
THE COUNTRY WITH MY SOCIAL MEDIA
ACCOUNTS ON HOW WE CAN CONTINUE
TO EAT OUR CULTURAL FOODS AND
STILL MANAGE CHRONIC CONDITIONS
AND LEARN THE NUTRITION IN OUR
FOOD.
SOMETHING THAT I SEE OR ISSUES
THATISSUESTHAT I SEE IN MY COMMN
WORKING WITH THEM IS THAT THERE
IS A LACK OF CULTURAL HUMBLE
RESOURCES.
A LOT OF TIMES IN THE MEDICAL
SYSTEM THEY'RE JUST GETTING
HANDOUTS OR RECOMMENDATIONS THAT
ARE NOT FULLY HUMBLE.
AND REALLY ARE COMING FROM
STEREOTYPES TOWARDS OUR FOODS
AND A LOT OF TIME EDUCATION IS
VERY FEAR-BASED.
AND SO WHETHER MY PATIENTS
CLIENTS -- SO WHEN MY PATIENTS
CLIENTS ARE GOING TO THE
DOCTORS, THERE IS STWRES AND
SHAME AND GUILT INVOLVED --
STWRES AND SLAIM AND GUILT
INVOLVED.
WHEN I GET KATE, I LIKE TO #ED
KATE OA ON POSITIVE NUTRITION
AND NUTRITION IN OUR DISHES
THAWR GOING TO PROVIDE US THE
NUTRITION THAT WE NEED TO MANAGE
CHRONIC CONDITIONS.
FOR INSTANCE, I LIKE TO REDUCE
STRESS BY EDUCATING ON THE
NUTRITION IN THE DISHES THAT WE
ARE ALREADY EATING.
HOW ARE WE PUTTING THE DISHES
TOGETHER?
HOW ARE WE COOKING IT?
WHAT INGREDIENTS ARE WE USING?
WHEN THE CLIENT IS ABLE TO SEE
ALL THOSE PIECES AND I'M ABLE TO
EDUCATE ON THE NUTRITION IN
THOSE FOODS, THEY'RE ABLE TO
THEN TAKE THAT INFORMATION AND
AS THEY ARE BUILDING OTHER
DISHES THROUGHOUT THE DAY,
THEY'RE ABLE TO SEE ALL OF THE
NUTRITION THAT THEY ARE BEING
GIVEN BY THESE FOODS AND
REDUCING THE STRESS AND HELPING
THEM FOCUS ON HEALTHY BEHAVIOR
INSTEAD EVER RESTRICTIONS FROM
TAKING OUT.
I THINK A LOT OF THE TIMES THERE
ARE SO MANY SOCIAL DETERMINANTS
EVER HEALTH THAT MY CLIENTS ARE
DEALING WITH SO A LOT MUCH THE
TIME I WANT TO HELP REDUCE THAT
STRESS.
I WANT TO BE A RESOURCE FOR THEM
WHERE THEY CAN COME TWO MY
APPOINTS AND LOOK FOR RESOURCES
IN THEIR COMMUNITY OR LEARN
ABOUT RESOURCES IN THEIR
COMMUNITIES THAT ARE GOING TO
HELP THEM WITH THEIR HEALTH.
THEY ARE GOING TO BE TIMES WHERE
I THINK BECAUSE I HAVE AN HOUR
WITH THEM, I'M ABLE TO HELP THEM
SOLVE PROBLEMS THAT MAY THEY
WEREN'T ABLE T TO DO AT THE
DOCTOR'S OFFICE BECAUSE THEY
WEREN'T ABLE TO DO THAT AND HAVE
THOSE CONVERSATIONS.
BEING A REGISTERED DIETICIAN
ALLOWS ME TO HAVE THE TIME AND
SPACE WITH PATIENTS SO I
ENCOURAGE YOU TO REFER TO
REGISTERED DIETICIANS ESPECIALLY
DIETICIANS THAT LOOK LIKE YOUR
COMMUNITY AND THEY'RE GOING TO
UNDERSTAND THE DISHES THAT DISHY
ARE ALREADY EATING AND
UNDERSTAND THE CULTURE AND
TRADITIONS BEHIND THOSE DISHES
SO THEY'RE HELPING THAT PATIENT,
THAT CLIENT UNDERSTAND HOW THOSE
FOODS CAN BENEFIT THEIR HEALTH
INSTEAD OF FEARING THEM AND
THINKING THAT THEY HAVE TO
COMPLETELY STOP EATING THEM.
WHEN WE CAN TRULY CONTINUE TO
EAT THEM AND ADD NUTRITION TO
THEM TO HELP THEM.
THAT'S WHAT I FOCUS ON.
I FOCUS ON HEALTHY BEHAVIORS AND
FOCUS ON THE WHOLE PERSON AND
SNOT NOT JUST FOOD BUT FOCUSING
ON HOW REDUCING STRESS AND HOW
WE'RE GOING TO SLEEP MORE.
WHAT OTHER RESOURCES YOU HAVE
AVAILABLE TO YOU AND YOUR FAMILY
TO REDUCE THE STRESS.
WILL WE SHOP FOR FROZEN VEGGIES
OR FROZEN FOODS THAT CAN BE
STORED LONGER.
HOW CAN WE SHOP FOR FOODS THAT
ARE CONVENIENT FOR THEM TO BE
ABLE TO BUILD COMPLETE DISHES
WITH.
AND SO, MY JOB REALLY IS TO BE A
RESOURCE FOR THE COMMUNITY AND
REALLY EDUCATE THEM.
AGAIN, NOT ONLY ABOUT THE
NUTRITION IN OUR DISHES, BUT
ALSO HOW THEY CAN MANAGE THEIR
CHRONIC DISEASE WITH THESE
FOODS.
AND SO, IF YOU'D LIKE TO BE
CONTACT ME AND LEARN MORE, HOW I
WORK WITH THE COMMUNITY, THESE
ARE ALL THE DIFFERENT WAYS THAT
YOU CAN FIND MY WORK AND ALSO
YOU ARE FREE TO e-MAIL ME IF
YOU HAVE ANY QUESTIONS.
>> TERRIFIC, THANK YOU DALINNA.
I WANT TO THANK ALL OUR SPEAKERS
FROM PANEL THREE AND GETTING
READY NOW TO HAND IT OVER --
PANEL 4 OVER TO THE MODERATOR
FOR THE NEXT PANEL.
THANKS.
>> GOOD AFTERNOON, EVERYONE.
CAN YOU HAIR ME?
I'M A TEACHING PROFESSOR AND THE
DIRECTOR OF THE GRADUATE PROGRAM
IN THE DEPARTMENT EVER NUTRITION
AND FOOD STUDIES SAT SYRACUSE
UNIVERSITY.
I'M A FELLOW OF THE ACADEMY OF
NUTRITION AND DIET.
MY FOCUS IS ON HEALTH OF
IMMIGRANTS ESPECIALLY FROM
INDIA.
WE'LL A ADDRESS THE DIETARY
RECOMMENDATIONS FOR ASIAN AND
ISLANDER GROUPS.
THANK YOU FOR INCLUDING US IN
THIS EVENT.
WE HAVE AN EXCELLENT PANEL OF
SPEAKERS TO SPEAK ON THE HEALTH
AND NUTRITION ISSUES RELATED TO
THE U.S. AS WELL AS THE SOUTH
ASIAN AND CHINESE POPULATIONS IN
THE U.S.
I WOULD LIKE TO REITERATE THE
HOUSEKEEPING FOR QUESTIONS.
PLEASE SEND QUESTIONS AND IS
STATE WHICH PANELIST YOU ARE
DIRECTING YOUR QUESTION TO.
OUR FIRST PRESENTATION IS TITLED
"CULTURE AND DIETARY
INTERVENTIONS FOR
MARSHALLESSINGE POPULATIONS.
WOUR SPEAKER HAS OVER 15 YEARS F
WORKING IN THE CLINIC AND PUBLIC
HEAT SETTING WITH EYE PARTICULAR
FOCUS ON SERVING UNDERSERVED
POPULATIONS.
WELCOME.
>> THANK YOU.
HELLO, EVERYONE.
I'M A NURSE EDUCATOR WITH THE
OFFICE EVER COMMUNITY LET AND
RESEARCH.
IT'S MY HONORING TO HERE TO TALK
TO YOU ABOUT THE MARSHALINGE
BASE IN NORTHWEST ARKANSAS AND
ACROSS THE WORLD.
BEFORING CONTINUING, I WANT TO
TELL YOU ABOUT UMS OR THE
UNIVERSITY EVER ARKANSAS
COMMUNITY HEALTH AND RESEARCH
IS.
WE ARE A DIVERSE TEAM DEDICATED
TO WORKING WITH COMMUNITIES TO
CREATE A BETTER STATE OF HEALTH
FOR ALL.
WE HAVE PROGRAMS THROUGHOUT
ARKANSAS AND ALSO HAVE WORKED
WITH MARSHALESE COMMUNITIES.
