Qualitative analysis of in-depth interviews with nutrition educators identifies challenges and strategies for serving Alaska Native clients

Abstract

Alaska Native people experience disproportionate occurrence of diet and behavior related health disparities and have been recognized as a population in need of effective nutrition education. It is, however, unclear whether and to what extent nutrition education programs have been effective for improving the diets and health of Alaska Native People. The objective of this study is to understand nutrition educators’ perceptions of challenges and most effective strategies for improving diet quality and health of Alaska Native people to inform program development. Nutrition educators serving Alaska Native Clients (n=20) were asked: What are the challenges their clients face to improving diet quality? What challenges do educators face to improving clients’ diet quality? And, What are the best strategies for improving clients’ diet quality? Interviews were in-depth and open ended. Qualitative analysis of interview texts showed that nutrition educators perceived challenges regarding subsistence foods and lifestyles, the need for cultural competence, and the benefits of employing local knowledge. Specifically, access to subsistence foods and lack of client knowledge regarding nutritional value, procurement, and processing of subsistence foods were identified as challenges to improving health. Cultural competence was identified as necessary for overcoming barriers associated with language, psychosocial issues, and client responsiveness. Working with a local contact/mentor was a recommended as a source of information and means of increasing access to community members. Education which addresses the context of subsistence foods and lifestyles, is committed to cultural sensitivity and familiarity with clients, and seeks local input to guide programs and access audiences is an important means of improving effectiveness of nutrition programs for Alaska Native people.