title: Barriers and facilitators for consumer adherence to the dietary guidelines for Americans: the HEALTH study.
abstract: The majority of the US population does not meet recommendations for consumption of milk, whole grains, fruit, and vegetables. The goal of our study was to understand barriers and facilitators to adherence to the Dietary Guidelines for Americans for four nutrient-rich food groups in fifth-grade children and unrelated adult caregivers across six sites in a multistate study. A total of 281 unrelated adult caregivers (32% African American, 33% European American, and 35% Hispanic American) and 321 children (33% African American, 33% European American, and 34% Hispanic American) participated in 97 Nominal Group Technique sessions. Nominal Group Technique is a qualitative method of data collection that enables a group to generate and prioritize a large number of issues within a structure that gives everyone an equal voice. The core barriers specific to unrelated adult caregivers were lack of meal preparation skills or recipes (whole grains, fruit, vegetables); difficulty in changing eating habits (whole grains, fruit, vegetables), cost (milk, whole grains, fruit, vegetables), lack of knowledge of recommendation/portion/health benefits (milk, vegetables), and taste (milk, whole grains, vegetables). Specific to children, the core barriers were competing foods (ie, soda, junk foods, sugary foods [whole grains, milk, fruit, vegetables]), health concerns (ie, milk allergy/upset stomach [milk]), taste/flavor/smell (milk, whole grains, fruit, vegetables), forget to eat them (vegetables, fruit), and hard to consume or figure out the recommended amount (milk, fruit). For both unrelated adult caregivers and children, reported facilitators closely coincided with the barriers, highlighting modifiable conditions that could help individuals to meet the Dietary Guidelines for Americans.
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Nicklas
authors.forename: Lisa
authors.initials: L
authors.lastname: Jahns
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Bogle
authors.forename: Deirdra N
authors.initials: DN
authors.lastname: Chester
authors.forename: Maria
authors.initials: M
authors.lastname: Giovanni
authors.forename: David M
authors.initials: DM
authors.lastname: Klurfeld
authors.forename: Kevin
authors.initials: K
authors.lastname: Laugero
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Sandra
authors.initials: S
authors.lastname: Lopez
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
mesh_terms: D000328:Adult; D001628:Beverages; D002648:Child; D003611:Dairy Products; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D002523:Edible Grain; D005006:Ethnicity; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D017408:Guidelines as Topic; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D014675:Vegetables
keywords: Barriers; Caregivers; Children; Dietary guidelines; Facilitators