A Socio-Ecological Analysis of Childhood Obesity and School Nutrition Policies and Practices in Select Elementary and Middle Schools on the Navajo Reservatio

Navajo and other American Indian children are most affected by overweight and obesity in comparison to their US counterparts, and schools have become a focal setting for prevention interventions. The study applied an ecological and a cultural framework to analyze the various factors that influence the food choices available to students and the impact of these choices on childhood obesity. The overall purpose of this descriptive study was to examine and describe how schools that participate in the National School Lunch Program (NSLP) are contributing to the diets of Navajo students since the passage of the Healthy Hunger Free Kids Act of 2010. National data have shown that schools have not always supported a healthy food environment, and with no current data about the food environment of schools serving Navajo students, this study was designed to collect data from multiple sources that included survey questions with quantitative and qualitative questions, conversations with participants, and observations.;As a baseline study, the results of this study addressed a number of areas. Overall, school lunches were meeting the nutrition standards by providing healthy food options, while a few schools also offered unhealthy foods through a la carte food options. Participants offered mixed views about students' nutrition behaviors. One on hand, students were making healthy food choices, but there were also concerns about food waste of nourishing foods. Further, students' access to unhealthy foods often displaced healthful food choices. From a policy and policy implementation perspective, there are areas where schools are doing well, and other areas that still need additional work. Schools have an opportunity to incorporate strategies to enhance their food environment, including finding ways to further strengthen and integrate Navajo culture teachings and practices that will ultimately create a school environment that reflects the teachings of Hozho', as well as restoring Hozho' in health and wellness within Navajo children.