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Internationally, governments and scientists are bound by legal and treaty rights when working with Indigenous nations. These rights include the right of Indigenous people to control the conduct of science with Indigenous nations. Unfortunately, in some cases, individual scientists and scientific teams working with biological and genetic data collected from Indigenous people have not respected these international rights. Here, we argue that the scientific community should understand and acknowledge the historical harms experienced by Indigenous people under the veil of scientific progress (truth) and implement existing standards for ethical conduct of research and sovereign control of data collected within Indigenous communities (reconciliation). Specifically, we outline the rationale for why scientists, scientific journals and research integrity and institutional review boards/ethics committees should adopt, and be held accountable for upholding, current international standards of Indigenous data sovereignty and ethical use of Indigenous biological samples.
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BACKGROUND: Inequities in health access and outcomes exist between Indigenous and non-Indigenous populations. Embedded pragmatic randomized, controlled trials (ePCTs) can test the real-world effectiveness of health care interventions. Assessing readiness for ePCT, with tools such as the Readiness Assessment for Pragmatic Trials (RAPT) model, is an important component. Although equity must be explicitly incorporated in the design, testing, and widespread implementation of any health care intervention to achieve equity, RAPT does not explicitly consider equity. This study aimed to identify adaptions necessary for the application of the 'Readiness Assessment for Pragmatic Trials' (RAPT) tool in embedded pragmatic randomized, controlled trials (ePCTs) with Indigenous communities. METHODS: We surveyed and interviewed participants (researchers with experience in research involving Indigenous communities) over three phases (July-December 2022) in this mixed-methods study to explore the appropriateness and recommended adaptions of current RAPT domains and to identify new domains that would be appropriate to include. We thematically analyzed responses and used an iterative process to modify RAPT. RESULTS: The 21 participants identified that RAPT needed to be modified to strengthen readiness assessment in Indigenous research. In addition, five new domains were proposed to support Indigenous communities' power within the research processes: Indigenous Data Sovereignty; Acceptability - Indigenous Communities; Risk of Research; Research Team Experience; Established Partnership). We propose a modified tool, RAPT-Indigenous (RAPT-I) for use in research with Indigenous communities to increase the robustness and cultural appropriateness of readiness assessment for ePCT. In addition to producing a tool for use, it outlines a methodological approach to adopting research tools for use in and with Indigenous communities by drawing on the experience of researchers who are part of, and/or working with, Indigenous communities to undertake interventional research, as well as those with expertise in health equity, implementation science, and public health. CONCLUSION: RAPT-I has the potential to provide a useful framework for readiness assessment prior to ePCT in Indigenous communities. RAPT-I also has potential use by bodies charged with critically reviewing proposed pragmatic research including funding and ethics review boards.
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Povos Indígenas , Ensaios Clínicos Pragmáticos como Assunto , Humanos , Povos Indígenas/estatística & dados numéricos , Ensaios Clínicos Pragmáticos como Assunto/métodos , Serviços de Saúde do Indígena/normas , Inquéritos e Questionários , Projetos de Pesquisa , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricosRESUMO
INTRODUCTION: High prevalence of commercial tobacco product (CTP) use among American Indian and Alaska Native (AI/AN) youth is a public health crisis. A multi-level Tribal-community-based participatory research project under Tribal public health authority implemented a retailer-focused intervention to reduce AI/AN youth CTP use. METHODS: We sought resolutions in support of a retailer-focused CTP intervention from Tribal Nations organized by a tribally-directed research program. We identified tobacco retail outlets operating on and within 5 miles of 9 Tribal reservations, and CTP products sold at these outlets. We conducted a four-wave Reward and Reminder intervention with apparent minor buyers. Clerks who complied with the law received a modest reward and commendation in social media posts to the local Tribal communities, while clerks who sold without age verification were reminded of the laws. RESULTS: Of 18 retail outlets selling CTP, 8 sold e-cigarettes, and all sold combustible cigarettes. The Reward and Reminder intervention showed an approximate 25% reduction in sales of CTP to apparent minors, with a 33% baseline CTP sales rate without age verification and an 8% intervention CTP sales rate without age verification. CONCLUSIONS: The intervention increased awareness of laws prohibiting CTP sales to minors and mandating age verification for young adults seeking to buy CTP. The intervention, which had support from all governing Tribal Nations, builds the evidence base of effective practices which Tribal public health authorities may utilize to reduce youth access to CTP on and around Tribal reservations. IMPLICATIONS: Sovereign Tribes have authority over commercial businesses operating on their lands. Tobacco 21 laws aiming to restrict commercial tobacco availability to youth are supported by Tribes. A retailer intervention in which apparent minors attempt commercial tobacco purchases can offer accountability feedback to retailers both on and near Tribal reservations. Obtaining Tribal support and publicizing the interventions helps mobilize Tribal communities to support commercial tobacco prevention and promote healthy youth.
