title: Constructs of health and environment inform child obesity prevention in American Indian communities.
abstract: OBJECTIVE
  Obesity prevention efforts have had limited success in American Indian (AI) populations. More effective prevention programs might be designed using insights into linkages between parental health beliefs, environmental constraints and healthy lifestyle choices.
  
  
  METHODS
  Focus group sessions (n = 42 participants) were conducted to explore parental perspectives on children's health, diet and physical activity in three Wisconsin Tribal communities. Focus group questions were derived from preliminary interviews and observations on environmental barriers surrounding nutrition and physical activity.
  
  
  RESULTS
  Two broad thematic areas emerged from the focus groups: child health themes and environmental themes. Health themes included views of child health (emphasizing emotional health), views on parenting, and assessment of risks to child safety. Environmental (social and physical) themes included assessments of personal support networks, assessments of local facilities and programs, and values regarding household relationships. A provisional model of family behaviors related to child nutrition and physical activity was developed to better understand these themes and the potential tensions among them.
  
  
  CONCLUSIONS
  Understanding the unique cultural constructs of health and environment of AI communities can inform decision making in community-level prevention research. The proposed model served as a useful starting point for designing healthy lifestyle interventions in these AI communities. This model may also be applicable to other minority communities.
authors.affiliation: Department of Family Medicine, University of Wisconsin, Madison, WI, USA. alex.adams@fammed.wisc.edu
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Adams
authors.forename: Heather
authors.initials: H
authors.lastname: Harvey
authors.forename: David
authors.initials: D
authors.lastname: Brown
mesh_terms: D002648:Child; D002675:Child, Preschool; D004493:Education; D017144:Focus Groups; D015438:Health Behavior; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American; D007407:Interviews as Topic; D008019:Life Style; D017145:Models, Educational; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D012931:Social Environment; D014922:Wisconsin