Abstract
OBJECTIVE: To examine the Indigenous Nourishment Scales (INS), a set of community-developed strengths-based measures of nourishment, for psychometric validity and reliability through community-based research with two urban American Indian/Alaska Native (AI/AN) communities. DESIGN: Cross-sectional survey of health measures and INS. Descriptive statistics, exploratory factor analysis (EFA), correlation analysis and regression were used to determine the psychometric properties of the INS and their relationship with Physical (Fruit and Vegetable Intake), Spiritual (Spiritual Well-being), Emotional (Emotional Well-being) and Relational (Social Well-being) health outcomes. SETTING: Two urban cities in the USA. PARTICIPANTS: 249 urban AI/AN adults. RESULTS: EFA revealed two unidimensional scales (Connectedness to Food; Indigenous Food Identity) and one two-factor scale (Access to and Participation in Indigenous Foodways). The INS demonstrated strong internal consistency reliability and convergent construct validity as evidenced by their association with fruit and vegetable intake and other related concepts. Regression models showed that Access to Indigenous Foodways and Participation in Indigenous Foodways were significantly and positively associated with all four domains of well-being. Food Connectedness was positively and significantly associated with spiritual, emotional and relational well-being, while Indigenous Food Identity was positively and significantly associated with spiritual and emotional well-being. CONCLUSIONS: Positive associations between scale scores and multiple domains of well-being indicate the potential relevance of Indigenous nourishment as a meaningful determinant of health. By establishing the psychometric validity of community-developed measures, this study offers a pathway for Indigenizing assessments of nutrition and well-being among AI/AN peoples.