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OBJECTIVE: Invasive colonial influences and continuing neoliberal policies have a detrimental impact on Land, health, food and culture for Indigenous Communities. Food security and sovereignty have significant impacts on Indigenous well-being and, specifically, oral health. Aspects relating to food security, such as availability of nutritious foods, are a common risk factor of oral diseases. This scoping review aimed to collate existing evidence regarding the relationship between food sovereignty and/or food security and oral health for Indigenous Communities, globally. DESIGN: Four databases were searched using keywords related to 'Food security' or 'Food sovereignty,' 'Indigenous Peoples' and 'Oral health.' Duplicates were removed, and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data were summarised narratively, presenting a conceptual model which illustrates the findings and relationships between food security and/or food sovereignty and oral health. RESULTS: The search identified 369 articles, with forty-one suitable for full-text review and a final nine that met inclusion criteria. The impact of food security and food sovereignty on oral health was discussed across different populations and sample sizes, ranging from eighteen Kichwa families in Brazil to 533 First Nations and Metis households in Canada. Pathways of influence between food sovereignty and/or food security are explored clinically, quantitatively and qualitatively across oral health outcomes, including early childhood caries, dental caries and oral health-related quality of life for Indigenous Communities. CONCLUSIONS: Innovative strategies underpinned by concepts of Indigenous food sovereignty are needed to promote oral health equity for Indigenous Communities. The nexus between oral health and Indigenous food sovereignty remains largely unexplored, but has immense potential for empowering Indigenous rights to self-determination of health that honour Indigenous ways of knowing, being and doing.
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Segurança Alimentar , Povos Indígenas , Saúde Bucal , Humanos , Abastecimento de Alimentos , Saúde GlobalRESUMO
OBJECTIVES: Cultural food security is crucial for cultural health and, for people from refugee backgrounds, supports the settlement journey. Cultural communities are vital in facilitating access to cultural foods; however, it is not understood how refugee-background communities sustain cultural food security in the Australian context. This study aimed to explore key roles in refugee-background communities to understand why they were important and how they facilitate cultural food security. DESIGN: Interviews were conducted by community researchers, and data analysis was undertaken using best-practice framework for collaborative data analysis. SETTING: Greater Brisbane, Australia. PARTICIPANTS: Six interviews were conducted between August and December 2022 with people from a refugee-background community, lived in Greater Brisbane and who fulfilled a key food role in the community that facilitated access to cultural foods. RESULTS: Fostering improved cultural food security supported settlement by creating connections across geographical locations and cultures and generated a sense of belonging that supported the settlement journey. Communities utilised communication methods that prioritised the knowledge, wisdom and experience of community members. It also provided community members with influence over their foodways. Community leaders had an ethos that reflected collectivist values, where community needs were important for their own health and well-being. CONCLUSIONS: Communities are inherently structured and communicate in a way that allows collective agency over foodways. This agency promotes cultural food security and is suggestive of increased food sovereignty. Researchers and public health workers should work with communities and recognise community strengths. Food security interventions should target cultural food security and autonomy.
