This pilot project is part of an ongoing partnership with members of the Navajo Nation in New Mexico. The long range goal of this cancer-related public health intervention proposal in underserved communities is to improve vegetable and fruit consumption and general health among people ofthe Navajo Nation. The Southwest American Indian population has low intake of vegetables and fruit, especially among the Navajo, who also have high rates of obesity. The Navajo Nation land is a food desert because of its lack of access to affordable healthy foods, but the Navajo people are receptive to the wellness intervention proposed. Gardens and small farms that involved growing your own produce were once part of a healthy lifestyle for Navajo people. Traditionally, planting is viewed as a renewing activity, and each growing season is an opportunity for self renewal. Research collaborations with the Navajo Nation require dedication of hours in conversations and meetings at regular intervals over several years to gain trust. We have worked closely with members of the Navajo Nation over the past five years and have built a successful collaborative relationship. Many community leaders are now reaching out to NMSU and other cooperative extension agents for assistance with bringing gardens back to the communities on the Navajo Nation. We plan to build further on these current collaborations and together build the Capacity of our partners to develop and evaluate a sustainable garden-based health intervention program to improve health and wellness of the Navajo people and their neighbors. Specifically, we aim to: 1) Develop a multi-component intervention that integrates community gardens, educational workshops and community outreach components in Navajo communities;2) Estimate the effects of an integrated intervention on adoption of gardening practices, vegetable and fruit intake;and 3) Estimate the effects of an integrated intervention on self-monitoring, self-efficacy, behavioral capability, and social norms related to gardening and vegetable and fruit consumption. Guided by an adaptation of social cognitive theory, we plan jointly to develop community gardens and to provide a culturally appropriate integrated behavioral change program with technical horticultural support to augment these garden projects through a phased collaborative intervention in Navajo communities. Aspects of Navajo culture and traditional practices will be integrated into the intervention activities. Navajo Technical College, Dine College and NMSU cooperative extension agents are an essential part ofthe intervention to ensure sustainability. This project will lay the groundwork, including specification ofthe intervention and ofthe outcome measures, for an R01 type proposal to formally evaluate the effectiveness ofthe intervention with a group randomized design. In the pilot, using a quasi-experimental design, we will obtain estimates of effect size and variability for use in determining the sample size for the R01. This proposal is directly responsive to the overall goal ofthe NMSU/FHCRC partnership: it will increase the capacity of NMSU to conduct cancer research in a competitive environment and attention at FHCRC to cancer-related health disparities research.
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