Decreasing Obesity on the Navajo Nation: Educating Providers on Food Insecurity Screening

Abstract

Purpose: The purpose of this quality improvement (QI) project was to improve the food insecurity screening process for all adult-primary care patients, by educating providers on food insecurity, assessing for household food quality and sufficiency, identifying the barriers that cause food insecurity, and identifying the interventions needed to increase access to healthy food. Background: Patients living in rural communities throughout the Navajo Nation continue to be negatively impacted by the lack of resources and various social determinants of health. Patients who screen positive for food insecurity are more likely to be diagnosed with chronic illnesses, such as obesity, hypertension, cardiovascular disease, diabetes, non-alcoholic fatty liver disease, and cancer. Educating providers on adequate food insecurity screening tools and the consequences of food insecurity can reveal the challenges that residents of the Navajo Nation face when it comes to accessing healthy and nutritious foods. Methods: The study was comprised of a 22-question pretest, a live educational presentation, and a 14-question posttest. The pretest was distributed to participants, prior to the intervention, to determine the participant’s baseline knowledge of food insecurity screening. Next, a live educational presentation was conducted at the Primary Care Clinic weekly staff meeting on October 17, 2024. Lastly, the participants completed the posttest to evaluate the effectiveness of the educational material. The pre- and posttests included questions about food insecurity, screening, and the readiness of the participant to implement food security screening and provide education to the patient. Results: A total of 44 staff members from the Tséhootsooí Medical Center Primary Care Clinic participated in the project. After attending the educational presentation on food insecurity and decreasing obesity on the Navajo Nation and completing the pre- and post- surveys, all participants (100%) reported an increase in knowledge about food insecurity. Conclusions: This project successfully increased participants’ knowledge of food insecurity and their ability to correctly enter medical nutrition referrals. The interventions introduced the ongoing issues affecting the patients throughout the Navajo Nation. Providers need to utilize evidence-based practice and the knowledge gained from this QI project to improve the food insecurity process and help patients get the resources they need.