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Refugiados , Humanos , Austrália , Pesquisa Qualitativa , Alimentos , Segurança AlimentarRESUMO
BACKGROUND: Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia. METHODS: A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations. RESULTS: Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings. CONCLUSION: Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.
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Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Serviços de Saúde do Indígena , Neoplasias , Humanos , Austrália/epidemiologia , Atenção à Saúde , Neoplasias/terapiaRESUMO
BACKGROUND: Addressing Indigenous food security and food sovereignty calls for community-driven strategies to improve access to and availability of traditional and local food. Participatory approaches that integrate Indigenous leadership have supported successful program implementation. Learning Circles: Local Healthy Food to School is a participatory program that convenes a range of stakeholders including food producers, educators and Knowledge Keepers to plan, implement and monitor local food system action. Pilot work (2014-2015) in Haida Gwaii, British Columbia (BC), showed promising results of the Learning Circles (LC) approach in enhancing local and traditional food access, knowledge and skills among youth and adolescents. The objective of the current evaluation was therefore to examine the process of scaling-up the LC vertically within the Haida Nation; and horizontally across three diverse First Nations contexts: Gitxsan Nation, Hazelton /Upper Skeena, BC; Ministikwan Lake Cree Nation, Saskatchewan; and Black River First Nation, Manitoba between 2016 and 2019. METHODS: An implementation science framework, Foster-Fishman and Watson's (2012) ABLe Change Framework, was used to understand the LC as a participatory approach to facilitate community capacity building to strengthen local food systems. Interviews (n = 52), meeting summaries (n = 44) and tracking sheets (n = 39) were thematically analyzed. RESULTS: The LC facilitated a collaborative process to: (1) build on strengths and explore ways to increase readiness and capacity to reclaim traditional and local food systems; (2) strengthen connections to land, traditional knowledge and ways of life; (3) foster community-level action and multi-sector partnerships; (4) drive actions towards decolonization through revitalization of traditional foods; (5) improve availability of and appreciation for local healthy and traditional foods in school communities; and (6) promote holistic wellness through steps towards food sovereignty and food security. Scale-up within Haida Gwaii supported a growing, robust local and traditional food system and enhanced Haida leadership. The approach worked well in other First Nations contexts, though baseline capacity and the presence of champions were enabling factors. CONCLUSIONS: Findings highlight LC as a participatory approach to build capacity and support iterative planning-to-action in community food systems. Identified strengths and challenges support opportunities to expand, adopt and modify the LC approach in other Indigenous communities with diverse food systems.
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Instituições Acadêmicas , Humanos , Instituições Acadêmicas/organização & administração , Abastecimento de Alimentos , Indígenas Norte-Americanos , Adolescente , Colúmbia Britânica , Canadá , Pesquisa Participativa Baseada na Comunidade , Fortalecimento Institucional , Participação da Comunidade , Segurança Alimentar , CriançaRESUMO
INTRODUCTION: The number of American Indian and Alaska Native (AI/AN) elders is expected to double by 2060. Thus it is imperative to retain AI/AN participants in longitudinal research studies to identify novel risk factors and potential targets for intervention for Alzheimer's disease and related dementias in these communities. METHODS: The National Alzheimer's Coordinating Center houses uniformly collected longitudinal data from the network of National Institute on Aging (NIA)-funded Alzheimer's Disease Research Centers (ADRCs). We used logistic regression to quantify participant retention at 43 ADRCs, comparing self-identified AI/AN participants to non-Hispanic White (NHW) participants, adjusting for potential confounding factors including baseline diagnosis, age, sex, education, and smoking. RESULTS: The odds of AI/AN participant retention at the first follow-up visit were significantly lower than those for NHW participants (adjusted odds ratio [aOR]: 0.599; 95%: 0.46-0.78; p < 0.001). DISCUSSION: These results suggest the need for improved strategies to retain AI/AN participants, perhaps including improved researcher-community relationships and community engagement and education. HIGHLIGHTS: American Indian and Alaska Native (AI/AN) research participants were retained to the first follow-up appointment at lower rates than non-Hispanic White (NHW) participants. AI/AN participants are retained at lower rates than NHW participants for long-term follow-up. The majority of AI/AN participants were not retained to the second follow-up visit.
