Understanding fruit and vegetable intake of Native American children: A mixed methods study

• Fruit/vegetable information was associated with fruit/vegetable motivation.
• Fruit/vegetable information was not associated with behavioral skills or intake.
• Fruit/vegetable information was associated to fruit/vegetable motivation.
• Fruit/vegetable behavioral skills was associated with intake.
• A revised IMB model was developed to explain these relationships.

Native American children experience greater rates of obesity and risk for chronic diseases in comparison to their counterparts in other ethnic groups. Contributing to this risk may be inadequate consumption of fruits and vegetables. The objective of this study was to investigate the fruit and vegetable consumption of Native American children between the ages of 2 and 5 by using an exploratory sequential mixed methods research design. This study first collected qualitative data from caregivers of Native American children (n = 45) and stakeholders in Native American communities (n = 10) to gain perspectives of fruit and vegetable consumption. Data was then utilized to develop a fruit and vegetable survey which was administered with a fruit and vegetable food frequency questionnaire. These quantitative assessments were administered to caregivers of Native American children (n = 92) to gain an understanding of predictors of fruit and vegetable intake among this population. This study was guided by the Information-Motivation-Behavioral Skills (IMB) model of health behavior. Findings from the mixed methods analysis demonstrate that, while the IMB model may be a useful tool to utilize in explaining the complex relationship between factors that impact fruit and vegetable consumption among Native American children, a revised model may be appropriate to use in future intervention development.