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Van Dyke N, Murphy M, Drinkwater EJ. "We know what we should be eating, but we don't always do that." How and why people eat the way they do: a qualitative study with rural australians. BMC Public Health 2024; 24:1240. [PMID: 38711054 DOI: 10.1186/s12889-024-18432-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND There is evidence that most people are aware of the importance of healthy eating and have a broad understanding regarding types of food that enhance or detract from health. However, greater health literacy does not always result in healthier eating. Andreasen's Social Marketing Model and Community-Based Social Marketing both posit that, in order to change health behaviours, it is crucial to understand reasons for current behaviours and perceived barriers and benefits to improved behaviours. Limited research has been conducted, however, that explores these issues with general populations. This study aimed to help address this gap in the evidence using a qualitative methodology. METHODS Three group discussions were conducted with a total of 23 participants: (1) young women aged 18-24 with no children; (2) women aged 35-45 with primary school aged children; and (3) men aged 35-50 living with a partner and with pre- or primary school aged children. The discussions took place in a regional centre of Victoria, Australia. Transcriptions were thematically analysed using an inductive descriptive approach and with reference to a recent integrated framework of food choice that identified five key interrelated determinants: food- internal factors; food- external factors; personal-state factors; cognitive factors; and sociocultural factors. RESULTS We found that food choice was complex, with all five determinants evident from the discussions. However, the "Social environment" sub-category of "Food-external factors", which included family, work, and social structures, and expectations (or perceived expectations) of family members, colleagues, friends, and others, was particularly prominent. Knowledge that one should practice healthy eating, which falls under the "Cognitive factor" category, while seen as an aspiration by most participants, was often viewed as unrealistic, trumped by the need and/or desire for convenience, a combination of Food-external factor: Social environment and Personal-state factor: Psychological components. CONCLUSIONS We found that decisions regarding what, when, and how much to eat are seen as heavily influenced by factors outside the control of the individual. It appears, therefore, that a key to improving people's eating behaviours is to make it easy to eat more healthfully, or at least not much harder than eating poorly.
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Affiliation(s)
- Nina Van Dyke
- Mitchell Institute, Victoria University, 300 Queen St, Melbourne, VIC, Australia.
| | | | - Eric J Drinkwater
- Centre for Sport Research, School of Exercise & Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Dualle MA, Robinette LM, Hatsu IE. Food Related Challenges and Mental Health Among U.S. African Migrants: A Narrative Review. J Immigr Minor Health 2024; 26:371-384. [PMID: 37400706 DOI: 10.1007/s10903-023-01512-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 07/05/2023]
Abstract
The United States' (US) African immigrant (AI) population is growing, yet they are underrepresented in health and nutrition research. This population experiences difficulties finding culturally appropriate foods and navigating the US food environment (FE), is highly food insecure (FI), and vulnerable to mental disorders. This review examined the current evidence for AIs' food and mental health outcomes and connections; and identified gaps in the literature and future research opportunities. A literature search was conducted using Google Scholar, PubMed, CINAHL, MEDLINE, and SCOPUS. Twenty-one studies were identified, reporting high (37-85%) FI rates, poor diet quality, and increased risk of mental disorders among participants. Challenges in the FE, lack of transportation, limited access to ethnic foods, low SES, and language barriers were associated with FI and poor diet quality. Similarly, discrimination, substance use, and immigration status were associated with depression and anxiety. However, studies examining the connection between AI's food experience and mental health are lacking. AIs are at a higher risk for FI, poor diet quality, and mental disorders. Ethnic-specific research to understand the connection between their food and mental health is needed to reduce nutrition and mental health disparities.
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Affiliation(s)
- Maryan A Dualle
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Lisa M Robinette
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Irene E Hatsu
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA.
- College of Education and Human Ecology, Department of Human Sciences | Human Nutrition Program, 341 Campbell Hall, 1787 Neil Ave, Columbus, OH, 43210, USA.
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Kovacic V, Sanhueza C, Hinostroza B, Cabezas J, Leonario-Rodríguez M. Attitudinal factors associated with protein sufficiency in Chilean vegan university students - A pilot study. NUTR HOSP 2024. [PMID: 38501809 DOI: 10.20960/nh.04878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION vegan diets are currently an essential topic of discussion because they are recognized as a prototype of a healthy diet but are also associated with deficits in the intake of critical nutrients such as protein. Evaluating the factors that influence the deficit in their intake in vulnerable populations such as university students represents an important topic of interest, considering that this is one of the groups where veganism is most popular. Given this, the present study aimed to determine the degree of protein sufficiency and its associated factors in a sample of Chilean vegan university students. MATERIALS AND METHODS an exploratory cross-sectional study was conducted on 114 vegan university students who responded to an online survey on academic, attitudinal, clinical, dietary, and sociodemographic variables. Protein intake was calculated, and based on self-reported weight, daily protein adequacy was calculated according to the recommendation of 0.9 g/kg/day. Finally, the association between protein adequacy and previously consulted variables was calculated by determining the odds ratios. RESULTS only 53.5 % had adequate daily protein intake, which was associated with the length of time respondents had been vegan (OR, 2.86; 95 % CI, 1.07 to 7.34; p < 0.05), use of supplements (OR, 5.24; 95 % CI, 1.17 to 25.2; p < 0.05), and the frequency with which they ate lunch at home (OR, 87.7; 95 % CI, 24.1 to 304; p = 0.000). CONCLUSION there needs to be more protein adequacy in the assessed sample. Protein adequacy is associated with the length of time on the vegan diet, frequency of eating lunch away from home, and use of supplements regularly.