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Doença de Alzheimer , Indígena Americano ou Nativo do Alasca , Idoso , Humanos , Coleta de DadosRESUMO
Indigenous peoples around the world suffer from health disparities attributed to a plethora of risk factors and social determinants of health stemming from colonialism and systemic oppression. Community-based health interventions have been identified as a means for addressing and reducing Indigenous health disparities by allowing for Indigenous sovereignty to be respected and centered. However, sovereignty relating to Indigenous health and well-being is underresearched. The present article explores the role of sovereignty in Indigenous community-based health interventions. A qualitative metasynthesis was conducted among 14 primary research studies co-authored by Indigenous people describing and evaluating Indigenous community-based health interventions. Five conceptual themes emerged as aspects of sovereignty which benefit Indigenous health and well-being outcomes: integration of culture; relocation of knowledge; connectedness; self-actualization; and stewardship. Implications are discussed, with the goal of creating a decolonial framework rooted in Indigenous epistemologies and perspectives for how sovereignty impacts Indigenous health, as well as strengthening a clear need for further research on and praxis of sovereignty in Indigenous healthcare.
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Colonialismo , Saúde Pública , Humanos , Povos Indígenas , Conhecimento , MotivaçãoRESUMO
IMF interventions are often associated with rising political discontent in countries where the Fund intervenes. Studies examining this relationship, however, face the challenge of disentangling the impact of the IMF from the impact of the crisis that triggered the intervention. To address this challenge, we conduct survey experiments in Greece, Ireland, Portugal, and Spain and directly assess how voters evaluate the costs and benefits of an IMF intervention. We find that voters believe that the crisis will more likely be solved when the IMF intervenes, but they are also critical of the corresponding loss of national sovereignty. Because the former consideration, on average, dominates their assessment, IMF interventions increase the support of voters for unpopular economic policies. Nonetheless, cross-country differences suggest that continued public support for intervention hinges on the IMF's ability to deliver on its promise to help resolve the crisis.
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BACKGROUND: An increasingly industrialized food system has marginalized local, traditional food cultures in Puerto Rico (PR). Recent efforts to decolonize diets have promoted local food intake; however, how resulting dietary patterns may influence cardiometabolic disease remains unknown. OBJECTIVES: This study aimed to 1) identify dietary patterns in PR and 2) determine their associations with metabolic syndrome (MetS) and its components. METHODS: Data were obtained from participants (30-75 y) in PROSPECT (PR Observational Study of Psychosocial, Environmental, and Chronic Disease Trends; n = 989). Dietary patterns were derived using partial least squares analysis with food frequency questionnaire data, using nutrients associated with local food purchasing (dietary fiber, magnesium, saturated fat) as response variables. MetS was classified using harmonized criteria from clinical and laboratory measures and medication use. Fully adjusted generalized linear models tested associations between tertiles of dietary patterns and MetS. RESULTS: Approximately half (52%) of the participants were classified with MetS. Four dietary patterns were revealed: conventional (legumes, coffee, and dairy), industrialized starch and meat-centric (red/processed meats, pasta, and starchy roots), industrialized sugar-centric (rice, sugary beverages, and refined grains), and neo-traditional (local plants and seafood). Individuals in the highest (compared with lowest) tertile of the industrialized starch and meat-centric dietary pattern had higher mean waist circumference (102 compared with 99 cm) (P = 0.01), fasting glucose (106 compared with 98 mg/dL) (P = 0.019), and systolic blood pressure (123 compared with 119 mmHg) (P = 0.022). Individuals in the highest (compared with lowest) tertile of the neo-traditional diet were 0.69 (0.49, 0.97) times less likely to have MetS (P = 0.035) and had 4.1 cm lower mean waist circumference (P = 0.002). CONCLUSIONS: Promoting a neo-traditional diet and curbing industrialized starch and meat-centric diets may improve cardiometabolic health in PR. Results can guide local food promotion as a healthful, decolonizing approach in island settings.
