Growing Resilience in Wind River Indian Reservation: an RCT on gardens for health

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 DESCRIPTION (provided by applicant): Growing Resilience in Wind River Indian Reservation In the face of historical trauma and gross health disparities, Native American (NA) communities need health promotion interventions that enable them to control and improve their health. Home gardens may be such an intervention. The long-term goal of Growing Resilience (GR) is to build tribal capacity to improve NA health by identifying and evaluating suitable, scalable and sustainable health promotion interventions aimed at ending health disparities. The objective is to collaborate with tribal health professionals and community-based organizations to establish, evaluate, and sustain home food gardening as a health intervention that improves health of Northern Arapaho and Eastern Shoshone families of Wind River Indian Reservation who are interested in gardening and native food production. The gardening intervention will be evaluated using a randomized controlled trial (RCT) design. Building on the GR pilot study, the central hypothesis is that, after two years of home gardening, the body mass index (BMI) and other objectively verifiable health indicators in intervention family members will show positive and significant differences from those of control families. The rationale is that upon RCT confirmation of observational data and positive data trends in the GR pilot about the impacts of gardens on health, supporting home gardens will become a culturally relevant and empowering health promotion strategy for tackling health disparities with tribal families. Community health representatives (CHRs) from tribal health organizations will form the bridge between families and health promoting services (such as gardening) that are provided by community-based organizations (CBO). GR will accomplish two aims to achieve these goals and test this hypothesis: (1) establish a sustainable and scalable intervention that enables tribal health professionals and CBOs to support tribal families in successful food gardening; and (2) identify health impacts of home gardening in NA families via an RCT with adult BMI as the primary outcome. GR innovations include developing an empowering, scalable and sustainable family-based health promotion intervention with, by, and for NA families, and being the first RCT to assess health impacts of home gardens. We will also generate an LMS z-score reference data set from recent NHANES data for people aged 5 to 74. Should this prove biologically and statistically as reasonable as the common practice of comparing z-scores among children of varying ages, then this study will also provide the first internally consistent single health outcome measure for interventions expected to impact BMI of all family members. The proposed research is significant because it is expected to create a scalable, sustainable, and culturally appropriate health promotion intervention to reduce NA health disparities that leverages, arguably, the strongest foundations for rebuilding tribal wellbeing: family, land, cultural and spiritual traditions, and tribal health care professionals and institutions.