NEXT SLIDE, PLEASE.
WHO WILL ARE THESE
MARSHALLESSINGE PEOPLE?
IT IS NORTH EVER THE EQUATOR.
FAMILY IS A CRUCIAL PART OF
THEIR CULTURE.
DECISIONS CAN MADE BY THE FAMILY
EXPHEMS NOT AS AN INDEPENDENT
PERSON.
TO UNDERSTAND HOW IT TO SERVE
THIS COMMUNITY, RESEARCHERS AND
HEALTH PROVIDERS NEED TO
UNDERSTAND THE LIST TRI AND
CULTURE OF THE PEOPLE.
NEXT SLIDE, PLEASE.
THE MARSHALLESE COMMUNITY PLACE
IMPORTANCE ON HEALTH.
THEIR ISLANDS WERE USED AS A
TEST SITE FOR NUCLEAR WEAPONS
FROM 1946 TO 1958.
THEREIN 2,007 HAD 2,700 HIROSHIE
TOES DEDICATED.
AS A RESULT THE WHOLE ISLAND WE
VAPORIZED.
RADIATION EXPOSURE TO THE
ENVIRONMENT AND FOOD.
DURING THE TESTING IN 1954,
PROJECT 4.1 WAS CONDUCTED.
TO STUDY THE EFFECT OFFER
23450UBG LAR RADIATION ON HUMANS
WITHOUT CITIZEN CONSENT.
IT LEFT BEHIND RADIOACTIVE
DEBRIS ON A DOME LOCATED AT
THEIR RUINED IENLTS.
ISLANDS.
YOU SEE THE DOME AND IT WILL IS
CURRENTLY LIKING TODAY.
HIGH RATES OF HEALTH DISPARITIES
INCLUDING DIABETES,
CARDIOVASCULAR DISEASE AND LOW
BIRTH BABIES AND EARS ARE EYE
RESULT OF THIS.
HERE ASK A TIMELINE OF HOW THE
UNITED STATES WAS INVOLVED WITH
THE MARSHALLESE.
UNTIL 1946 NUCLEAR TESTING AND
IN 1957, THE ISLAND BECAME A
U.S. TRUST TERRITORY IN THE U.S.
1958 NUCLEAR TESTING ENDED.
1979 THEY BECAME AN INDEPENDENT
STATE AND CALLED THE REPUBLIC OR
RMI.
IN 1983, RMI AND THE U.S. BECAME
A COFA AGREEMENT AND IT WAS
FINALLY FORMED IN 1986 WHERE
MARSHALLINGESE SPHRG THE ISLAND
ARE NOT ALLOWED TOKING MY GREAT
TO THE UNITED STATES WITHOUT ANY
VISAO PR RESIDENT CARDS.
DURING THE COFA AGREEMENT, THEY
WERE GIVEN FEDERAL BENEFITS SUCH
AS MEDICAID AND OTHER FEDERAL
BENEFITS.
UNTIL 1996, THE PERSONAL
RESPONSIBILITY AND WORK
OPPORTUNITY RECONCILIATION ACT
OR THE PORA KNOWN AS THE CLINTON
WELFARE ACT HALTED THE BEN FITH
FOR THEM.
IN 2020 ALTHOUGH THE MEDICAID
WAS RESTORED, THEY'RE STILL NOT
ELIGIBLE FOR FEDERAL GRANTS LIKE
ACCOUNT SNAP WHICH IS VITAL
ASSISTANCE PROGRAM FOR OUR
PEOPLE.
PRIOR TO THE U.S. INVOLVEMENT,
THE PEOPLE WRL HUNTER, GATHERERS
AND FARMERS.
HARVESTING WAS ONE OF THE MOST
IMPORTANT SKILLS THAT ENSURED
SURVIVAL FOR EACH PERSON.
SINCE THERE WEREN'T ANY IMPORTED
FOOD, PEOPLE HAD TO RELY ON
NATURAL RESOURCES.
FOOD THAT PEOPLE HAD TO RELY ON
INCLUDING LOCAL GRAPEFRUIT, AND
BANANA AS TO NAME A FEW.
BUT THE RADIATION ALTERED THE
HEALTH OF THESE PEOPLE.
WHILE U.S. PROVIDED AID WITH
FOOD, ALL THE FOOD THAT WAS
IMPORTED WAS PROCESSED FOOD.
THIS RESULTED IN HEALTH
DISPARITIES NOT ONLY IN THE RMI
BUT AS THEYING MY GRATED TO THE
UNITED STATES THEY CARRIED THE
BURDEN OF THESE DISEASE WITH
THEM.
20 TO 50% OF ADULTS HAVE
DIABETES, 40% HAVE HYPERTENSION.
10 TO 15% INFECTED WITH CHRONIC
HEPATITIS AND CHRONIC HBV.
NEXT SLIDE, PLEASE.
UNTIL DIET IN THE RMI, MAJORITY
IS IMPORTED PROCESSED FOOD.
ADDS YOU SEE IN THE PICTURE ON
THE LEFLT LEFT, WE DEPENDED ON D
FOOD.
THEY'RE SO USED TO THE DIET THEY
PREFER THAT DIET AND THEIR TASTE
SYSTEM IS NOT USED TO THE FRESH
PRODUCE THAT ARE AVAILABLE IN
THE UNITED STATES.
TO BE HEALTHY IN THE R, MR. I IS
VERY EXPENSIVE AS THE MINIMUM
WAGE IS ABOUT TWO DOLLARS AND
EVERYTHING IS UNAFFORDABLE.
HEALTH IS UNAFFORDABLE ALTHOUGH
THE U.S. HAVE ACCESS TO
AFFORDABLE FOOD, THE PEOPLE ARE
USED TO THE PROCESSED FOOD AND
IT IS SO DIFFICULT TO SCHAING
THEIR DIET.
REGARDLESS OF THE FRESH AND
HEALTHIER FOOD CHOICES THEY HAVE
HERE AS WELL AS COFA CITIZEN IN
THE MAINLAND DUE TO THE WELL P
PAIR ACT AND IMMIGRATION STATUS
OF THE COMMUNITIES, THEY
STRUGGLE TO FIND JOBS TO MEET
THE BASIC NEEDS SUCH AS FOOD.
IT'S EVIDENT THAT -- HEALTHIER
FOOD CAN IMPROVE HEALTH
DISPARITIES.
THE FAIR POLICIES HAS MADE
HUNGER WORSE LEAVING THEM OUT OF
FEDERAL SAFETY NET LIKE SNAP
WHICH IS SUPPOSED TO HELP
LOW-INCOME FAMILIES.
AND MIGRATION IS ALREADY A
DIFFICULT THING.
NEXT SLIDE PLEASE.
AT THE UNIVERSITY EVER ARKANSAS
FOR MEDICAL SCIENCE OFFICE OF
HEALTH AND RESEARCH, WE HAD
PILOTED A CULTURAL FAMILY MODEL
FOR EDUCATION AND SUPPORT
PROGRAM.
DIETARY INTERVENTION IS ONE OF
THE CORE CONTENTS HIGHLIGHTED IN
THE RMI AND IMPLEMENTED HERE IN
ARKANSAS.
THROUGH THIS PROJECT --
VEGETABLES ARE HARD TO ACCESS
FROM THE RMI AND FOODS WITH HIGH
CARBS ARE FOUND IN TEENA, SMAM
AND RICE WHICH IS THE DAILY
NORMS OF THE DIE OAT.
ALTHOUSTUDIES SHOW A POSITIVE
IMPROVEMENT IN ARKANSAS AND
OTHER STATES.
THIS IS EVIDENT BY LIFESTYLE
CHANGE, PORTION CONTROL WITH
FOOD MY CARB -- REDUCTION 6 FOOD
HIGH IN CARBS AND SUGAR AND A 1
C.
NEXT SLIDE, PLEASE.
TO BETTER UNDERSTAND THE
COMMUNITIES, WE USE A
COMMUNITY-BASED PARTICIPATORY
APPROACH THAT INVOLVES THE
COMMUNITY IN THE DEVELOPMENT OF
OUR PROGRAM.
THIS HELPS BUILD TRUST
ESPECIALLY IN RELATIONSHIP WHILE
CREATING PROGRAMS THAT ARE
EFFECTIVE AND ENJOYABLE FOR THE
COMMUNITIES TO BE INVOLVED.
CREATING AND SUPPORTING PROGRAM
TO FILL IN THE GAP IN RESOURCES
BY PORING A, WE NEED TO HAVE THE
FAIRNESS ACT, HEALTH WORKERS,
HEALTHY START AND OTHER THINGS
RELATED TO THE WELFARE ACT.
TO CONTINUE TO FILL IN THE TBAP,
WE NEED TO WORK TO UNDERSTAND
AND EFFECTIVELY ADDRESS HEALTH
DISPARITIES AND THIS INCLUDES
MONITORING FOR HYPERTENSION AND
DIABETES PATIENTS AND DELIVERY
SYSTEM AND CREATING AND REFINING
NUTRITION EDUCATION PROGRAM.
