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Along-standing partnership exists between rural, Indigenous communities in the American Southwest and the Johns Hopkins Center for American Indian Health (JHCAIH). The partnership has focused on different community needs throughout the last several decades. In 2008, food distribution experts and private philanthropists Rick and Beth Schnieders approached JHCAIH to partner on nutrition promotion, and provided seed funding for community planning. Three communities' Community Advisory Boards (CABs), stakeholders, and JHCAIH staff, participated in a community visioning process in 2009 and 2010 to develop strategic plans to address community concerns about diabetes and obesity. After hearing the developed plans, the Schnieders committed to supporting community efforts, with a particular interest in the potential for a mobile grocery store. Guided by the CABs, the "Feast for the Future" began in 2010 to promote child and family nutrition, revitalize traditional food systems, and transform food deserts, with one community supporting the development of a mobile grocery store (MoGro).
Diabetes and obesity are a global pandemic with disproportionate burdens in American Indian/Alaska Native communities. American Indian/Alaska Native youth had seven times the prevalence of type 2 diabetes when compared with White U.S. youth in 2009,1 and adults were 60% more likely to be obese than White U.S. adults in 2011.2 American Indian/Alaska Native people experience high rates of nutrition-related health concerns, in part because of a lack of access to affordable and nutritious foods.3
Figure 1.
MoGro conceptual foundations, initiative components, and evaluation measures.
Food insecurity is defined as having limited and/or uncertain access to adequate food, and is associated with a greater risk of obesity and diabetes.4,5 Households and individuals that are food insecure tend to purchase and consume more low-cost, nutrient-poor, and calorie-dense foods, placing these individuals and families at a greater risk of being overweight and obese.4–7 The community–academic partnership had a growing and intuitive understanding of the interconnectedness of diabetes, obesity, and food security, which motivated the development of MoGro.
MoGro was created to promote food security, that is, adequate access to safe and nutritious food. The Schneiders provided the vision and funding to create MoGro, JHCAIH staff facilitated the project and provided evaluation expertise, and the food distributor La Montañita Co-Op operated MoGro. The CAB provided oversight and direction for...