# Chickasaw Healthy Eating Environments in Retail Stores (CHEERS)

> **NIH NIH U54** · WASHINGTON STATE UNIVERSITY · 2020 · $244,667

## Abstract

PROJECT 1 
Abstract 
Cardiovascular disease (CVD) risk is associated with poor food environments, which are characterized by limited 
access to affordable healthy foods. Such environments are extremely common in American Indian communities, 
yet, few studies have addressed food environments or food policies in Native communities. Retail food 
interventions that can expand access to healthy foods and stimulate community demand for healthier choices 
have shown promise in addressing CVD risk among American Indians. Citizens of the Chickasaw Nation, an 
Oklahoma tribe that is the 13th largest in the US, experience a disproportionate burden of CVD risk, along with 
substantial barriers to healthy eating. In 2014, 80% of almost 20,000 adult patients in the Chickasaw tribal health 
system had pre-hypertension or hypertension, while 84% were overweight or obese and 13% had diabetes. In 
collaboration with the Chickasaw Nation, we designed the Chickasaw Healthy Eating Environments in Retail 
Stores (CHEERS) study. This multilevel intervention will be conducted over 24 months in partnership with the 
first full-service, Chickasaw-owned supermarket, which will open in 2017. CHEERS comprises several mutually 
reinforcing strategies to improve blood pressure control in people with hypertension. We will implement CHEERS 
in the Chickasaw town of Ada, Oklahoma, while designating 2 other Chickasaw towns – Sulphur and Tishomingo, 
Oklahoma – as the control sites, since both lack a tribally-run supermarket. We will recruit 700 adults (350 per 
arm) with diagnosed hypertension and collect survey and clinical data at baseline, 12 months, and 24 months to 
assess the effects of CHEERS on blood pressure control and secondary outcomes (food purchasing, diet, and 
body mass index). Tribal members with uncontrolled hypertension will receive cookbooks featuring heart-healthy 
recipes tailored to traditional Chickasaw diets and culture, along with invitations to attend the healthy cooking 
demonstrations. During the intervention, a tribal media team will collect material to create a documentary film on 
its implications for public health and the local economy. The documentary will be disseminated to tribal leaders, 
who we will subsequently survey and interview to assess their readiness to implement CHEERS more widely. 
CHEERS will culminate in a multimedia presentation detailing the supermarket-based intervention and featuring 
personal success stories by hypertensive community members. Our Specific Aims are: 1) at the environmental 
level, to collect data on the availability, price, and shelf space devoted to healthy and less healthy options in 
existing local retail outlets at baseline (before the intervention) and again at 12 and 24 months; 2) at the 
individual level, to measure change in blood pressure and secondary outcomes among hypertensive 
community members at baseline and again at 12 and 24 months; and 3) at the policy level, to evaluate the 
documentary’s eff...

## Key facts

- **NIH application ID:** 9868830
- **Project number:** 5U54MD011240-05
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** Valarie Blue Bird Jernigan
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $244,667
- **Award type:** 5
- **Project period:** — → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9868830

## Citation

> US National Institutes of Health, RePORTER application 9868830, Chickasaw Healthy Eating Environments in Retail Stores (CHEERS) (5U54MD011240-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9868830. Licensed CC0.

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