BACKGROUND American Indian and Alaskan Native individuals experience disproportionate levels of chronic health conditions such as type 2 diabetes and overweight and obesity that are influenced by dietary patterns and food choices. Understanding factors that influence healthy food choices among tribal college students can enrich education and programs that target dietary intake. OBJECTIVE To build an understanding of factors that influence healthy food choices among tribal college students at increased risk for college attrition. DESIGN A nonexperimental cohort design was used for qualitative descriptive analysis. PARTICIPANTS/SETTING Participants (N=20) were purposively sampled, newly enrolled, academically underprepared tribal college students enrolled in a culturally relevant life skills course at an upper Midwest tribal college between September 2013 and May 2015. Participant demographic characteristics included various tribal affiliations, ages, and number of dependents. MAIN OUTCOME MEASURES Participant responses to qualitative research questions about dietary intake, food choices, self-efficacy for healthy food choices, psychosocial determinants, and barriers to healthy food choices during telephone interviews were used as measures. ANALYSIS Qualitative analysis included prestudy identification of researcher bias/assumptions, audiorecording and transcription, initial analysis (coding), secondary analysis (sorting and identifying meaning), and verification (comparative pattern analysis). RESULTS Qualitative analysis revealed a variety of themes and subthemes about healthy food choices. Main themes related to barriers included taste, food gathering and preparation, and difficulty clarifying healthy food choices. Main themes related to strategies included taste, cultural traditions and practices, and personal motivation factors. CONCLUSIONS Qualitative analysis identified barrier and strategy themes that may assist nutrition and dietetics practitioners working with tribal/indigenous communities, tribal college educators and health specialists, and tribal community health workers who target health and dietary intake of American Indian and Alaskan Native students.

中文翻译：

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美国印第安部落大学生健康食品选择的障碍和策略：定性分析

背景美洲印第安人和阿拉斯加原住民个体经历了不成比例的慢性健康状况，例如受饮食模式和食物选择影响的2型糖尿病和超重和肥胖症。了解影响部落大学生健康食物选择的因素可以丰富针对饮食摄入的教育和计划。目的 了解影响大学流失风险增加的部落大学生健康食物选择的因素。设计 非实验性队列设计用于定性描述性分析。参与者/设置参与者 (N=20) 是有目的地抽样的，新注册的，2013 年 9 月至 2015 年 5 月期间，学业准备不足的部落大学生在中西部上游部落学院参加了与文化相关的生活技能课程。参与者的人口统计特征包括各种部落隶属关系、年龄和家属人数。主要结果测量参与者在电话采访中对关于饮食摄入、食物选择、健康食物选择的自我效能、心理社会决定因素和健康食物选择障碍的定性研究问题的回答被用作测量。分析 定性分析包括研究前识别研究人员的偏见/假设、录音和转录、初始分析（编码）、二次分析（分类和识别意义）和验证（比较模式分析）。结果 定性分析揭示了有关健康食品选择的各种主题和子主题。与障碍相关的主要主题包括口味、食物收集和准备以及难以阐明健康食物的选择。与策略相关的主题包括品味、文化传统和实践以及个人动机因素。结论 定性分析确定了可能有助于营养和饮食从业者与部落/土著社区、部落大学教育工作者和健康专家以及针对美洲印第安人和阿拉斯加土著学生的健康和饮食摄入量的部落社区卫生工作者合作的障碍和策略主题。并且难以阐明健康的食物选择。与策略相关的主题包括品味、文化传统和实践以及个人动机因素。结论 定性分析确定了可能有助于营养和饮食从业者与部落/土著社区、部落大学教育工作者和健康专家以及针对美洲印第安人和阿拉斯加土著学生的健康和饮食摄入量的部落社区卫生工作者合作的障碍和策略主题。并且难以阐明健康的食物选择。与策略相关的主题包括品味、文化传统和实践以及个人动机因素。结论 定性分析确定了可能有助于营养和饮食从业者与部落/土著社区、部落大学教育工作者和健康专家以及针对美洲印第安人和阿拉斯加土著学生的健康和饮食摄入量的部落社区卫生工作者合作的障碍和策略主题。