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Journal of Community Health
Published in: Journal of Community Health 6/2008

01-12-2008 | Original Paper

Applying the Socio-ecological Model to Improving Fruit and Vegetable Intake Among Low-Income African Americans

Author: Tanya Robinson

Published in: Journal of Community Health | Issue 6/2008

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Abstract

Despite the growing body of literature that provides evidence of the health benefits of a diet high in fruits and vegetables, most Americans eat much less than the recommended amounts of this food group. Among those who are least likely to meet the USDA guidelines for the recommended daily servings of fruits and vegetables are non-Hispanic Blacks and individuals with lower incomes. The purpose of this literature review is to examine the dietary behaviors, focusing on fruit and vegetable intake, of low-income African Americans from a socio-ecological perspective, and to offer rationale for and guidance on integrating socio-ecological concepts into health promoting programs intended to improve dietary behaviors among this population. Based on the 12 descriptive studies retrieved in the review, dietary behaviors and fruit and vegetable intake among African Americans are the result of a complex interplay of personal, cultural, and environmental factors that can be categorized and described using the five levels of influence conceptualized by the socio-ecological model: Intrapersonal level (taste preferences, habits, and nutritional knowledge and skills), Interpersonal level/social environment (processes whereby culture, social traditions, and role expectations impact eating practices; and patterns within peer groups, friends and family), and Organizational, Community, and Public Policy levels/physical environment (environmental factors that affect food access and availability). The socio-ecological model provides a useful framework for achieving a better understanding of the multiple factors and barriers that impact dietary behaviors, and therefore can provide guidance for developing culturally appropriate and sensitive intervention strategies for African Americans. It is an integrative framework that shows great promise in moving the field closer to attaining the goal of improving dietary behaviors and nutritional status among African Americans.
Literature
1.
Baker, H. (2007). Nutrition in the elderly: Nutritional aspects of chronic disease. Geriatrics, 62, 21–25.PubMed
2.
Bowman, S. (2007). Low economic status is associated with suboptimal intakes of nutritional foods by adults in the National Health and Nutrition Examination Survey 1999–2002. Nutrition Research, 27, 515–523.CrossRef
3.
Centers for Disease Control, National Centers for Chronic Disease Prevention and Health Promotion. (2003). Physical activity and good nutrition: essential elements to prevent chronic diseases and obesity. Nutrition in Clinical Care, 6, 135–138.
4.
Henning, B., Ettinger, A., Jandacek, R., Sung, K., McClain, C., Seifried, H., et al. (2004). Using nutrition for intervention and prevention against environmental chemical toxicity and associated diseases. Environmental Health Perspectives, 115, 493–495.
5.
Kennedy, E. (2006). Evidence for nutritional benefits in prolonging wellness. American Journal of Clinical Nutrition, 83, 410s–414s.PubMed
6.
Shikany, J., & White, G. (2000). The dietary guidelines for chronic disease prevention. Southern Medical Journal, 93, 1133–1151.
7.
Stitzel, K. (2006). Position of the American Dietetic Association: The roles of registered dieticians and dietetic technicians, registered in health promotion and disease prevention. Journal of the American Dietetic Association, 106, 1875–1884.PubMedCrossRef
8.
9.
Casagrande, S., Wang, Y., Anderson, C., & Gary, T. (2007). Have Americans increased their fruit and vegetable intake? The trends between 1988 and 2002. American Journal of Preventive Medicine, 32, 257–263.PubMedCrossRef
10.
Bazzano, L. (2006). The high cost of not consuming fruits and vegetables. Journal of the American Dietetic Association, 106, 1364–1368.PubMedCrossRef
11.
Bazzano, L. A., He, J., Ogden, L. G., Loria, C. M., Vupputuri, S., Myers, L., et al. (2002). Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first national health and nutrition examination survey epidemiologic follow-up study. American Journal of Clinical Nutrition, 76, 93–99.PubMed
12.
