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Barriers and Strategies for Healthy Food Choices among American Indian Tribal College Students: A Qualitative Analysis

Published:October 20, 2017DOI:https://doi.org/10.1016/j.jand.2017.08.003

      Abstract

      Background

      American Indian and Alaskan Native individuals experience disproportionate levels of chronic health conditions such as type 2 diabetes and overweight and obesity that are influenced by dietary patterns and food choices. Understanding factors that influence healthy food choices among tribal college students can enrich education and programs that target dietary intake.

      Objective

      To build an understanding of factors that influence healthy food choices among tribal college students at increased risk for college attrition.

      Design

      A nonexperimental cohort design was used for qualitative descriptive analysis.

      Participants/setting

      Participants (N=20) were purposively sampled, newly enrolled, academically underprepared tribal college students enrolled in a culturally relevant life skills course at an upper Midwest tribal college between September 2013 and May 2015. Participant demographic characteristics included various tribal affiliations, ages, and number of dependents.

      Main outcome measures

      Participant responses to qualitative research questions about dietary intake, food choices, self-efficacy for healthy food choices, psychosocial determinants, and barriers to healthy food choices during telephone interviews were used as measures.

      Analysis

      Qualitative analysis included prestudy identification of researcher bias/assumptions, audiorecording and transcription, initial analysis (coding), secondary analysis (sorting and identifying meaning), and verification (comparative pattern analysis).

      Results

      Qualitative analysis revealed a variety of themes and subthemes about healthy food choices. Main themes related to barriers included taste, food gathering and preparation, and difficulty clarifying healthy food choices. Main themes related to strategies included taste, cultural traditions and practices, and personal motivation factors.

      Conclusions

      Qualitative analysis identified barrier and strategy themes that may assist nutrition and dietetics practitioners working with tribal/indigenous communities, tribal college educators and health specialists, and tribal community health workers who target health and dietary intake of American Indian and Alaskan Native students.

      Keywords

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      Biography

      J. F. Keith is an assistant professor, Department of Family and Consumer Sciences, University of Wyoming, Laramie.

      Biography

      S. Stastny is an associate professor, Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo.

      Biography

      A. Brunt is a professor, Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo.

      Biography

      W. Agnew is a faculty and extension nutrition educator, Land Grant Department, United Tribes Technical College, Bismarck, ND.