Implementation of the Navajo fruit and vegetable prescription programme to improve access to healthy foods in a rural food desert

Michael A. Sundberg, Abigail C. Warren, Joan Vanwassenhove-Paetzold, Carmen George, Danya S. Carroll, Leandra Jewel Becenti, Akeemi Martinez, Burrell Jones, Karen Bachman-Carter, Mae Gilene Begay, Taylor Wilmot, Henrietta Sandoval-Soland, Onagh Mackenzie, Lindsey Hamilton, Memarie Tsosie, Caitlyn K. Bradburn, Emilie Ellis, Jamy Malone, Julia Pon, Ashley FitchSara M. Selig, Gail Gall, Sonya S. Shin

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective:To utilise a community-based participatory approach in the design and implementation of an intervention targeting diet-related health problems on Navajo Nation.Design:A dual strategy approach of community needs/assets assessment and engagement of cross-sectorial partners in programme design with systematic cyclical feedback for programme modifications.Setting:Navajo Nation, USA.Participants:Navajo families with individuals meeting criteria for programme enrolment. Participant enrolment increased with iterative cycles.Results:The Navajo Fruit and Vegetable Prescription (FVRx) Programme.Conclusions:A broad, community-driven and culturally relevant programme design has resulted in a programme able to maintain core programmatic principles, while also allowing for flexible adaptation to changing needs.

Original languageEnglish (US)
Pages (from-to)2199-2210
Number of pages12
JournalPublic Health Nutrition
Issue number12
StatePublished - Aug 2020

Bibliographical note

Funding Information:
Acknowledgements: Please note that authors M.A.S. and A.C.W. contributed equally to this work and share authorship position. We acknowledge the many important contributions from multiple clinic sites and providers, non-profit programmes, tribal programmes, governmental agencies and participants in the development of Navajo FVRx. Financial support: Funding (in part) was by the Notah Begay III Foundation (NB3F) through the Walmart Foundation, the Rx Foundation, the Zegar Family Foundation and the Leonard Family Foundation. Funding was made possible (in part) by a cooperative agreement with the U.S. Centers for Disease Control and Prevention (no. 5NU58DP005872). This project was supported (in part) by the University of Minnesota General Internal Medicine Research Fund. Conflict of interest: The views expressed do not necessarily reflect the official views of the Indian Health Service or policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices or organisations imply endorsement by the U.S. Government. Authorship: M.A.S.: formulation of study design, analysis of data and writing of article. A.C.W.: formulation of study design, carrying out study and writing of article. J.V.P., C.G., S.M.S. and G.G.: formulation of study design, carrying out study and analysis of data. D.S.C., L.J.B., A.M., B.J., K.B.C., M.G.B., T.W., H.S.S., O.M., L.H., M.T., C.K.B., E.E., J.M., J.P. and A.F.: formulation of study design and carrying out study. S.S.S.: formulation of study design, carrying out study, analysis of data and writing of article. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving human subjects/patients were approved by the Navajo Nation Human Research Review Board. Verbal informed consent was obtained prior to enrolment of participants in the programme.

Publisher Copyright:
© The Authors 2020.


  • American Indian
  • Food access
  • Food assistance
  • Fruits and vegetables
  • Low income

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't


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