Neqpiaput Iinruugut for Heart Disease Risk

(Food is Med Trial)

This study Neqpiaput Iinruugut ("Our Food is Medicine"), will test if a tribally designed Indigenous food sovereignty intervention can lower the risk of coronary heart disease in Alaska Native adults ages 18 to 65 years old. Designed by Yup'ik Elders, the 12-month intervention combines Calricaraq, an established Elder-designed behavioral health program rooted in ancestral wisdom, with hands-on activities focused on traditional foodways. About 150 adults in three Alaska Native communities will take part. The main questions it aims to answer are:

* Does the intervention lower participants' Framingham Risk Score, a measure of a person's chance of developing heart disease?

* Do cultural strengths, such as cultural identity, Yup'ik wellness, community connectedness, social support, and family cohesion, grow with participation, and does that growth help explain changes in heart disease risk?

* Does the intervention improve Indigenous food sovereignty, including practice and value of traditional foodways and the cultural systems that support them?

Researchers will compare communities receiving the intervention to communities waiting to start it (a dynamic wait-listed design) to see if the intervention lowers Framingham Risk Scores.

Participants will:

* Attend monthly in-person Calricaraq gatherings in their community for 12 months

* Attend quarterly hands-on food sovereignty workshops

* Join a Facebook group that shares resources and supports engagement between in-person sessions

* Have blood pressure and cholesterol measured and complete surveys during the study, including 6 months after the intervention ends

* Be invited to take part in focus groups at 12 and 18 months