Cox, B. D., Whichelow, M. J., & Prevost, A. T. (2000). Seasonal consumption of salad vegetable and fresh fruit in relation to the development of cardiovascular disease and cancer. Public Health Nutrition, 3, 19–29.PubMedCrossRef
13.
Joshipura, K. J., Hu, F. B., Manson, J. E., Stampfer, M. J., Rimm, E. B., Speizer, F. E., et al. (2001). The effect of fruit and vegetable intake on risk from coronary health disease. Annals of Internal Medicine, 134, 1106–1114.PubMed
14.
He, F., Nowsibm, C., Lucas, M., & MacGregor, G. (2007). Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: Meta-analysis of cohort studies. Journal of Human Hypertension, 21, 717–728.PubMedCrossRef
15.
Jen, C., Brogan, K., Washington, O., Flack, J., & Artinian, N. (2007). Poor nutrient intake and high obese rate in an urban African American population with hypertension. Journal of the American College of Nutrition, 26, 57–65.PubMed
16.
Joshipura, K. J., Ascherio, A., Manson, J. E., Stampfer, M. J., Rimm, E. B., Speizer, F. E., et al. (1999). Fruit and vegetable intake in relation to risk of ischemic stroke. Journal of the American Medical Association, 282, 1233–1239.PubMedCrossRef
17.
Steffen, L. M., Jacobs, D. R., Stevens, J., Shahar, E., Carithers, T., & Folsom, A. R. (2003). Associations of whole-grain, refined grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: The atherosclerosis risk in communities (ARIC) study. American Journal of Clinical Nutrition, 78, 383–390.PubMed
18.
Bazzano, L. (2006). The high cost of not consuming fruits and vegetables. Journal of the American Dietetic Association, 106, 1364–1368.PubMedCrossRef
19.
Guenther, P., Dodd, K., Reedy, J., & Krebs-Smith, S. (2006). Most Americans eat much less than recommended amounts of fruits and vegetables. Journal of the American Dietetic Association, 106, 1371–1379.PubMedCrossRef
20.
Kruger, J., Yore, M., Solera, M., & Moeti, R. (2007). Prevalence of fruit and vegetable consumption and physical activity by race/ethnicity—United States, 2005. Journal of the American Medical Association, 297, 2072–2074.CrossRef
21.
22.
Li, R., Serdula, M., Bland, S., Mokdad, A., Bowman, B., & Nelson, D. (2000). Trends in fruit and vegetable consumption among adults in 16 US states: behavioral risk factor surveillance system 1990–1996. American Journal of Public Health, 90, 777–781.PubMed
23.
Serdula, M. K., Gillespie, C., Kettel-Khan, L., Farris, R., Seymour, J., & Denny, C. (2004). Trends in fruit and vegetable consumption among adults in the United States: behavioral risk factor surveillance system 1994–2000. American Journal of Public Health, 94, 1014–1018.PubMedCrossRef
24.
Gary, T. L., Baptiste-Roberts, K., & Gregg, E. W. (2004). Fruit, vegetable, and fat intake in a population-based sample of African Americans. Journal of the National Medical Association, 96, 1599–1605.PubMed
25.
26.
Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R., et al. (1994). Socioeconomic status and health: the challenge of the gradient. American Psychologist, 48, 15–24.CrossRef
27.
Williams, C. (1995). US socioeconomic and racial differences in health: patterns and explanations. Annual Review of Sociology, 21, 349–386.CrossRef
28.
Chen, E., Martin, A., & Matthews, K. (2006). Understanding health disparities: The role of race and socioeconomic status in children’s health. American Journal of Public Health, 96, 702–708.PubMedCrossRef
29.
Braithwaite, R., & Taylor, S. (Eds.). (2001). Health issues in the Black community. San Francisco: Jossey-Bass, pp. 3–12.
30.
31.
Isaac, E., Rowland, M., & Blackwell, L. (2007). Fighting health disparities: The educational role of the African American church. Cross Currents, 57, 261–265.
32.
Russell, K., & Jewell, N. (1992). Cultural impact of health care access: Challenges for improving the health of African Americans. Journal of Community Health Nursing, 9, 161–169.PubMedCrossRef
33.
Ferrans, C., Akpan, B., Davis, M., Giachello, A., Johnson, T., Martinez, V., et al. (2006). Cultural beliefs contributing to late-stage diagnosis of breast cancer in African American, Latina, and Caucasian women. Oncology Nursing Forum, 33, 415.
34.
Peters, R., Aroian, K., & Flack, J. (2006). African American culture and hypertension prevention. Western Journal of Nursing Research, 28, 831–854.PubMedCrossRef
35.
Padgett, J., & Biro, F. (2003). Different shapes in different cultures: Body dissatisfaction, overweight, and obesity in African American and Caucasian women. Journal of Pediatric and Adolescent Gynecology, 16, 349–354.PubMedCrossRef
36.