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Doenças Cardiovasculares , Síndrome Metabólica , Humanos , Adulto , Fatores de Risco , Porto Rico , Dieta , Síndrome Metabólica/epidemiologia , Doenças Cardiovasculares/epidemiologia , Amido , Comportamento AlimentarRESUMO
BACKGROUND: Data-sharing is increasingly encouraged or required by funders and journals. Data-sharing is more complicated for lifecourse studies that rely upon ongoing participation, but little is known about perspectives on data-sharing among participants of such studies. The aim of this qualitative study was to explore perspectives on data-sharing of participants in a birth cohort study. METHODS: Semi-structured interviews were conducted with 25 members of the Dunedin Multidisciplinary Health and Development Study when aged between 45 and 48 years. Interviews were led by the Director of the Dunedin Study and involved questions about different scenarios for data-sharing. The sample consisted of nine Dunedin Study members who are Maori (the Indigenous peoples of Aotearoa/New Zealand) and 16 who are non-Maori. RESULTS: Principles of grounded theory were applied to develop a model of participant perspectives on data-sharing. The model consists of three factors that inform a core premise that a one-size-fits-all approach to data-sharing will not suffice in lifecourse research. Participants suggested that data-sharing decisions should depend on the cohort and might need to be declined if any one Dunedin Study member was opposed (factor 1). Participants also expressed a proven sense of trust in the researchers and raised concerns about loss of control once data have been shared (factor 2). Participants described a sense of balancing opportunities for public good against inappropriate uses of data, highlighting variability in perceived sensitivity of data, and thus a need to take this into account if sharing data (factor 3). CONCLUSIONS: Communal considerations within cohorts, loss of control over shared data, and concerns about inappropriate uses of shared data need to be addressed through detailed informed consent before data-sharing occurs for lifecourse studies, particularly where this has not been established from the start of the study. Data-sharing may have implications for the retention of participants in these studies and thus may impact on the value of long-term sources of knowledge about health and development. Researchers, ethics committees, journal editors, research funders, and government policymakers need to consider participants' views when balancing the proposed benefits of data-sharing against the potential risks and concerns of participants in lifecourse research.
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Disseminação de Informação , Consentimento Livre e Esclarecido , Humanos , Pessoa de Meia-Idade , Estudos de Coortes , Teoria Fundamentada , Pesquisa QualitativaRESUMO
BACKGROUND: Indigenous populations in Canada and the United States (US) have maintained reciprocal relationships with nature, grounded in respect for and stewardship of the environment; however, disconnection from traditional food systems has generated a plethora of physical and mental health challenges for communities. Indigenous food sovereignty including control of lands were found to be factors contributing to these concerns. Therefore, our aim was to conduct a scoping review of the peer-reviewed literature to describe Indigenous disconnection from Indigenous food systems (IFS) in Canada and the US. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-SR) and Joanna Briggs Institute guidelines, we searched MEDLINE, SCOPUS, International Bibliography of the Social Sciences, Sociological Abstracts, and Bibliography of Native North Americans. Data was extracted from 41 studies and a narrative review completed based on study themes. RESULTS: The overarching theme identified in the included studies was the impact of colonization on IFS. Four sub-themes emerged as causes for Indigenous disconnection from traditional food systems, including: climate change; capitalism; legal change; and socio-cultural change. These sub-themes highlight the multiple ways in which colonization has impacted Indigenous food systems in Canada and the US and important areas for transformation. CONCLUSIONS: Efforts to reconnect Indigenous knowledge and values systems with future food systems are essential for planetary health and sustainable development. Traditional knowledge sharing must foreground authentic Indigenous inclusion within policymaking.
