Applying the socio-ecological model to improving fruit and vegetable intake among low-income African Americans.

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.