IT WILL BE A TWRE HELP FOR THE
MARSHALLESE IN NORTHWEST
ARKANSAS AS WELL AS OTHER STATES
TO BE SUPPORTIVE WITH THE FARM
BILL ACT TO RESTORE THE BENEFITS
OF THE LEGAL IMMIGRANTS AND THAT
INCLUDES SNAP.
THANK YOU FOR YOUR TIME AND FOR
THIS OPPORTUNITY TO PRESENT.
NEXT SLIDE.
>> THANK YOU FOR THAT EXCELLENT
AND INFORMATIVE PRESENTATION
HIGHLIGHTING THE HISTORY SVELTE
THE CURRENT ISSUES FACED BY THIS
POPULATION.
NEXT PRESENTATION IS BY DR.
KALUDA.
THIS PRESENTATION IS TITLED
SOCIAL CULTURAL FACTORINGS AND
INTERVENTION AS AMONG SOUTH
ASIAN IMMIGRANTS.
SHE IS IN GENDER MEDICINE AND A
PRIMARY CARE PHYSICIAN.
SHE'S INTERNATIONALLY KNOWN FOR
RESEARCH ON SOUTH ASIAN
CARDIOVASCULAR HEALTH AND
RESEARCH TO HELP DISPARITIES.
>> THANK YOU DR. RAJ.
CAN I PLEASE HAVE THE NEXT
SLIDE?
I WANT TO THANK THE NHLDI AND
NCI FOR PUTTING TOGETHER THIS
WORKSHOP.
I ENJOYED THE VIDEOS AND COOKING
DEMONSTRATIONS.
NEXT SLIDE.
I HAVE NO RELEVANT FINANCIAL
RELATIONSHIPS TO DISCLOSE.
OBJECTIVES OF THIS TALK ARE TO
REVIEW FOODWAYS, CULTURAL
CONTACTS AND LINKS WITH
CARDIOMETABOLIC HEALTH AND TO
DESCRIBE THE EVIDENCE-BASED
DIETARY COUNSELING INTERVENTION
IN THE PREVENTION TRIAL AND TO
IDENTIFY GAPS AND OPPORTUNITIES
IN RESEARCH OF EVIDENCE-BASED
DIETARY APPROACHES TO IMPROVE
HEALTH IN CULTURALLY DIVERSE
POPULATIONS.
INDIVIDUALS OF SOUTH ASIAN
BACKGROUND IN THE UNITED STATES
REPRESENT MANY DIFFERENT
COUNTRIES SUCH A AS BANGLADESH
SRI LANKAA AND BERMA.
THIS REFLECTS IDENTITY, CULTURE,
RELIGION, MIGRATION AND CHANGE
THAT COMES WITH MIGRATION.
IT'S AN EXTREMELY HET R HETEROGS
POPULATION AND IS -- ONE OF THE
LARGEST DIASPORAS IN THE WORLD.
IN SOUTH ASIAN CULTURES, WE INTO
IELDITY VALU VALUES AND NORMS AE
TIED TO FOOD.
THIS IS SA CROSS ALL CULTURES.
MANY SOUTH ASIAN LANGUAGES USE
THE WORD THAT MEANS FOOD, MEAL
AND MOST IMPORTANTLY ENJOYMENT.
THAT'S THE THEME THAT I THINK
WE'VE HEARD FROM SEVERAL PEOPLE
IS THAT A LOT OF THE
INTERCEPTIONS MAYBE MORE
EFFECTIVE IF WE CAN GET PEOPLE
TO ENJOY THEIR FOOD RATHER THAN
MAKING THEM FEEL WE'RE TRYING TO
TAKE ZAG WAY FROM THEM.
IT'S IMPORTANT O RECOGNIZE THAT
PEOPLE HAVE INTERSECTING
IDENTITIES IN THEIR RELIGION AND
THE REGION THEY COME FROM 234
SOUTH ASIA, GENDER AND
ACCULTURATION ALL OF THESE
THINGS INFORM THEIR FOOD
PRACTICES.
IN SOUTH ASIA, THEY HAVE
IMPORTANCE EVER COMMUNITY AND
FAMILY ARE CORE VALUES.
IN ADDITION, THERE ARE ANCIENT
PRACTICES OF MEDICINE WHERE FOOD
CONSUMPTION I IS LINKED TO
WELL-BEING AND BALANCE.
WE LEARNED FROM OUR COMMUNITY
THAT SWEETS HAVE AN IMPORTANT
ROLE BECAUSE THEY'RE OFTEN
SERVED IN CELEBRATIONS.
NEXT SLIDE.
THERE ARE MANY SCHALS TO
UNDERSTANDING THE HEALTH OF
HAPPY COMMUNITIES IN THE UNITED
STATES.
BUT THAT IS CHANGING AND RECENT
WORK HAS SHOWN THAT SOUTH ASIAN
AMERICANS EXPERIENCE CARD
SLARVECARDIOVASCULAR DISPARITIE.
ASIAN INDIANS BOTH MINUTE AND
WOMEN HAVE SOME OF THE HIGH ESES
RATES OF CORONARY DRUSH HIGHEST
CASES EVER CORONARY HEART
DISEASE AND STROKE.
SO SINCE 2010, WE'VE BEEN
FOLLOWING A COHORLT OF SOUTH
ASIAN IMMIGRANTS IN THE UNITED
STATES.
AND PARTICIPANTS -- OVER A
THOUSAND PARTICIPANTS WHO HAVE
BEEN ADMINISTERED A FOOD
FREQUENCY QUESTIONNAIRE.
WE WERE ABLE TO DERIVE SEVERAL
DIETARY PATTERNS THAT ARE
INTERESTING.
THIS IS THE FIRST DESCRIPTION OF
SOUTH ASIAN DIETARY PATTERNS.
THREE OF THE DIETARY PATTERNS
THAT WE DERIVED WASSEN MALL
PROTEIN PATTERN THAT INCLUDED
MORE WESTERN-TYPES EVER FOODS.
HIGH FAT DAIRY PATTERN EVER
SOUTH ASIAN FOODS AND ANOTHER
DIETARY PATTERN WAY WAS SOUTH
ASIAN FOODS THAT WE CALL FRUITS
AND VEGETABLES NUTS AND LEDGE L.
A THIRD OF OUR SAMPLE BELONGED
TO EACH OF THESE.
WE LEARNED THAT EACH OF THESE
DIFFERENT DIETARY PATTERNS WERE
DIFFERENTLY ASSOCIATED WITH
CARDIOMETABOLIC DISEASE WITH THE
ANIMAL PROTEIN AND FRIED SNACKS
BEING ASSOCIATED WITH WOWRS
METABOLIC HEALTH AND NUTS AND
LEGUMES BEING ASSOCIATED WITH
BETTER HEALTH.
AN IMPORTANT THING O POINT OUT
HERE IS THAT BOTH BOTTOM TWO
WERE PREDOMINANTLY VEGETARIAN
APPARENTS BUT IT DOESN'T MEAN
THAT ALL VEGETARIAN DIETS ARE
ASSOCIATED WITH BETTER HEALTH
AND THAT'S AN IMPORTANT MESSAGE
TO TALK ABOUT WITHIN OUR
COMMUNITY.
NEXT SLIDE.
USING THE FOOD FREQUENTLY
QUESTIONNAIRE, THERE WAS A
HEALTHFUL PLANT-BASED DIETARY
PATTERN AND FOUND THAT A HEALTHY
PATTERN WAS ASSOCIATED FROM OUR
COHORT WITH LESS FATLY LIVER AND
LESS OBESITY AND LOWER RISK FOR
TYPE 2 DIABETES.
RECOGNIZING THAT NOT ALL
VEGETARIAN DIETS ARE CREATED
EQUAL.
THERE IS A HIGH REV LENS OF
VEGETARIANISM IN SOME SOUTH
ASIAN COMMUNITIES.
CAN YOU ADVANCE THIS.
SO WE USE A CONCEPTIONAL
FRAMEWORK OF DRIVERS THAT
INFLUENCE DIET AND OTHER
BEHAVIORS RECOGNIZING THAT THERE
ARE SOCIAL AND CULTURAL FACTORS.
THE IMPORTANCE OF IMMIGRATION AS
WELL AS ENVIRONMENTAL FACTORS
AND ALL OF THESE THINGS
INFLUENCE INDIVIDUALS,
COMMUNITIES, SOCIAL NETWORKS AND
FAMILIES, HOW THEY A CU A CULTE
AND AFFECT PATTERNS.
WE EULS THAT FRAMEWORKING TO
INVESTIGATE AND -- WE USE THAT T
TO DETERMINE THEIR PATTERN.
