Exploring Fruit and Vegetable Intake of American Indian Children Using a Mixed Methods Approach

Abstract

American Indian (AI) children experience disproportionate rates of obesity compared to counterparts in other ethnic groups. Contributing to this issue may be inadequate consumption of fruits and vegetables (f/v). Little research exists on factors that contribute to f/v intake of American Indian children. The objective of this on‐going study is to assess how perceptions of f/v impact the f/v intake of AI children. During the initial qualitative phase, caregivers (n=45) and community stakeholders (n=10) participated in focus groups and individual interviews, respectively. The questions asked during these sessions focused on understanding what perceptions caregivers and community stakeholders have in regards to children's f/v intake. Data was analyzed using qualitative content analysis strategies, with each focus group and interview analyzed separately and then combined and assessed for concordance and discordance. Codes and categories were assessed for applicability to and grouped into the three constructs of the Information‐Motivation‐Behavioral Skills (IMB) Model of health behavior. Key quotes from each construct have been used in the development of a quantitative assessment tool. Construct/Theme Sub‐Theme Qualitative Quote Quantitative Item Information Food Safety "Some vegetables are worse than others. You always hear about tomatoes and spinach, so I don't even buy them." "Some fruits and vegetables will give you food poisoning." Motivation Social Support "I am the only one in my family that cares about fruits or vegetables at all." "I am the only one in my family that cares about eating healthy." Behavioral Skills Role Modeling "My daughter, she'll be like, mom is doing it so let me try it." "When it comes to eating vegetables, I feel I am a good role model for my child." This tool will be administrated with a f/v food frequency questionnaire to empirically test and validate these qualitative findings. Findings from this mixed methods study will aid public health and nutrition professionals working with caregivers of AI children to develop effective nutrition messaging.