Barriers and facilitators to following the dietary guidelines for vegetable intake: Follow-up of an intervention to increase vegetable intake

Abstract

The Dietary Guidelines for Americans (DGA) stress the importance of a diet high in vegetables; however, intake remains low. Recently, we found that self-identified low vegetable consumers ate the recommended daily amounts of vegetables when they were provided gratis but returned to habitual intake when vegetables were no longer supplied. This follow-up study aimed to identify key barriers and facilitators to vegetable consumption and to assess if barriers and facilitators differ between adults who had been provided vegetables in recommended amounts (N = 18) and those who had acted as controls with no vegetables provided (N = 16) during a randomized, controlled trial. Nominal group technique (NGT) sessions were conducted to identify and prioritize perceived barriers and facilitators to following the DGA for vegetables. Responses from all NGT sessions were aggregated and grouped into major themes. Convenience, availability, cost, and knowledge were core facilitators in both groups, while motivation emerged as a facilitator only in the control group. Time, preference, and cost were core barriers in both groups, while availability emerged as a barrier only in the control group and social support a barrier only in the intervention group. The barriers and facilitators identified by the intervention group and the control group from the primary study differed in relative rankings, suggesting that the experience of consuming provided vegetables influenced the strength of the perceived barriers and facilitators. The multi-factorial nature of the identified barriers and facilitators underscores the importance of addressing individual, social, and environmental factors to increase vegetable consumption.