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15, 351–377.PubMed
37.
Stokols, D. (1996). Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10, 282–298.PubMed
38.
Richards, L., Potvin, L., Kishchuk, N., Prlic, H., & Green, L. (1996). Assessment of the Integration of the ecological approach in health promotion programs. American Journal of Health Promotion, 10, 318–327.
39.
40.
Green, L., Richard, L., & Potvin, L. (1996). Ecological foundations for health promotion. American Journal of Health Promotion, 10, 270–281.PubMed
41.
Minkler, M. (1999). Personal responsibility for health: A review of the arguments and the evidence at century’s end. Health Education and Behavior, 26, 121–140.PubMedCrossRef
42.
Ahye, B., Devine, C., & Odoms-Young, A. (2006). Values expressed through intergenerational family food and nutrition management systems among African American women. Family and Community Health, 29, 5–16.PubMed
43.
Befort, C., Kaur, H., Nollen, N., Sullivan, D., Nazir, N., Choi, W., et al. (2006). Fruit, vegetable, and fat intake among non-Hispanic Black and non-Hispanic White adolescents: Associations with home availability and food consumption settings. Journal of the American Dietetic Association, 106, 367–373.PubMedCrossRef
44.
Hargreaves, M., Schlundt, D., & Buchowski, M. (2002). Contextual factors influencing the eating behaviors of African American women: A focus group investigation. Ethnicity and Health, 7, 133–147.PubMedCrossRef
45.
Henry, H., Reimer, K., Smith, C., & Reicks, M. (2006). Associations of decisional balance, processes of change, and self-efficacy with stages of change for increased fruit and vegetable intake among low income, African American Mothers. Journal of the American Dietetic Association, 106, 841–849.PubMedCrossRef
46.
James, D. (2004). Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model. Ethnicity and Health, 9, 349–367.PubMedCrossRef
47.
Liburd, L. (2003). Food, identity, and African American women with Type II diabetes: An anthropological perspective. Diabetes Spectrum, 16, 160–165.CrossRef
48.
Molaison, E., Connell, C., Stuff, J., Yadrick, M., & Bogle, M. (2005). Influences on fruit and vegetable consumption by low-income black American adolescents. Journal of Nutrition Education and Behavior, 37, 246–251.PubMedCrossRef
49.
Mushi-Brunt, C., Haire-Jushu, D., & Elliot, M. (2007). Food spending behaviors and perceptions are associated with fruit and vegetable intake among parents and their preadolescent children. Journal of Nutrition Education and Behavior, 39, 26–30.PubMedCrossRef
50.
Reimer, K., Smith, C., Reicks, M., Henry, H., Thomas, R., & Atwell, J. (2003). Child-feeding strategies of African American women according to stage of change for fruit and vegetable consumption. Public Health Nutrition, 7, 505–512.
51.
Satia, J., Galanko, J., & Siego-Riz, A. (2004). Eating at fast food restaurants is associated with dietary intake, demographic, psychosocial and behavioral factors among African Americans in North Carolina. Public Health Nutrition, 7, 1089–1096.PubMedCrossRef
52.
Watters, J., Satia, J., & Galanko, J. (2007). Associations of psychosocial factors with fruit and vegetable intake among African Americans. Public Health Nutrition, 10, 701–711.PubMedCrossRef
53.
Zenk, S., Schulz, A., Hollis-Neely, T., Campbell, R., Holmes, N., Watkins, G., et al. (2005). Fruit and vegetable intake in African Americans: Income and store characteristics. American Journal of Preventive Medicine, 29, 1–9.PubMedCrossRef
54.
Vanwormer, J., Boucher, J., & Pronk, N. (2006). Telephone-based counseling improves dietary fat, fruit, and vegetable consumption: A best-evidence synthesis. Journal of the American Dietetic Association, 106, 1434–1444.PubMedCrossRef
55.
56.
Airhihenbuwa, C. O., Kumanyika, S., Agurs, T. D., Lowe, A., Saunders, D., & Morssink, C. B. (1996). Cultural aspects of African American eating patterns. Ethnicity and Health, 1, 245–260.PubMedCrossRef
57.
Campbell, M., Resnicow, K., Carr, C., Wang, T., & Williams, A. (2006). Process evaluation of an effective church-based diet intervention: Body & Soul. Health Education and Behavior, 20, 1–17.
Metadata
Title
Applying the Socio-ecological Model to Improving Fruit and Vegetable Intake Among Low-Income African Americans
Author
Tanya Robinson
Publication date
01-12-2008
Publisher
Springer US
Published in
Journal of Community Health / Issue 6/2008
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-008-9109-5

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