Using A Community‐Based Participatory Approach To Design Changes To The Food Environment In A Central American Immigrant Community
Authors: Colon‐Ramos Uriyoan , Edberg Mark , Cleary Sean D , Evans William Doug , Andrade Elizabeth 
Published: November 2023

Objective

Arising from youth and parents’ concerns about lack of access to healthy foods in their neighborhood, we formed a community coalition to design interventions to improve access to healthier food options. We hereby present the results from the first year of work, focused on the design of strategies to improve the food environment.

Methods

We facilitated monthly meetings with the community advisory board (CAB) and trained CAB members to assist in conducting formative work to identify barriers, facilitators to behaviors, and potential strategies. This formative work included food environment observations, 10 focus group discussions, 15 photovoice interviews, 9 key informant interviews with school staff, and six key informant interviews to assess community readiness to act on drinking water promotion. We also developed and piloted a youth advocacy curriculum around disparities in access to drinking water.

Results

The community coalition included parents, youth, non‐governmental organizations working in the area, and other local non‐governmental organizations whose work focuses on nutrition, health, and the environment. The CAB created a mission statement, identified risk factors for diet behaviors in the community, and decided to focus on the promotion of drinking water instead of sugary drinks. Results from observation protocols reveal that supermarkets and other stores display a wide array of sodas from the US and from Latin American countries, and that water products (bottles, filters, or large water containers) are less prominently displayed in stores and restaurants. In schools, youth reported that they rarely drank bottled water and never drank tap or fountain water because of its taste. School staff drank bottled water brought from home, or soda and other drinks bought from vending machines at school. Mothers and youth reported that they never drank tap water because of its taste and color, but that they commonly bought bottled water for consumption at home. The community readiness assessment revealed that there is only a vague awareness about the importance of drinking water and lack of access to drinking water [define] in the neighborhood. The community advisory board chose five settings to focus drinking water promotion and interventions: early care centers, schools, stores, restaurants and informal food vendors, and the community at large. Interventions for the second year of this project are focused on schools and early care centers. These interventions were selected after a review of the published literature and in consultation with school staff and CAB members to assess acceptability and ability to bolster the existing efforts in schools and early care centers. A youth advocacy curriculum shows promise to increase awareness about access to water and other beverages in the neighborhood.

Conclusion

The community‐based approach may provide additional support to policy, system, and environmental changes by creating greater buy‐in for the interventions among community members.

Support or Funding Information

Centers for Disease Control (Racial and Ethnic Approaches to Community Health ‐ REACH)