THEY NEED FRUITS AND VEGETABLES
1K8 HEALTHY PROTEINS, NUTS, FISH
AND SEA FOOD, LOW-FAT DAIRY,
VEGETABLE OILS, MINIMUM CLI
PROCESSED FOODS AND LIMITING
SALT AND PROCESSED SUGARS.
WINDOW TOOK THIS PATTERN AND
WORKED WITH COMMUNITY MEMBERS
THROUGH A MULTI-SECTOR ENGAGE
THE PARTNERSHIP TO THINK ABOUT
HOW DO WE TAKE THIS INFORMATION
AND ADAPT IT INTO A BEHAVIORAL
COUNSELING PROGRAM FOR THE SOUTH
ASIAN COMMUNITY?
NEXT SLIDE.
THE COMMUNITY INVOLVEMENT AND
CULTURAL ADAPTATION IN THE
DESIGN OF OUR CURRICULUM
MANIFESTED IN SEVERAL DIFFERENT
WAYS.
WE HAD COMMUNITY MEMBERS
INVOLVED IN ITERATIVE FEEDBACK
SESSIONS SORT OF LIKE A USER
CENTER DESIGNER PROSES AND BETA
TESTING.
WE HAVE SEVERAL DIFFERENT
COMMUNITY PARTNERS AND THEIR
STAFF AND LEADERSHIP PROVIDED
INPUT ON THE DESIGN OFFER --
>> TWO MINUTES REPLAINING.
>> THEY PARTICIPATED IN A
PROCESS EVALUATION AND WE HAD
STAKEHOLDER ADVISORY RESOURCE
PANELS THAT GAVE US FEEDBACK.
SO THE SAHELEO I CURRICULUM,
THIS WAS A TRIAL FUNDED BY NIH.
ONE EXAMPLE IS THE MESSAGE
STEREO EAT MORE WHOLE GRAINS.
WE EVER A SESSION FOCUSED ON THE
WHOLE GRAINS THAT THEY MIGHT USE
TO CREATE SOUTH ASIAN DISHES AND
DO A GROCERY STORE TOUR TO FIND
THOSE TYPES EVER WHOLE GRAINS.
IN ADDITION, WE TRY TO FOCUS ON
SOME OF THE STRESSORS AS WELL AS
HOW IMMIGRATION MIGHT AFFECT
PEOPLE'S DIETARY PATTERN.
NEXT SLIDE.
WE ALSO HAD AK EXPECTS OF
SERVICE A DAP STATION SUCH AS
RE-THINK YOUR DRINK.
WE SHOWED THE SUGAR IN BEVERAGES
WE INCLUDED SOUTH ASIAN SPECIFIC
DRINKS.
WE HAVE A HEALTHY PLATE EXERCISE
WHERE WE VEE EVALUATE THE
NUTRITIONAL CONTENT.
AND WE HAVE DEEPER ADAPTATIONS
WHERE WE TRY TO CREATE DIETARY
MESSAGES BUT RECOGNIZING THAT
THEY CAN CON SNRICT WITH
BELIEVES, KNOWLEDGE, FAMILY AND
COMMUNITY AND MAKING SURE THAT
MESSAGING IS RESPECTFUL AND THAT
THE GROUPS ARE TALKING ABOUT HOW
THEIR SOCIAL, MISSER TO CAL,
RELIGIOUS AND COMMUNITY CONTEXT
INFLUENCE THE FOODS OFFER OFFERD
SCEUNLED AND HOW THE
MULTI-GENERATIONAL RELATIONSHIPS
AND COMMUNITY STRENGTHS
INFLUENCE OUR HEALTH AND
FOODWAYS.
THESE ARE SOME EXAMPLES OF
COMMUNITY KNOWLEDGE AND
PRACTICES THAT CAME OUT OF OUR
GROUP SESSIONS.
THERE WERE MEDICINAL DIETARY
PRINCE SUCH AS USING JINGER AND
BLACK PEPPER AND GARLIC.
THEY HAVE A LADY SECTION.
THERE ARE SWEETS.
THE IMPORTANCE OF SERVING GOOD
FOOD AT A FESTIVAL OR AT A
PARTY.
IF YOU ONLY HAVE VEGETABLES AT
YOUR PARTY, NOBODY WILL COME TO
YOUR HOUSE AND HOW CAN YOU FAST
IN A HEALTHY WAY?
FASTING IS AN IMPORTANT PRACTICE
IN THE SOUTH ASIAN COMMUNITY.
I'M GOING TO CONCLUDE WITH
SEVERAL GAPS AND OPPORTUNITIES
THAT I THINK HAVE EMERG EMERGEDM
MY EXPERIENCE IN THE CLINICAL
TRIAL AS WELL AS MY RESEARCH.
IS CULTURAL ADAPTATION
EFFECTIVE?
HOW DO WE MONITOR NON-WESTERN
DIETARY PATTERNS IN TERMS OF
SELF-MONITORING AND BEE MAY
HAVIER CHANGE?
WHAT IS THE ROLE OF DIETARY
CHANGE AND CAN WE MOVE BEYOND
WESTERN EVIDENCE-BASED MODELS
AND MOVE TO OAL RATE ISING
CULTURAL KNOWLEDGE THAT IS VERY
DEEP AND USING TRADITIONAL
MODELS FL HEALTH.
AND HOW DO TO DESIGN STRUCTURAL
INTERVENTIONS TO FOCUS MORE ON
OUR ENVIRONMENT AND POLICIES TO
MAKE SURE THAT IMMIGRANT
COMMUNITIES HAVE ACCESS TO
HEALTHY FOODS AND HEALTH
INFORMATION.
THANK YOU SO MUCH.
I WANT TO ACKNOWLEDGE -- NEXT
SLIDE -- I WANT TO ACKNOWLEDGE
ALL THE COMMUNITY PARTNERS AND
OUR STUDY PARTICIPANTS AND MY
TEAM THAT MAKE THIS WORK A JOY
EVERY DAY.
>> THANK YOU FOR THAT EXCELLENT
PRESENTATION.
OUR NEXT PRESENTATION IS BY DR.
MING-CHIN YEH.
HIS PRESENTATION IS ON CULTURAL
LINGUIST ILINGUISTIC ADAPTATIONB
BASED DIABETES PREVENTION
PROGRAM IN CHINESE AMERICANS.
HE HAS STRATEGIES FOR HEALTH
PROMOTION AND CHRONIC DISEASE
PREVENTION.
WELCOME, DR. YEH.
>> THANK YOU.
IT'S GREAT TO BE HERE TO SHARE
WITH YOU THE GROUP MY SEARCH ON
THE CULTURE AND LINGUISTIC FOR
CHINESE AMERICANS SPECIFICALLY
HERE IN NEW YORK CITY.
NEXT SLIDE, PLEASE.
I WANT TO PROVIDE INFORMATION ON
CONVENTIONAL PROGRAM DESIGNS.
IT STARTED OUTS RANDOMIZED
CONTROL.
IT AIMS TO PREVENT OR DELAY THE
ON SET OF DIABETES AT HIGH-RISK
POPULATIONS AND THE GOALS OF THE
ORIGINAL IS TO ACHIEVE 7% WEIGHT
LOSS.
WE CAN DISCUSS ABOUT THIS.
AND ANOTHER GOAL IS TO A SCHEEF
AT LEAST 150 MINUTES OF PHYSICAL
CAL ACTIVITIES HER WEEK.
THE RESULT OF THE DPP HAS BEEN
PUBLISHED IN THE "NEW ENGLAND
JOURNAL OF MEDICINE" IN 2022.
IT SHOWS THAT IT WILL REDUCED
DIABETES BY 58% AND THE
METFOREMAN WAS 32%.
THIS IS ONE OF THE FIRST STUDIES
SHOWING THAT LIFESTYLE
INTERVENTION DID BETTER THAN THE
DRUG GROUP.
WHAT MAKES THE LIFESTYLE
INTERVENTION SUPERIOR TO THE
DRUGS 1234.
THERE ARE SEVERAL KEY FEATURES.
FIRST EACH INDIVIDUAL
PARTICIPANT WERE ASSIGNED A
LIFESTYLE COACH AND THE DIVE
STYLE COACH DELIVER THE
CURRICULUMS ON 1-ON-1 BASIS.
THE CURRICULUM INCLUDES 16
WEEKLY SESSIONS AND FOLLOWED BY
MONTHLY SESSIONS AND IT INCLUDES
PHYSICAL ACTIVITIES, STRESS
REDUCTION, AND SUPERVISED
PHYSICAL ACTIVITY TO INCREASE
PARNTS PHYSICAL AK -- INCREASE
PARTICIPANT'S PHYSICAL ACTIVITY
LEVELS.
THERE ARE OPTIONS FOR
PARTICIPANTS.
THE DIVE STYLE COACH WORKS WITH
EACH INDIVIDUAL PARTICIPANT TO
COME UP WITH SOLUTIONS WHERE
THEY CAN OVERCOME THE CHALLENGES
WHERE THEY'RE NOT EATING HEALTHY
OR NOT BEING PHYSICALLY ACTIVE.