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Povos Indígenas , Saúde Mental , Estados Unidos , Humanos , CanadáRESUMO
BACKGROUND: Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. METHODS: This scoping review, conducted in December 2022, adhered to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. RESULTS: The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. CONCLUSIONS: Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape.
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Comunicação , Ecossistema , Humanos , Privacidade , Tecnologia , Consentimento Livre e EsclarecidoRESUMO
BACKGROUND: Smartphone apps, including those for digital contact tracing (DCT), played a crucial role in containing infections during the COVID-19 pandemic. Their primary function is to generate and disseminate information to disrupt transmissions based on various events, such as encounters, vaccinations, locations, or infections. Although the functionality of these apps has been extensively studied, there is still a lack of qualitative research addressing critical issues. OBJECTIVE: We will demonstrate that the use of DCT presents a challenge due to the tension between continuous health monitoring and uncertainties related to transparency and user sovereignty. On one hand, DCT enables the monitoring of various risk factors, including data-based calculations of infection probabilities. On the other hand, continuous risk management is intertwined with several uncertainties, including the unclear storage of personal data, who has access to it, and how it will be used in the future. METHODS: We focus on the German "Corona-Warn-App" and support our argument with empirical data from 19 expert interviews conducted between 2020 and 2021. The interviews were conducted using a semistructured questionnaire and analyzed according to the principles of grounded theory. RESULTS: Our data underscores 3 dimensions: transparency, data sovereignty, and the east-west divide. While transparency is considered an essential foundation for establishing trust in the use of DCT by providing a sense of security, data sovereignty is seen as a high value during the pandemic, protecting users from an undesired loss of control. The aspect of the east-west divide highlights the idea of incorporating sociocultural values and standards into technology, emphasizing that algorithms and data-driven elements, such as distance indicators, encounters, and isolations, are also influenced by sociocultural factors. CONCLUSIONS: The effective use of DCT for pandemic containment relies on achieving a balance between individual control and technological prevention. Maximizing the technological benefits of these tools is crucial. However, users must also be mindful of the information they share and maintain control over their shared data.
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COVID-19 , Aplicativos Móveis , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teoria Fundamentada , Pandemias/prevenção & controle , Alemanha , Busca de Comunicante , Pesquisa QualitativaRESUMO
Building local food systems through a food sovereignty lens, harnessing the right of people to control their own food systems, may enhance healthy food access and increase the consumption of fruits and vegetables in local communities. While research to date has described the outcomes of various multilevel, multicomponent food systems interventions, no known literature reviews to date have systematically examined food system interventions and dietary and health outcomes through the context of a food sovereignty lens. Utilization of a food sovereignty framework allows for the incorporation of key food systems and community-based concepts in the food environment literature. The purpose of this systematic review was to describe and summarize the efficacy of community-based local food system interventions, using the food sovereignty framework, for both pediatric and adult populations and their impact on health behaviors and physiological outcomes. We searched for peer-reviewed articles using Scopus, PubMed, PsychInfo and CINAHL databases and identified 11 articles that met the inclusion criteria for this study. Seven studies found that food systems interventions had a significant positive effect on improving health outcomes, three had null findings and one had null or negative results. Two studies utilized a community-based participatory approach. The most successful interventions involved community-based engagement involving multiple aspects of the food system and involving both children and adults for maximum impact. Our results inform how community-based food systems interventions can be guided by food sovereignty principles to improve health outcomes, such as body weight and fruit and vegetable intake, for both pediatric and adult populations.
