Navajo Nation Stores Show Resilience During COVID-19 Pandemic

Author:

John Brianna123ORCID,Etsitty Sean O.12ORCID,Greenfeld Alex12,Alsburg Robert12,Egge Malyssa13,Sandman Sharon13,George Carmen12,Curley Caleigh34,Curley Cameron12,de Heer Hendrik D.3,Begay Gloria5,Ashley Martin E.6,Yazzie Del7,Antone-Nez Ramona7,Sunhi Shin Sonya12,Bancroft Carolyn2

Affiliation:

1. Community Outreach & Patient Empowerment, Gallup, NM, USA

2. Brigham and Women’s Hospital, Boston, MA, USA

3. Northern Arizona University, Flagstaff, AZ, USA

4. The University of Arizona, Mel & Enid Zuckerman College of Public Health, Tucson, AZ, USA

5. Diné Food Sovereignty Alliance, Gallup, NM, USA

6. Office of the Navajo Tax Commission, Window Rock, AZ, USA

7. Navajo Epidemiology Center, Window Rock, AZ, USA

Abstract

On April 8, 2020, the Navajo Nation issued an administrative order limiting business operations. Facing high coronavirus disease 2019 (COVID-19) rates and limited food infrastructure, a survey was conducted among Navajo Nation store managers to assess: (1) COVID-19 adaptations; (2) challenges; (3) changes in customer volume and purchasing; and (4) suggestions for additional support. Purposive sampling identified 29 stores in Navajo communities. Representatives from 20 stores (19 store managers/owners, 1 other; 7 grocery, and 13 convenience/other stores) were interviewed by phone or in-person to reach saturation (new information threshold < 5%). Responses were coded using frequencies and inductive thematic analysis. All 20 stores implemented COVID-19 guidelines (Centers for Disease Control and Prevention [CDC]/Navajo Nation) and most received orientation/support from local chapters, community organizations, or health centers. Stores implemented staff policies (50%, handwashing, vaccinations, protective personal equipment (PPE), sick leave, temperature checks), environmental changes (50%, hand sanitizer, checkout dividers), customer protocols (40%, limit customers, mask requirements, closed restrooms), and deep cleaning (40%). Most stores (65%) reported challenges including stress/anxiety, changing guidelines, supply chain and customer compliance; 30% reported infection or loss of staff. Weekday customer volume was slightly higher vs. pre-COVID, but weekend lower. Stores reported consistent or more healthy food purchases (50%), more nonfood essentials (20%), or shelf-stable foods (10%). Desired support included further orientation (30%), leadership support (20%), overtime/time to learn guidelines (20%), and signage/handouts (15%). Despite a high COVID-19 burden and limited food store infrastructure, Navajo Nation stores adapted by implementing staff, environmental and customer policies. Local support, staffing, and small store offerings were key factors in healthy food access.

Funder

National Institute on Minority Health and Health Disparities

Publisher

SAGE Publications

Subject

Nursing (miscellaneous),Public Health, Environmental and Occupational Health

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