AS YOU CAN SEE FROM THIS
ORIGINAL APPROACH, IT'S
INDIVIDUAL-BASED AND VERY
INTENSIVE AND HIGH COST.
NEXT SLIDE, PLEASE.
WHAT WE DO MOVING FORWARD -- HOW
CAN WE MAKE IT DPP MUCH MORE
SUSTAINABLE IN THE FUTURE AND
MAKE IT MORE APPROPRIATE FOR
CHINESE -- MINORITY POPULATIONS
SO WE CAN DISSEMINATE OR
IMPLEMENT IT WILL IN FUTURE
STUDIES.
MY FU STUDIES TRY 20 ADDRESS THE
ISSUES.
TRY TO ADDRESS THOSE ISSUES.
THE PROJECTS TRY TO SEE IF WE
CAN ADOPT AND TRANSLATE A DPP
KRIM ALUMINUM THAT IS CULTURALLY
APPROPRIATE AND LINGUISTIC
APPROPRIATE FOR CHINESE AMERICAN
DIABETES PREVENTION AND WE WANT
TO TRANSFORM THIS CURRICULUM
THAT YOU CAN BE HOUSED IN SOME
SORT OF ON LINE FORMAT AND WE
CAN DO A FEASIBILITY TEST TO SEE
IF IT'S ACCEPTABLE.
TO THE
CHINESE AMERICANS.
THIS STUDY WAS DIVIDED INTO
THREE PHASES.
FIRST ONE IS FORMATIVE
ITERATIONS.
WE HAVE FOCUS GROUPS TO GET
FEEDBACK TO SEE WHAT THEY LIKE
ABOUT THIS PROGRAM AND WHAT THEY
DON'T LIKE AND WHAT ARE THE
AREAS THEY'RE MISSING.
BASED ON THESE FEEDBACKS, WE
WERE ABLE TO REVISE OUR
CURRICULUM FURTHER BEFORE WE
SENT IT TO OUR ADVISORY BOARD.
SO THEY GAVE US ADDITIONAL
FEEDBACK AND ADDITIONAL
REVISIONS.
UNTIL WE ARE SATISFIED, WE MOVE
ON TO THE PHASE 2 WHERE WE WERE
ABLE TO TRANSFORM THIS.
WITH THE HELP OF OUR I.T.
PERSONNEL, WE WERE ABLE TO PUT
THE WHOLE CURRICULUM IN THE
PRIVATE FA Facebook GROUP WHERE
THEY WERE ABLE TO REVEAL THE
CURRICULUM AND UNDERSTAND THE
CONTENTS.
WE WERE ABLE TO DO A FEASIBILITY
AND ACCESSIBILITY STUDY BASED ON
THE CURRICULUM.
THE STUDY LASTS A YEAR.
WE ONLY HAD 13 PARTICIPANTS O
COMPLCANCOMPLETE THE STUDY.
WE USED FOCUS GROUPS, THEY END
OF SIX MONTHS AND ONE YEAR.
WE CAN SEE THAT CULTURAL STABLE
FROODZ IMPORTANT OR OUR
PARTICIPANTS.
ONE PARTICIPATE SAID CHINESE
LOVE RICE.
IF I DON'T EAT RICE AT ALL, I
WON'T BE USED TO IT, I NEED A
LITTLE RICE.
WE TOLD THEM, YOU DON'T NEED TO
ELIMINATE RICE FROM YOUR DIE
OAT.
MAYBE SWITCH OUT OR -- DIET, YOU
CAN JUST EAT HEALTHIER.
THE PARTICIPANT WOULD LIKE TO
SEE MORE CULTURAL FOODS IN THE
CURRICULUM.
ONE PARTICIPANT SAYS AMERICANS
GO TO BUY A DOUGHNUT BUT THE
CHINESE GO TO A BAKERY TO BUY
BREAD.
THERE IS A POPULAR STORE IN
CHINATOWN TO SELL CHINESE
PASTRIES AND THEY LIKE THAT.
ALSO THEY WOULD LIKE TO SEE MORE
REPRESENTATION IN THE CURRICULUM
WHERE THEY WANT TO SEE MORE
ASIAN FACING NOTICE CURRICULUM
ITSELF.
FOR EXAMPLE, ONE STATED IF I GO
ON LINE AND SEE ONLY WESTERN
FACES, I WOULD LOSE INTEREST
BECAUSE I THINK THIS IS NOT THE
CAUSE FOR ME.
WE'RE DELIGHTED TO SEE THAT, THE
FORMAT, THEY THINK ASSESS EASY
TO USE AND EASY TO UNDERSTAND.
THEY LIKE TO, HOWEVER, SOME OF
THE PARTICIPANTS EXPRESSED THAT
THEY'RE NOT FAMILIAR WITH USING
Facebook, BUT THEY ARE
EVERYONE MORE FAMILIAR WITH THE
SOFTWARE THAT IS POPULAR AMONG
CHINESE IMMIGRANTS.
LIKE WECHAT.
>> TWO MINUTES REMAINING.
>> IN TERMS OF THE PROGRAM, THEY
LIKING IT OVERCOMING THE INITIAL
HESITANCIES, THEY LIKE IT AND
THINK IT'S A GOOD WAY TO MANAGE
THEIR OWN SCHEDULES.
SO, WE ALSO THINK THAT IT'S
GREAT TO SEE THAT WE HAVE A HIGH
RETENTION RATE, EXPECTATIONS AND
WE SEE THERE IS SIGNIFICANT
REDUCTIONS STARTING AT MONTH TWO
GOING TO MONTH 10.
SO WHAT WE LEARNED, WE KNOW THAT
BASED ON THIS PRELIMINARY
FINDINGS, THE ON LINE PLATFORMS
OR APPLICATIONS SEEM FEASIBLE
AND ACCESSIBLE TO UNDER-SERVED
MINORITY POPULATIONS SUMP AS
ASIAN AMERICANS.
WOULD HOWEVER, WE DO OBSERVE GAR
CHALLENGES FOR EXAMPLE PROGRAM
GOALS FOR MEXICAN AMERICANS MAY
NOT BE APPROPRIATE FOR ALL
AMERICANS.
MAYBE THE 7% WEIGHT LOSS?
WE DON'T NEED THAT.
IT MAY NOT BE -- THE 7% MAY NOT
BE APPROPRIATE FOR ALL
POPULATIONS AND WE THINK NOT
EVERYBODY PPARTICIPANTS ARE FAMH
THE GUIDELINES.
THEY HAVE IMPLOAVMENTED THAT IN
THEIR REAL LIFE.
IMPLEMENTED THAT IN THEIR REAL
LIFE.
THIS IS A SIMPLE "MYPLATE."
YOU CAN SEE THAT HAD IS NOT THE
CASE FOR ASIAN AMERICANS.
THE CHINESE AMERICANS TO BE
SPECIFIC SCLD THIS IS ONE OF
MYPLATE EXERCISES THAT WE DID
SEVERAL IS YEARS BACK.
YOU CAN SEE THAT THEY HAVE
STRUGGLED INDIVIDUALIZING THOSE
CONCEPTS IN THE PLATE FORMAT.
A CHINESE STYLE IS DIFFERENT ON
THE TABLE.
THEY HAVE THE RICE IN A BOWL.
IT'S THIS CONCEPT PLATE CONCEPT
IS FOREIGN TO THEM AND THEY HAVE
TROUBLE CONCEPTUALIZING IT.
EVEN THOUGH IT'S SIMPLE, IT MAY
NOT BE CULTURALLY APPROPRIATE
FOR CHINESE AMERICANS.
NEXT SLIDE.
I DO WANT TO SAY THANK YOU TO MY
MENTORS AND MY COLLEAGUES DR.
JEWTH ROSETTE AND DR. MA AND
WINCEY LAU.
>> THANK YOU TO ALL OUR
PRESENTERS FOR YOUR EXCELLENT
PRESENTATIONS.
WE ARE CERTAINLY VERY EXCITED TO
FOLLOW YOUR RESEARCH.
AS A FRIENDLY REMINDER, PLEASE
SUBMIT ANY QUESTIONS USING THE
LIVE FEEDBACK BUTTON IN THE
CAST.
PLEASE STATE WHICH PANELIST
YOU'RE DIRECTING YOUR QUESTION
TO.
I HAVE A FEW QUESTIONS HERE.
MY FIRST QUESTION IS TO ANY OF
THE THREE PANELISTS, CAN YOU
GIVE SOME EXAMPLES OF ENGAGING
SOCIAL NETWORKS AND COMMUNITIES
WITH THE HOPE OF REACHING
INDIVIDUAL SUCCESSFULLY TO
ADDRESS THEIR DIETARY FACTOR.
