Sociodemographic and Psychosocial Factors Associated With Diet Quality in 6 Rural Native American Communities
Journal of Nutrition Education and Behavior(2021)
摘要
Objective
To identify psychosocial and household environmental factors related to diet quality among Native Americans (NA).
Design
Analysis of baseline data from a community-randomized obesity prevention trial.
Setting
Six rural NA communities in the Midwest and the Southwestern US.
Participants
A total of 580 tribal members, aged 18–75 years old (mean 45 years), 74% female, self-identified as the main household food purchaser.
Variables Measured
Diet quality (Healthy Eating Index–2015 [HEI]) was derived from a semiquantitative food frequency questionnaire. Sociodemographic, psychosocial, and home food environment factors were assessed via interviewer-administered questionnaires.
Analysis
One-way ANOVA, linear regression models, and 2-tailed t tests compared HEI scores among sociodemographic categories. Multiple linear regression models assessed the relationship between psychosocial factors, home food environment, and HEI.
Results
Prevalence of obesity was 59%. Mean HEI–2015 score was 49.3 (SD = 8.1). Average HEI scores were 3.0 points lower in smokers than nonsmokers (P < 0.001), and 2.2 points higher in females than males (P < 0.01). Higher self-efficacy (β = 0.97; P < 0.001) and healthier eating intentions (β = 0.78; P < 0.001) were positively associated with HEI. Healthier household food patterns score was associated with higher HEI (β = 0.48; P < 0.01).
Conclusions and Implications
Psychosocial factors were associated with diet quality, a finding that supports the use of social-cognitive intervention approaches in rural NA communities in the Midwest and Southwest, and warrants evaluation in other locations. There remains a need to elucidate the association between the Food Distribution Program on Indian Reservations and diet quality.
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关键词
American Indians,Native Americans,diet,Healthy Eating Index,psychosocial factors
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