Understanding American‐Indian Children's Perceived Barriers and Facilitators to Following the Dietary Guidelines for Americans (DGA)

Abstract

Ninety‐two American Indian 5th graders from a rural, northern plains reservation community completed Nominal Group Technique (NGT) sessions designed to understand both barriers and facilitators to following DGA. Individually and in small groups, children generated lists of responses to specific questions, then ranked responses as a group. Environmental concerns were perceived as barriers to being physically active (“cops yell at us”; “it's too cold”; “too much glass”; “dogs”), to fruit, (“there is only a little bit at home”) and vegetable (“cost too much”; school don't have the kind I like”) consumption. Children also reported intrinsic barriers to consuming fruits (“don't like them much”) and vegetables (“they smell funny”). Facilitators to following DGA recommendations for fruit consumption referred to hedonic values (“fruit is good”; “fruits make me happy”), while facilitators for vegetable consumption were prescriptive (“put vegetables out for lunch”; “make a garden and plant vegetables”). While it is clear that features of the food and built environment contribute to children's lack of compliance to the DGA, responses indicate that room exists for improving children's health behavior knowledge, attitudes, and behaviors.