>> I THINK THIS IS SOMETHING
THAT WE HAVE NOT DONE FORMALLY
IN TERMS OF A FORMAL SOCIAL
NETWORK ANALYSIS, BUT ONE
EXAMPLE WOULD BE ASKING PEOPLE
WHO IS THE PERSON WHO DOES --
TRYING UNDERSTAND WHO IN YOUR
FAMILY OR HOUSEHOLD DOES THE
GROCERY SHOPPING.
WHO IS THE PERSON THAT DOES THE
COOKING?
WHO IS THE PERSON AT THAT
DECIDES WHAT THE MEALS SNRB THAT
WOULD BE AN EXAMPLE OF TRYING TO
UNDERSTAND WHO IS -- WHO ARE THE
INFLUENTIAL PEOPLE THAT
DETERMINE WHAT FOOD IS
PURCHASED, WHERE PEOPLE GET FOOD
AND WHO DECIDED WHAT PEOPLE WILL
EAT FOR DINNER.
ONE THING IS WE HAD A BARRIER TO
BEHAVIOR CHANGE SI WANT TO MAKE
THE CHANGES BUT MY KIDS DON'T
BECAUSE MANY OF THE CHILDREN OF
THE PEOPLE IN OUR TRIAL WERE
MORE WHEREINIZED OR AMERICANIZED
AND THOUGH WANTED TO EAT THEIR
OWN DISMINGS IT WAS UNCLEAR HOW
DO YOU NAVIGATE NOT JUST THE
BEHAVIOR SCHAING AND THE HEALTH
BUT DIFFERENT DIETARY PATTERNS.
I THINK FIRST IN RATING THE
FAMILY MEMBERS WHO ARE PART OF
THAT PROCESS AND ARE HELPFUL OR
BARRIERS IS REALLY IMPORTANT.
>> I JUST WANT TO SAY THAT
SOCIOSUPPORT IS IMPORTANT.
FAMILY MEMBERS, FRIENDS, CLOSE
FRIENDS ARE IMPORTANT.
FOR EXAMPLE, A ESPECIALLY THE
MALE PARTICIPANTS, MY WIFE
DOESN'T PREPARE THAT FOOD SO I
DON'T HAVE THE OPPORTUNITY TO
EAT IT.
IF I WANT TO EAT HEALTHY, I NEED
TO TALK TO MY WIFE OR YOU.
YOU NEED TO TUQUE MY WIFE SO
THEY CAN PREPARE HEALTHY FOOD
FOR US.
I THOUGHT IT WAS INTERESTING THE
FAMILY DYNAMIC.
IF WE INTERVENE ON ONE PERSON
BUT THE OTHER FAMILY MEMBERS
DOESN'T GET ON BOARD, IT'S GOING
TO BE DIFFICULT TO HAVE
EFFECTIVE INTERVENTION AS A
WHROAL.
>> TWHOLE.
>> DR. MA, WOULD YOU LIKE TO
ADDRESS THAT?
UNMUTE YOURSELF.
>> I DID NOT QUITE GOAT THE
QUESTION.
>> IT SAYS, CAN YOU GIVE SOME
EXAMPLES OF ENGAGING SOCIAL
NETWORKS AND COMMUNITIES WITH
THE HOPE OF REACHING INDIVIDUALS
SUCCESSFULLY TO ADDRESS THEIR
DIETARY PATTERNS?
WHAT KIND OF SOCIAL SUPPORT CAN
YOU ENVISION TO HAVE SUCCESS
WITH YOUR INTERVENTION PROGRAMS.
>> THE INTERVENTION PROGRAMS
WERE SUCCESSFUL.
BECAUSE WE COLLABORATED WITH A
LOT OF THE CHURCH COMMUNITIES.
IN THE MARSHALLESE CULTURE, IT'S
IMPORTANT AND WORKS FOR US TO
WORK WITH CHURCH LEADERS AS WELL
AS LOCAL ORGANIZATIONS TO BETTER
UNDERSTAND AND TO ADDRESS THESE
NUTRITIONAL NEEDS.
HOWEVER, LIKE WITH THE
MARSHALLESE COMMUNITY ALTHOUGH
IT WORKS WELL AND PEOPLE WERE
EDUCATED AND RECEIVED
INTERVENTION WELL, THE ONLY
ISSUE WE HAD WAS WITH THE DIET.
I MEAN WITH THE COST OF FOOD FOR
EXAMPLE IN THE ISLANDS.
BUT HERE IN THE UNITED STATES,
IT'S THE SAME THING.
WE USE FAMILY MEMBERS TO HELP
WITH -- TO COLLABORATE WITH DIE
OAT INTERVENTIONS.
THANK YOU.
>> MY NEXT QUESTION IS TO DR.
KABUA.
CAN YOU TALK ABOUT THE ORIGIN?
MEDIATORS OF AR THOROUGH CLOSEIS
LIVING IN AMERICA.
SAME LAR TO THE STUDY IT'S AN
HLBI STUNNEDDED COHORT AND NOW
MIHD FUNDED.
WE'VE BEEN FOLLOWING 1,000 SOUTH
ASIANS SINCE 2010 TO UNDERSTAND
RISK FACTORS FOR THE DEVELOPMENT
OF CARDIOVASCULAR DISEASE AND
DIABETES.
THEY'VE BEEN FEENO TY THENO REP.
IMHD FUNDED US TO ENRICH THE
INDIVIDUALITY OF OUR COHORT AND
WE'RE IN THE PROSIS EVER
RECRUITING ANOTHER 1,000
INDIVIDUALS OF PAKISTANI ORIGIN.
OUR DATA ARE AVAILABLE.
WE EVER A WEBSITE FOR
RESEARCHERS TO USE.
AND WE WELCOME COLLABORATION.
>> THANK YOU.
THE NEXT QUESTION IS EITHER
EITHER KABUA OR DR. YEH.
CAN YOU PEEK TO HOW YOU CONSIDER
THE VARIOUS ACCULTURATION LEVELS
IN INTERVENTION DESIGN AND THE
MATERIALS YOU USE.
SO YOU CAN RESEARCH THE
IMMIGRANTS THAT HAVE BEEN HERE A
LONG PERIOD OF TIME.
>> SO MAYBE I CAN START.
THE ACCULTURATION IS A VERY
IMPORTANT THING IN OUR STIDDIE Y
DESIGNS BECAUSE IMMIGRANTS ARE
OFTEN TIMES IN THE COMMUNITY
LONGER LIKE 15 OR 30 YEARS.
IN MY CURRENT STUDY, THE ONE
WHICH JUST ENDED, I THINK IT'S
MOSTLY THE CURRENT IMMIGRANTS.
AND SO, THEY STILL HAVE A LOT OF
ATTACHMENT TO THEIR ORIGINAL
CULTURES AND WOULD LIKE TO SEE
MORE OF THOSE THINGS IN THEIR
DAILY LIFE AS OPPOSED TO THOSE
HERE LONGER AND WOULD LIKE TO
KNOW MORE ABOUT AMERICAN WAY OF
EATING.
IT'S INTERESTING AND LIKE TO
KNOW MORE ABOUT IT.
BECAUSE THEY STAY IN SOME SORT
OF ENCLAVE.
WE TRIED TO SEE IF WE CAN
DIFFERENTIATE OUT OF THESE TWO
POPULATIONS AND TAILOR OUR
MESSAGE TO THEM.
THIS IS A SMALL STUDY.
WE WEREN'T ABLE TO DO THAT, BUT
I RECOGNIZE THIS IS ONE OF THE
AREAS MOVING FORWARD.
WE NEED TO SOMEHOW DIFFERENTIATE
SUBTLE DIFFERENCES.
>> THE ONLY THING WOULD I ADD IS
IT'S IMPORTANT TO MEASURE
ACCULTURATION IN MULTI-DIMENSION
THE WAYS INTOS THEY STUDIES SO
WE CAN UNDERSTAND IF A CULL
STRAITION AN EXECUTIVE MODIFIER
AND IF PEOPLE OF DIFFERENT
ACCULTURATION BACKGROUNDS FEEL
LIKE THE INTERVENTION MET THEIR
NIEDZ OR IF THEY'RE DROPPING OUT
AT A HIGHER RATE.
WE LEARNED FROM OUR PROCESS
EVALUATION THAT YOUNGER PEOPLE
WHO ARE HIGHLY A CULL TRAITED
MAYBE EVEN BORN IN THE UNITED
STATES DID NOT FEEL LIKE THE
SAHELI ACCULTURATION WAS FOR
THEM BUT MORE FOR THEIR PARENTS.
YOU CAN'T NECESSARILY ADDRESS
EVERYTHING IN ONE INTERVENTION,
BUT WE WERE AWARE OF IT AND
ASKED ABOUT IT AND TRIED O
MEASURE IT.
>> IT IS A CHALLENGE WHEN IT
COMES TO LEVELSES ADULTS AND BY
THE TIME YOU HAVE SECOND AND
THIRD GENERATION, THEY EVENT THE
REGULAR WESTERNER DIET.
I HAVE ONE MORE QUESTION.
