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 and Procedures: 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. Discussion: 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.

Assessment of Body Mass Index, Sugar Sweetened Beverage Intake and Time Spent in Physical Activity of American Indian Children in Oklahoma

“…Possible contributors for lower PA levels within AIs versus the general population have been previously reported and include lower household income, perceived unsafe neighborhoods, single family households, and higher likelihood of watching two or more hours of television per day [32]. Possible interventions that target AI children must address the socioeconomic barriers to PA and focus on culturally and geographically specific obstacles, which may include limited availability of community resources, culture-specific healthy lifestyle perceptions, and relevancy of preventive lifestyle choices when basic needs are difficult to meet [33].…”

High Food Insecurity and Its Correlates Among Families Living on a Rural American Indian Reservation

“…Similar positive associations between food insecurity and intake of fried and high-fat foods, and specifically fried chicken, were seen in a study of Mexican-born children of migrant workers in California. 37 On the Pine Ridge Reservation, as in many rural areas, 38,39 convenience stores and gas stations are common and provide fast and inexpensive, although rarely nutritionally adequate, meals for families. Food-insecure families may be particularly reliant on food from convenience stores because of the inability to travel to larger grocery stores, which are farther away, or to budget and plan for less frequent shopping trips.…”

Correlates of Physical Activity in Young American Indian Children

“…Prior to HCSF intervention design, we addressed some of these issues by the use of caregiver focus groups, key informant interviews, and direct observations of environmental barriers to obesity prevention at tribal sites. 30 …”