Food Perceptions and Dietary Behavior of American-Indian Children, Their Caregivers, and Educators: Formative Assessment Findings from Pathways.
Dietary findings from a school-based obesity prevention project (Pathways) are reported for children from six different American-Indian nations. A formative assessment was undertaken with teachers, caregivers, and children from nine schools to design a culturally appropriate intervention, including classroom curriculum, food service, physical education, and family components. This assessment employed a combination of qualitative and quantitative methods (including direct observations, paired-child in-depth interviews, focus groups with child caregivers and teachers, and semistructured interviews with caregivers and foodservice personnel) to query local perceptions and beliefs about foods commonly eaten and risk behaviors associated with childhood obesity at home, at school, and in the community. An abundance of high-fat, high-sugar foods was detected in children's diets described by caregivers, school food-service workers, and the children themselves. Although children and caregivers identified fruits and vegetables as healthy food choices, this knowledge does not appear to influence actual food choices. Frequent high-fat/high-sugar food sales in the schools, high-fat entrees in school meals, the use of food rewards in the classroom, rules about finishing all of one's food, and limited family resources are some of the competing factors that need to be addressed in the Pathways intervention.
Center for Human Nutrition and Division of Human Nutrition, Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205-2179.
Joel
J
Gittelsohn
WIC Program, Minnesota Department of Health, Minneapolis, Minnesota 55440-9441.
Elanah Greer
EG
Toporoff
Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota 55454.
Mary
M
Story
National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892-7936.
Marguerite
M
Evans
Center for Human Nutrition and Division of Human Nutrition, Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205-2179.
Jean
J
Anliker
Center for Health Promotion and Disease Prevention, Department of Pediatrics, School of Medicine, University of New Mexico, Albuquerque, New Mexico 87131-5311.
Sally
S
Davis
Center for Human Nutrition and Division of Human Nutrition, Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205-2179.
Anjali
A
Sharma
Health Education, Department of Health Services, Sacaton, Arizona 85247.
Jean
J
White
Health Educ Res. 1998 Jun;13(2):251-65
10181023
Am J Dis Child. 1985 Feb;139(2):181-5
3976591
Am J Clin Nutr. 1999 Apr;69(4 Suppl):803S-809S
10195606
Am J Clin Nutr. 1999 Apr;69(4 Suppl):796S-802S
10195605
Health Educ Q. 1989 Summer;16(2):155-69
2659554
N Engl J Med. 1976 Jul 1;295(1):6-9
1272299
Obes Res. 1996 May;4(3):229-43
8732957
J Am Diet Assoc. 1997 Jul;97(7):750-3
9216551
Am J Clin Nutr. 1999 Apr;69(4 Suppl):747S-754S
10195597
J Nutr. 1997 Oct;127(10 Suppl):2085S-2093S
9339174
Am J Epidemiol. 1992 Jul 15;136(2):201-13
1415142
J Sch Health. 1988 Mar;58(3):104-7
3352232
Am J Clin Nutr. 1992 Jul;56(1):14-8
1609751
J Am Diet Assoc. 1993 Oct;93(10):1136-40
8409135
J Nutr. 1991 Mar;121(3):408-15
2002411
Am J Clin Nutr. 1999 Apr;69(4 Suppl):760S-763S
10195599
Am J Clin Nutr. 1991 Jun;53(6 Suppl):1616S-1620S
2031495
Am J Clin Nutr. 1999 Apr;69(4 Suppl):767S-772S
10195601
Arch Pediatr Adolesc Med. 1995 Oct;149(10):1085-91
7550810
Am J Clin Nutr. 1999 Apr;69(4 Suppl):788S-795S
10195604
Prev Med. 1992 Mar;21(2):162-76
1579552
Am J Clin Nutr. 1999 Apr;69(4 Suppl):810S-815S
10195607
JAMA. 1994 Jul 20;272(3):205-11
8022039
Am J Clin Nutr. 1991 Jun;53(6 Suppl):1535S-1542S
2031484
Obes Res. 1995 Sep;3 Suppl 2:289s-297s
8581789
Am J Public Health. 1987 May;77(5):588-92
3565653
Am J Dis Child. 1992 Mar;146(3):289-95
1543174
Health Educ Q. 1994 Winter;21(4):521-38
7843981
Ann Intern Med. 1985 Dec;103(6 ( Pt 2)):1068-72
4062127
Lancet. 1989 Jun 24;1(8652):1450-1
2567455
JAMA. 1996 Mar 13;275(10):768-76
8598593