title: Barriers and facilitators to following the Dietary Guidelines for Americans reported by rural, Northern Plains American-Indian children.
abstract: OBJECTIVE
  The Dietary Guidelines for Americans (DGA) promote healthy dietary choices for all Americans aged 2 years and older; however, the majority of Americans do not meet recommendations. The goal of the present study was to identify both barriers and facilitators to adherence to DGA recommendations for consumption of five recommended food groups: grains (specifically whole grains), vegetables, fruits, meat/beans and milk (specifically reduced-fat/non-fat), among American-Indian children.
  
  
  METHODS
  Nominal group technique sessions were conducted to identify and prioritize children's perceived barriers and facilitators to following the DGA, as presented in the 'MyPyramid' consumer education icon. After response generation to a single question about each food group (e.g. 'What sorts of things make it harder (or easier) for kids to follow the MyPyramid recommendation for vegetables?'), children individually ranked their top five most salient responses. Ranked responses are presented verbatim.
  
  
  METHODS
  A rural Northern Plains American-Indian reservation, USA.
  
  
  METHODS
  Sixty-one self-selected fifth-grade children.
  
  
  RESULTS
  Core barriers for all food groups studied included personal preference (i.e. 'don't like') and environmental (i.e. 'cost too much'; 'store is too far to get them'; 'grandma don't have'). Core facilitators included suggestions, i.e. 'make a garden and plant vegetables'; 'tell your friends to eat healthy'.
  
  
  CONCLUSIONS
  Barriers and facilitators are dissimilar for individual food groups, suggesting that dietary interventions should target reduction of barriers and promotion of facilitators specific to individual food groups recommended by the DGA.
authors.affiliation: 1USDA/ARS Grand Forks Human Nutrition Research Center,2420 2nd Avenue North,Grand Forks,ND 58203,USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jahns
authors.affiliation: 2Cankdeska Cikana Community College,Spirit Lake Dakota Nation,Fort Totten,ND,USA.
authors.forename: Leander
authors.initials: L
authors.lastname: McDonald
authors.affiliation: 2Cankdeska Cikana Community College,Spirit Lake Dakota Nation,Fort Totten,ND,USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Wadsworth
authors.affiliation: 3Tate Topa Tribal School,Spirit Lake Dakota Nation,Fort Totten,ND,USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Morin
authors.affiliation: 4USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine,Department of Pediatrics,Houston,Texas,USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 4USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine,Department of Pediatrics,Houston,Texas,USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Nicklas
mesh_terms: D002648:Child; D002652:Child Behavior / Q000208:ethnology; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D065246:Culturally Competent Care; D004032:Diet / Q000009:adverse effects* / Q000191:economics / Q000208:ethnology; D005191:Family Characteristics / Q000208:ethnology; D005260:Female; D005518:Food Preferences / Q000208:ethnology; D005523:Food Supply / Q000191:economics; D006126:Group Processes; D006801:Humans; D007198:Indians, North American; D008297:Male; D009658:North Dakota; D018673:Nutrition Policy; D010349:Patient Compliance / Q000208:ethnology; D012111:Residence Characteristics; D012423:Rural Health / Q000191:economics / Q000208:ethnology
keywords: American-Indian children; Barriers and facilitators; Dietary Guidelines for Americans; Nominal group technique