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Dieta , Frutas , Adulto , Humanos , Criança , Verduras , Comportamentos Relacionados com a Saúde , Peso CorporalRESUMO
Globally, manufacturing ecosystems are facing the challenge of twin transition, i.e., how to utilize digitalization for improving or transforming the sustainability of manufacturing operations. Here, operations refer widely to the upstream of manufacturing, while the entire product lifecycle also covers the downstream and end-of-life operations. Here, sustainability is understood to consider the impact of the product lifecycle at environmental, social, and governance (ESG) levels. In this article, we explore this progress through the digitalization concept of business-to-business data sharing, and through one example of a manufacturing ecosystem in Finland. We discuss the federated data space concept and the international data spaces (IDS) architecture as technological building blocks of twin transition, and report the first results from an industry-research shared-risk project. Semi-structured interviews and a diary-style reporting from an industry-research IDS proof-of-concept (PoC) experiment are presented and analyzed within a design science research method framework. The findings give the first indications that while data sharing is seen as important and increasing in relevance in industry, it is currently challenging for companies to see how an open standard architecture creates value beyond a single limited ecosystem view. We also highlight possible avenues for further research.
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Settler colonialism disrupted traditional Indigenous foodways and practices and created high rates of diet-related disease among Indigenous peoples. Food sovereignty, the rights of Indigenous peoples to determine their own food systems, is a culturally centered movement rooted in traditional Indigenous knowledge. This approach directly intervenes upon systems-level barriers to health, making it an important strategy for health equity. While food sovereignty initiatives can be found within many Indigenous communities, the conceptual linkages between food sovereignty and health have not been well documented within the public health literature. We present a practice-informed conceptual framework developed as part of the Center for Indigenous Innovation and Health Equity (CIIHE) initiative, a community-academic partnership with the goal of strengthening Indigenous food systems and practices to promote health and well-being. The framework emphasizes connectedness, including the transmission of knowledge across generations and the restoration of relational responsibilities, as central to Indigenous concepts of health and wellness.
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Dieta , Promoção da Saúde , Humanos , Saúde Pública , Alimentos , Povos IndígenasRESUMO
Previous research in American Indian and Alaska Native (AI/AN) communities has documented high prevalence of food insecurity. Yet many AI/AN scholars and communities have expressed concerns that the dominant societal conceptions of food security are not reflective of the teachings, priorities, and values of AI/AN communities. Food security initiatives often focus on access to food and, at times, nutrition but little consideration is given to cultural foods, the spirituality carried through foods, and whether the food was stewarded in a way that promotes well-being not just for humans but also for plants, animals, land, and water. Despite the concerns of AI/AN communities that their needs are not centered in dominant societal food conceptualizations and food security programming, the food sovereignty efforts of AI/AN communities have captured national attention as a solution to modern food system inequities. Indigenous Food Sovereignty (IFS) is a holistic approach to food that incorporates values of relationality, reciprocity, and relationships. Fundamental differences exist between food security and food sovereignty, yet dominant society often reduces IFS as a solution to food security, rather than an entirely different food system that is predicated on values that contrast with that of dominant society. Despite calls to decolonize the definition and measurement of food security, we explore whether fixing the concept of food security is a worthy endeavor or whether efforts would be better spent supporting the resurgence and revitalization of AI/AN food values, food knowledge, and community food sovereignty initiatives.
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Estado Nutricional , Humanos , Alimentos , Abastecimento de Alimentos , Segurança AlimentarRESUMO
As an increasing number of Native Hawaiian and Pacific Islander adults move to the continental United States, the development and implementation of resources that promote access to cultural foods and support food sovereignty on the continent is crucial to perpetuate cultural practice and connection to the 'aina (land that feeds). Kalo (taro) is an important cultural food central to Native Hawaiian identity. Native Hawaiians connect their genealogy as far back to the cultivation of kalo and the creation of kalo itself. In this practice note, we describe the creation of a mala kalo (cultivated field for taro) in Oregon by the Ka'aha Lahui O 'Olekona Hawaiian Civic Club. An ongoing project over the past 3 years, the creation of a mala kalo exceeded expectations. Not only did the mala allow the cultivation of kalo outside of Hawaii, the mala became a place for the community to unite toward common goals of connecting with the land, promoting mental health, and creating a sense of place in their diaspora. This project indicates that not only is the creation of mala kalo in Oregon feasible, it may also be an important opportunity for the growing number of Native Hawaiians and Pacific Islanders adults living on the continent to improve health outcomes through connections with cultural foods and practices.