FOR DR. YEH, WOULD YOUR
[INDISCERNIBLE] BE AVAILABLE FOR
HEALTH CARE PRACTITIONERS DO YOU
THINK DOWN THE ROAD?
>> YES.
I THINK THAT'S ONE OF THE GOALS.
WE LIKE TO DISSEMINATE THE
INFORMATION OUT IN THE FIELD.
WE DO GET QUITE A FEW REQUESTS.
WE LIKE TO SEE THOSE TYPES EVER
INFORMATIONS ESPECIALLY
LINGUISTIC INFORMATION.
IN THE FUTURE WE WANT TO
DISSEMINATE INTO THE WIRED
POPULATION.
>> ONE LAST QUESTION WAS BOTH
DR. KABUA AND DR. YEH MENTION
ABOUT THE ROLE OF RELIGION AND
I'M SURE TRADITIONAL CHINESE
MEDICINE PLAYS A ROLE.
DO YOU HAVE ANY PLANS TO DO
SPECIFIC STUDIES ON THE ROLE OF
RELIGION AS A SOCIAL/CULTURAL
DETERMINANT AND HOW RELIGION CAN
INFLUENCE DIETARY PATTERNS
BECAUSE THERE CAN BE PEOPLE WHO
ARE FASTING AND FEASTING AND SO
MANY BEHAVIORS THAT ARE
ASSOCIATED WITH RELIGION.
I'M PUTTING OUT A QUESTION THERE
IF THERE IS A POSSIBILITY
SOMETIME IN THE NEAR FUTURE.
>> I THINK IT'S AN INTERESTING
AND IMPORTANT AREA THAT WE
HAVEN'T LOOKED AT ENOUGH.
I DO AGREE THAT RELIGION IS A
PRIME DETERMINANT OF FOOD AND
DIETARY PATTERNS SO IT WOULD BE
GOOD TO LOOK AT THAT MORE
CLOISLY.
>> I THINK WE'RE OUT OF TIME,
BUT I WOULD LIKE TO THANK THE
PANEL MEMBERS FOR SHARING YOUR
INSIGHTS ON THIS IMPORTANT
TOPIC.
THANK YOU TO THE AUDIENCE FOR
POSING RELATIVE QUESTIONS.
WE'LL NOW HAVE A BRIEF LIFE
EXPERIENCE PRESENTATION FROM OUR
FINAL PRESENTER SHARON COLLEENY
ODOM.
SHE'S BEEN INVOLVED IN HAWAIIAN
HEALTH FROM A CULTURAL
PERSPECTIVE.
>> CAN THE VIDEO BE PLAYED
PLEASE.
>> ALOHA, I'M THE EXECUTIVE
DIRECTOR OF HAWAII FOOD
ALLIANCE.
I WANTED TO SHARE WITH YOU OUR
INDIGENOUS THOUGHTS BEHIND FOOD
AND PREMISS NUTRITION.
WHAT DOES THE IMAGE OF THE FOOD
MERE MID LOOPYRAMID LOOK LIKE F.
THERE IS WHAT I SEE WHEN I LOOK
AT IT HERE IN HILY. HAWAII.
THIS IS SOMETHING THAT WAS USED
TO POUND POI AND YOU CAN SEE
THIS.
THIS IS ONE OF OUR MOST
IMPORTANT FOODS AND PALOA WE
TAKE CARE OF THE ISLAND.
IF WE CARE FOR THE ISLAND, THE
ISLAND WILL CARE AND FEED US.
IF YOU LOOK INTO THE MOUNTAINS,
YOU'LL SEE FACES TO REMIND US
THAT OUR AN VEST YOU ARE ALWAYS
THERE.
THREE SIT ON MY SHOULDER EVERY
DAY.
IF WE LOOK TO OUR EA ANCESTORS D
GRANDPARENTS TO THE FOOD THEY
COOKED WE UNDERSTAND MORE.
WE LOOK FROM THE MOUNTAIN TO THE
OCEANS WE HAVE GUIDELINES ON HOW
TO TAKE CARE OF WATER AND FOOD.
YOU HAVE TO PUT IN EFFORT.
THESE PEOPLE WORKING THE FIELDS
REMIND US OF THE EFFORT WE NEED.
YOU'LL SEE WATER COMING DOWN THE
PYRAMID.
WATER WAS SO IMPORTANT FOR US.
NOBODY OWNED THE WATER.
IF YOU USED IT, YOU NEEDED IT TO
GROW FOOD, YOU WERE ABLE TO USE
IT.
WE NEED TO CARE FOR OUR WATER.
WE MUST CARE FOR THE ELEMENTS ON
A DAILY BASIS AND THIS REMINDS
US OF THAT.
THE SURFER AND SWIMMER AND
CANOER MEAN US NEED TO BE ACTIVE
ON A DAILY BASIS AND INCORPORATE
THAT INTO YOUR LIFE JUST AS DO
YOU HEALTHY FOODS.
YOU CAN SEE HANDS HOLDING THIS
PONO ON THE BOTTOM OF YOUR
SCREEN.
WITH THAT, IT TALKS ABOUT OUR
FOOD CONNECTS US TO OUR
SPIRITUALITY.
IN OUR HAWAII CULTURE, THE FOOD
REPRESENTS DIFFERENT LELTS OF
NAIMP.
WE HAVE -- ELEMENTS OF NATURE.
WE DIDN'T OWN THE PLANTS OR
WATER, WE WERE IN RELATIONSHIP
WITH THEM.
WE KNEW IF WE TOOK CARE OF THEM
JUST AS THE LAND.
, IF WE TAKE CARE OF OUR
ELEMENTS, THEY WILL TAKE CARE OF
US.
THESE HANDS REMIND US THAT THE
FOOD IS SPIRITUAL FROM THE TIME
WE PLANT IT TO HOW WE PREPARE IT
TO HOW WE SERVE IT.
ALL OF THIS COMES FROM AN
INTERNAL SPIRITUALITY THAT
CONNECTS US TO THE FOOD AND TO
THE WHOLE PROCESS.
IF YOU LOOK AT THE BOTTOM OF THE
PYRAMID ON LEFT-HAND SIDE,
YOU'LL SEE SWEET POTATO AND
BANANAS.
THIS IS TO REMIND US THAT OUR
POLYNESIAN CA CAR BOW HYDRATES N
THE WORLD.
THEY ARE HIGH IN FIEBER AND
DON'T RAISE YOUR BLOOD SUGARS.
WE KNOW IF YOU CUT OUT PROCESSED
CACARBOHYDRATES YOU CAN BRING DN
BLOOD PRESSURE AND LOSE WEIGHT.
WEFT OTHER CAR BOW HYDRATES ON
WE HAVE OTHER CARBOHYDRATES BUT
THEY'RE PROCESSED.
OUR MESSAGE IS TO EAT YOUR
CARBOHYDRATES AS CLOSE AS THEY
WERE PUT ON THERE EARTH SO
UNPROCESSED.
YOU'LL SEE THE RAINBOW AND WE
HAVE ALL TYPES OF FRUITS AND
VEGETABLES AND GET YOUR PURPLES
AND GREENS AND YELLOWS.
SO EATING THE RAINBOW OF FRUITS
AND VEJ STABLES.
YOU'LL SEE ON THE -- VEJ
STABLES.
VEGETABLES.
YOU'LL SEE THE DAIRY
COMPARTMENT.
BUT HAWAIIANS DIDN'T HAVE COWS
BUT ALL THE BONES THAT HAVE BEEN
DUG UP HAVE BEEN HEALTHY.
WE KNEW THAT WITH THE POI AND
FISH AND BONES EVENT, THE
CALCIUM WITHOUT HAVING DAIRY.
WE ENCOURAGE HEALTHY DAIRY, BUT
WE REALIZE THAT YOU CAN GET YOUR
CALCIUM FROM MANY OTHER SOURCES
AND IT DOESN'T HAVE TO BE DAIRY.
ON THE RIGHT-HAND SIDE IS
PROTEIN.
IT CAN BE FISH OR MEAT OAR
NONANIMAL DAIRY.
ON THE LEFT-HAND SIDE ARE THE
HEALTHIER FATS.
FATS ARE IMPORTANT IN THE BODY.
IT'S THE A. NATS WE EAT AND TYPE
OF FATS THAT WE EAT THAT ARE
IMPORTANT.
FOR NEWS HAWAII, WE HAD COKE
NUT.
COKE NUT WAS A ZERO VERY FAT FOR
US.
OUR FISH AND CHICKEN, THE ER
THINGS THAT WE HAD WERE LOW FAT.
THIS IS ONE OF THE AREA AS THAT
WE DID GET A SUBSTANTIAL AMOUNT
OF FATS FROM AND YOU'LL SEE
AVOCADO AND OLIVE OIL AND NUTS
AND THE RIGHT-HAND SIDE IS JUST
A REMINDER THAT THESE ARE THE
FATS THAT AREN'T AS HEALTHY FOR
US.
