Perceptions of Dietary Habits and Risk for Type 2 Diabetes among Congolese Immigrants

Exploring the dietary practices and perceptions of African immigrants in Illinois- a qualitative study of immigrants from Nigeria and Congo

OBJECTIVE

Previous studies suggest an increased prevalence of diet-related chronic diseases among African immigrants with increased length of stay in the U.S. The objective of the current study is to understand the dietary practices and perceptions of recent African immigrant families.

DESIGN

Focus group sessions were conducted with Nigerian and Congolese immigrant parents residing in Illinois. Participants were recruited using convenience sampling methods and focus group sessions were conducted via videoconference. Participants discussed dietary practices, meal preparation, and family mealtimes for their families. They also discussed experiences with eating different kinds of foods since arrival in the U.S. Verbatim transcription of focus group sessions were completed and deductive thematic analysis of transcribed data was conducted using NVivo (QSR International Pty Ltd. [2020] NVivo [version 12]).

RESULTS

Twenty African immigrant parents (Mean age: 42 years, Female: 95%) residing in Northern and Central Illinois participated in a total of five focus group sessions. Seven themes were derived from the analysis. Participants had a positive attitude toward healthy diet and had a high level of interest in receiving educational resources to make healthier food choices. Participants preferred and mostly consumed foods they were familiar with before migration. A majority of the participants perceived 'American foods' as unhealthy, characterizing them as containing a high amount of sugar and salt. Parents reported that their school-aged children often preferred a western diet over traditional African meals.

CONCLUSION

This study helps to understand unique diet-related practices and perceptions of recent Nigerian and Congolese African immigrants in Illinois. Findings could help to inform cultural adaptation of evidence-based nutrition education programs for these groups of African immigrants.

Evidence from a Longitudinal Photovoice and Interview Assessment with Congolese Refugee Women in the Midwestern United States

Purpose: Refugees from the Democratic Republic of Congo have rapidly increased since 2016 and are growing to represent one of the top refugee groups in the United States. They are at high risk for health inequities, yet, there is limited qualitative research exploring the health needs, assets, and experiences of this group and even less longitudinal research. In addition, women refugees are understudied across all global contexts. Therefore, the purpose of this study was to conduct longitudinal qualitative research to provide rich contextual data on health and integration experiences of Congolese refugee women when they were newly resettled in 2016 and 3 years later in 2019. Methods: We conducted photovoice and interviews with 16 women in March through May of 2016 and 10 of the same women in March and April of 2019. Results: Women chose and discussed photos revealing a multitude of assets and needs spanning 2016 and 2019. Experiences with nutrition and food security were illuminated and are the focus of this article. Two major themes were access to food in contrast with availability of abundance of food in the United States and concern about what constitutes healthy food in the United States contrasted with accessing healthy and culturally appropriate food in the United States. Findings highlight strength bases of nutritional knowledge, attitudes, and skills as well as a strong social network aiding food security demonstrated by the Congolese refugee women in the study, offering an opportunity to shift to an assets and strength-based approach. Findings also note risk of food insecurity linked to barriers to employment and sociohistorical reflection on living with food shortages before migration to the United States that should be considered as providers strive to provide culturally relevant care. Conclusion: Findings offer contextual data for health care providers and public health professionals to improve nutritional health promotion and food security support for this population. Overlooking nuanced structural barriers may lead to providers perpetuating health inequities for this population.

Diabetes Risk and Control in Multi-ethnic US Immigrant Populations

PURPOSE OF REVIEW

The goal of this review is to assess current evidence on diabetes risk and control among adult immigrants in the USA.

RECENT FINDINGS

Patterns of diabetes risk in US immigrants may reflect global diabetes trends. Asian, Black, and Latinx immigrants all see a diabetes disadvantage relative to US-born Whites. Diabetes risk in Asian immigrants also surpasses US-born Asians. Relative diabetes risk among all groups increases with time in the USA. Research to explain patterns in diabetes risk and control among immigrants has broadened from lifestyle factors to include multi-level, life course influences on trajectories of risk. Some determinants are shared across groups, such as structural racism, healthcare access, and migration stress, whereas others such as diet are embedded in sending country culture. Current literature on diabetes in immigrant populations suggests a need to shift towards a transnational lens and macro-level social determinants of health framework to understand diabetes risk and potential prevention factors.

Positive health beliefs are associated with improvement of glycated hemoglobin and lipid profiles in Mexican patients with type 2 diabetes mellitus: a cross-sectional study

BACKGROUND

Health beliefs are relevant to consider in patients with type 2 diabetes since disease control depends mainly on the patient's behaviour. The aim of this study was to assess the association between health beliefs and glycated hemoglobin levels in Mexican patients with type 2 diabetes.

METHODS

An analytical cross-sectional study was conducted, and 336 patients were included. Fasting blood levels of glycated hemoglobin, glucose, cholesterol; triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) were measured. Body fat percentage, weight, height; waist circumference, and systolic and diastolic blood pressures were also obtained. A previously validated self-administered questionnaire was used to assess the health beliefs with regards to non-pharmacological treatment. Health beliefs were classified as positive, neutral, and negative.

RESULTS

The average age of patients was 54.7 ± 8.5 years, with a higher proportion of females (69%). The questionnaire had a good internal consistency with a Cronbach's alpha score of 0.83. More than 90% of patients attributed a health benefit to diet and exercise, 30 to 40% experienced barriers, and more than 80% had a perception of complications associated to uncontrolled diabetes. Patients with positive health beliefs had lower HbA1c levels (8.2 ± 1.7%) compared to those with neutral (9.0 ± 2.3%), or negative (8.8 ± 1.8%; p = 0.042). The LDL-c levels were lower (p = 0.03), and HDL-c levels were higher (0.002) in patients with positive heath beliefs.

CONCLUSIONS

Positive health beliefs are associated with better metabolic control indicators in patients with type 2 diabetes.

Beliefs and practices in diabetes care

Diabetes mellitus is considered a chronic non-communicable disease with high morbidity, presents to its high prevalence, social, family, and economic costs. Interventions aimed at life-style changes are fundamental in managing; due to this, patients must receive education. The aim of the study was to identify the beliefs and practices of the persons with diabetes mellitus, to propose nurse care according to these precepts. This was a descriptive study of systematic literature review, searching for articles in databases, Springer Science, Elsevier, ProQuest, Science Direct, Index, Pubmed, SciELO, Medigraphic, and Medline during 2016 to 2018, published between 2001 and 2018, in Spanish, English, and Portuguese. A total of 49 studies were contributing to fulfilling the objective. Within the beliefs for the management of disease, is the use of herbs, some consider as cause "fright"; Others take into account risk factors such as heredity, obesity, poor eating habits. Various beliefs are presented in relation to insulin treatment. Spirituality is emphasized; seeking refuge in God and prayer. Is important to understand the person, from their values, beliefs, customs and feelings. Education is a fundamental tool to control the disease, but health beliefs must be taken into account in order to achieve favorable results.