672-P: Supporting Gestational Diabetes (GDM) Risk Reduction among Young Indigenous Females Who Experience Food Insecurity—A Qualitative Exploration

The purpose of this study was to re-engage participants of a GDM risk reduction study along with additional key informants to explore GDM risk reduction opportunities among young Indigenous females who experience food insecurity. Participants were adult American Indian (AI) women who had GDM or who have female relatives (e.g., daughters) between 12-24 yo (n= 41), AI females between 12-24 yo (n=18), and key informants with expertise in food/nutrition and health within Indigenous communities (n=32) across the US. Data were collected using a semi-structured, conversation-based moderator guide. Zoom interviews were recorded, transcribed, and coded using thematic content analysis methods. Three themes emerged, which emphasize supporting wellness among young Indigenous females through culturally centered approaches and describe how colonization has interrupted healthful dietary practices. Themes include: 1) Guidance on how to support young female's holistic wellness (e.g., strong cultural identity, physical activity, and support from multigenerational family and community); 2) Generations of colonial violence including forced removal, forced poverty, and the imposition of a western based food system of high fat and sugary foods causes deeper, systemic fracturing of traditional cultural food knowledge and practice; 3) Opportunities for support may include investment in place-based, community-driven Indigenous food sovereignty efforts with economy and relationship building including traditional food teachings (e.g., gardening, gathering, farming, seed and land stewardship, hunting, fishing, and food/meal planning and preparation). These themes suggest alternative understanding about the relationships between food insecurity and GDM risk drawing from Indigenous values, strengths, and knowledge, within the context of colonialism, and can guide next steps of decreasing GDM disparities in Indigenous communities.