YOU DON'T WANT TO HAVE THEM ON A
DAILY BASIS.
SO OVERALL, WHEN WE TALK ABOUT
HEALTH AND NUTRITION FOR OUR
COMMUNITY, WE WANT THEM TO SEE
THAT THERE ARE SO MANY THINGS
THAT YOU CAN DO THAT A INSTEAD
OF BEING THE MESSENGER OF DON'T
DO THIS OR THIS ISN'T GOOD FOR
YOU AND DON'T EAT THAT, WE'RE
SAYING HERE IS A WIDE SELECTION
FEOFFER HEALTHY FOODS.
WE WANT YOU TO CONNECT WITH
HEALTH AND VISION AND
SPIRITUALITY AND KNOWLEDGE EVER
GRANDPARENTS AND PUT EFFORT INTO
EATING A HEALTHY DIE OAT.
THESE ARE ALL THE THINGS
COMBINED IN THIS PICTURE.
>> THANK YOU.
THAT IS SO INSPIRING AND
BEAUTIFUL.
THANK YOU VERY MUCH FOR SHARING
THAT WITH US, SHARON.
THANK YOU ALL FOR JOINING TOLD'S
PANEL AND AGAIN, THANK YOU TO
THE PANEL MEMBERS FOR SHARING
YOUR EXPERTISE.
WE'LL NOW MOVE FORWARD WITH THE
CLOSING OF DAY ONE.
THANK YOU.
>> SO I WANTED TO THANK EVERYONE
FOR ATTENDING TODAY PARTICULARLY
ALL OUR PANELISTS, MODERATOR,
SPEAKERS FOR SHARING THEIR
RESEARCHING AND EXPERTISE IN
WORKING WITH VARIOUS POPULATIONS
AROUND DIET AND CULTURE.
THANK YOU ATTENDEES FOR ASKING
YOUR THOUGHTFUL QUESTIONS FOR
THINKING THROUGH THE GAPS AND
OPPORTUNITIES IN THE AREA EVER
CULTURE CENTERED DIETARY
INTERVENTIONS.
NEXT SLIDE, PLEASE.
I'M JUST GOING TO WRAP UP WITH
OUR DAY ONE SO MY CO-CHAIR AND I
WILL TALK ABOUT BRIEFLY WHAT WE
TALKED ABOUT TODAY.
TODAY'S PRESENTATIONS DISCUSSED
SOME INNOVATIVE AND IMPACTFUL
RESEARCH AND THENNING CULTURAL
CONSIDERATIONS AND SOCIOCULTURAL
FACTORS AROUND DIETARY
INTERVNGSES AROUND NATIVE
AMERICAN COMMUNITIES, BLACK
COMMUNITIES, HISPANIC AND LATINX
COMMUNITIES AND EXPWRAITION
PACIFIC ISLANDER POPULATIONS.
DR. GITTALSON AND MATTEI TALKED
ABOUT THE IMPORTANCE OF TAKING
CULTURE INTO CONSIDERATION WHEN
DESIGNING DIETARY INTERVENTIONS.
OUR FIRST PANEL MOVE T MO MOCHEO
HEALTH EQUITY.
THERE WAS A COOKING MATTERS
INTERVENTION FOR THE SHEYENNE
RIVERS.
AND INVOLVING INDIGENOUS YOUTH
IN THE COMMUNITY AND I
APPRECIATED THE OVERVIEW OF
POSITIONALITY AS WELL IN
CONDUCTING RESEARCH 234
COMMUNITIES OUTSIDE OF YOUR OWN.
SECOND PANEL TOUCHED ON
PLANT-BASED DIETS FOR BLACK
AMERICANS LIVING IN THE BLACK
BELT AND USE OF SPICES AND
HERBS.
INFORMATION ABOUT HOW TO SCALE
UP THE PROGRAM.
I'LL TURN IT OVER TO JOSE TO MAP
UP THE OTHER ONCE.
>> OUR THANKS TO ALL OF THE
PANELISTS MOD EXPRAIRTS
PRESENTERS TODAY.
THIS LAS BEEN A FANTASTIC DAY.
WE'VE BEEN LEARNING
TREMENDOUSLY.
IN PANEL THREE WE LEARNED AND
HEARD FROM DR. FUSTER THE
IMPORTANCE EVER ACKNOWLEDGING
COMPLEXITY OF WHAT CULTURAL AND
WHAT ACCULTURATION IS AND HOW WE
NEED TO WE THINK THE FRAMEWORK
AND DETERMINE OTHER SOCIAL
DETERMINANTS.
THIS IS A TOPIC WE HEARD FROM
ALL OF THE PANELS TODAY AND DR.
VEGA LOPEZ PRESENTATION, WE GOT
CLOSER TO THE ACCULTURATIONING
AND THOUSAND HAPPENS IN AN OLDER
SITUATION.
AGAIN, EMPHASIZING THE
IMPORTANCE OF SOCIAL
DETERMINANTS AND THE SOCIAL
ENVIRONMENTAL ROLE.
IN DR. ROSAS'S PRESENTATION, WE
LOOKED AT VARIOUS INTERVENTIONS
AND I APPRECIATED HOW SHE WALKED
US THROUGH THE LEARNING PROCESS
OF THE INTERVENTIONS AND
RECOGNIZES HOW WE NEED TO TAILOR
TO ACCULTURATION LETTER AND TAKE
ALL THESE MESSAGES WITH FAMILY
AND SOCIAL SUPPORT THAT IS
CRUCIAL FOR THE LATINO
POPULATION AND WE'VE SEEN THE
DIVERSITY OF THE LATINO
POPULATION.
IN PANEL POWER, WE HAD THREE
EXCELLENT PRESENTATIONS STARTING
WITH THE MARSHAL ISLANDS.
RECOGNIZING HOW THE SOCIAL
POLITICAL CONTEXT CAN INFLUENCE
DIET AND CULTURE.
IT WAS VERY WELL APPRECIATED AND
A POINT WELL-GIVEN.
HOW CAN THOSE -- HOW CAN THEY
CANNOT BE IGNORED WHETHER WE'RE
DRAFTING AND CRAFTING DIETARY
INTERVENTIONS.
I ENJOYED THE PRESENTATION FROM
ABOUTTHE SOUTH ASIAN COMMUNITY.
NOT ONLY FOCUSING ON THE FOOD
AND ACTUAL MEAL BUT ON THE
ENJOYMENT OFFER THE FOOD.
AND ALSO REPRESENTING THE
INTERSECTIONALITIES THAT WE HAVE
SO MANY LAYERS THAT INCLUDE
RELIGION, GENDER, NOT ONLY THE
JUST ETHNICITY BUT WE EVER TO
RECOGNIZE ALL OF THESE
INTERSECTIONALITIES.
AND LASTLY, A GREAT PRESENTATION
AND ADAPTATION OF THE DPP
PROGRAM FOR CHINESE AMERICANS
EMPHASIZING THE IMPORTANCE EVER
SOCIAL SUPPORT AND DETERMINANTS
AND HOW WELL THE PLAYERS NEED TO
COME TOGETHER.
I THINK HEARING THESE TOPICS
EMPHASIZE THE COMMONALITIES
ACROSS ALL THE GROUPS BUT THREE
NEED TO BE TAILERS SPECIFICALLY
FOR EACH OF THESE GROUPS.
THANK YOU, AGAIN, IF WE CAN HAVE
THE NEXT LIGHTS FOR ONE LAST
MESSAGE.
>> THANKS, JOSE.
TOMORROW JUST A REMINDER, WE
START BACK AT NOON EASTERN
STANDARD TIME TO WRAP UP THIS
TWO-DAY VIRTUAL WORKSHOP.
PLEASE JOIN US AGAIN.
WE'LL START WITH A RECAP OF
TODAY AND MOVE INTO OUR THREE
PANELS ALONG WITH FLASH TALK
PRESENTATIONS.
THERE WILL BE AN EXECUTIVE
SUMMARY SHARED WITHIN A FEW
MONTHS AND POSTED TO THE
WORKSHOPS AND THE VIDEO CAST
WILL BE AVAILABLEAFTER WARDS.
AND FOR THOSE REGISTERED
DIETICIANS INTERESTED IN GETTING
CPEUs THIS WILL THERE ARE 9.25
CPEUs BUT IT'S CURRENTLY UNDER
REVIEW.
YOU CAN MAKE SURE TO VISITS THE
NMP WORKSHOP WEBSITE FOR
INFORMATION ON GETTING THE
CREDIT HOURS AND CERTIFICATES.
I WANT O THANK EVERYONE FOR
ATTENDING AND I HOPE EVERYONE
HAS A WONDERFUL REST OF THE DAY
AND WE'LL SEE EVERYONE TOMORROW.
NEXT SLIDE, PLEASE.
NEXT SLIDE.
THANKS EVERYONE.
WE'LL SEE EVERYONE TOMORROW.