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Expert Perspective

Home Visits May Help Prevent Obesity Among Young Native American Children


December 8th, 2020


Native American children have the highest rates of obesity in the United States. These high rates of obesity can put them at greater risk for severe consequences from COVID-19, and for diabetes and cardiovascular disease later in life.

The disparities in obesity rates stem from a history of colonization that led Native American peoples to lose their lands and disrupted traditional food networks, lifestyles favoring rigorous physical activity, and healthy food systems. Today more than 20% of Native American children ages 2 to 5 have obesity, compared to the 13.7% of U.S. children of all other races.

Home visiting, in which trained nurses, social workers, or child development specialists provide guidance to pregnant women and new families on healthy child development practices, has proven benefits. A new study shows it may even help prevent obesity among Navajo infants.

A study published in the Journal of American Medical Association examined the impact of an innovative six-lesson home visit program aimed at teaching Navajo mothers of infants about responsive feeding and the importance of avoiding sugar-sweetened beverages. The program was designed in partnership with tribal communities to address specific infant feeding practices that are associated with increased risk for early childhood obesity, including sugar-sweetened beverage consumption; introduction of foods other than breastmilk or formula before six months postpartum; and feeding styles that are overly restrictive or pressured.

“The study found that infants of mothers who participated in the program consumed fewer sugar-sweetened beverages and had healthier weights than the control group.”

The Journal of American Medical Association

The researchers also observed improved responsive feeding practices (i.e., eating when hungry and stopping when full) in the infants who received the Family Spirit Nurture (FSN) program intervention. The study suggests that a home-visiting intervention like this one—particularly one created in partnership with and for Native Americans—is an effective strategy for promoting healthy feeding and growth in a child’s all-important first year.

This kind of brief, cost-effective home intervention also holds promise for other Native American and U.S. communities across the countries. Already, hundreds of tribal communities and four non-Native communities across 21 U.S. states have been trained to deliver the FSN curriculum in their communities, presenting a strong opportunity to change the trajectory of childhood obesity.


A study published by the Journal of American Medical Association in November 2020 finds that a new home-visiting intervention designed in partnership with tribal communities helped promote healthy infant feeding practices and prevent obesity during the first year of life. The intervention involved 134 Navajo mothers and their infants.

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