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Affiliation(s)
- Vesna Kovacic
- School of Nutrition and Dietetics. Faculty of Medicine and Health Sciences. Universidad Mayor
| | - Camila Sanhueza
- School of Nutrition and Dietetics. Faculty of Medicine and Health Sciences. Universidad Mayor
| | - Beatriz Hinostroza
- School of Nutrition and Dietetics. Faculty of Medicine and Health Sciences. Universidad Mayor
| | - Juan Cabezas
- School of Nutrition and Dietetics. Faculty of Health. Universidad Santo Tomás
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Wieland ML, Molina L, Goodson M, Capetillo GP, Osman A, Ahmed Y, Elmi H, Nur O, Iteghete SO, Torres-Herbeck G, Dirie H, Clark MM, Lohr AM, Smith K, Zeratsky K, Rieck T, Herrin J, Valente TW, Sia IG. Healthy immigrant community study protocol: A randomized controlled trial of a social network intervention for cardiovascular risk reduction among Hispanic and Somali adults. Contemp Clin Trials 2024; 138:107465. [PMID: 38309526 PMCID: PMC10923143 DOI: 10.1016/j.cct.2024.107465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/18/2023] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Immigrants to the United States face structural barriers that contribute to rising cardiovascular risk factors and obesity after immigration. This manuscript describes the development of the Healthy Immigrant Community protocol and baseline measures for a stepped wedge cluster randomized trial to test the effectiveness of a social network intervention for cardiovascular risk reduction among two immigrant populations. METHODS We developed a social network-informed, community-based, participatory research-derived health promotion intervention with Hispanic and Somali immigrant communities in Minnesota consisting of mentoring, educational and motivational sessions, group activities, and a community toolkit for healthy weight loss delivered by culturally concordant health promoters (HPs) to their social networks. Using a stepped wedge cluster randomized design, social network-based groups were randomly assigned to receive the intervention either immediately or after a delay of one year. Outcomes, measured at baseline, 6 months, 12 months, and 24 months, were derived from the American Heart Association's "Life's Simple 7": BMI and waist circumference, blood pressure, fasting blood glucose, total cholesterol, physical activity level, and dietary quality. RESULTS A total of 51 HPs were enrolled and randomized (29 Hispanic; 22 Somali). There were 475 participants enrolled in the study, representing a mean social network group size of 8 (range, 5-12). The mean BMI of the sample (32.2) was in the "obese" range. CONCLUSION Processes and products from this Healthy Immigrant Community protocol are relevant to other communities seeking to reduce cardiovascular risk factors and negative health behaviors among immigrant populations by leveraging the influence of their social networks.
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Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership.
| | | | - Miriam Goodson
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership; Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Ahmed Osman
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Yahye Ahmed
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | - Hindi Elmi
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Omar Nur
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | | | - Gloria Torres-Herbeck
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | | | - Matthew M Clark
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership
| | | | - Katherine Zeratsky
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Thomas Rieck
- Rochester Healthy Community Partnership; Department of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, USA
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thomas W Valente
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Irene G Sia
- Rochester Healthy Community Partnership; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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Alcivar J, Mijares V, Hernandez J, Palacios C. Perceived Health and Diet Quality Among Hispanics in South Florida. J Immigr Minor Health 2024; 26:243-246. [PMID: 37768492 DOI: 10.1007/s10903-023-01548-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
There is limited information if perceived health is associated with diet quality in Hispanics. A cross-sectional study was conducted to evaluate is health perception is associated with diet quality among 109 adults in South Florida. Individuals conducting a primary grocery shopping event were asked to complete a survey about their perceived health and to provide a picture of their grocery receipt to estimate diet quality using the Grocery Purchase Quality Index 2016 (GPQI-2016). Data was analyzed using analysis of covariance, adjusting for age, gender, ethnicity, and household size. Mean age was 45.1 ± 13.5 years, 74% were female, 79% were Hispanics, and 36.7% perceived themselves as having 'Good' health. The total average GPQI-2016 score was 40.9 ± 1.0. Perceived health was not significantly associated with total average GPQI-2016 score (p > 0.05). There was no association between perceived health and total diet quality in this sample of Hispanic adults.
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Affiliation(s)
- Jair Alcivar
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Fl, USA
| | - Vanessa Mijares
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Fl, USA
| | - Jacqueline Hernandez
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Fl, USA
| | - Cristina Palacios
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Fl, USA.
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Ali SH, Cai J, Kamal F, Auer S, Yang K, Parikh RS, Parekh N, Islam NS, Merdjanoff AA, DiClemente RJ. A Multi-Stage Dyadic Qualitative Analysis to Disentangle How Dietary Behaviors of Asian American Young Adults are Influenced by Family. Behav Med 2024:1-13. [PMID: 38193280 DOI: 10.1080/08964289.2023.2298766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024]
Abstract
The dietary behaviors of Asian American (AA) young adults, who face a growing non-communicable disease burden, are impacted by complex socio-ecological forces. Family plays a crucial role in the lifestyle behaviors of AA young adults; however, little is known on the methods, contributors, and impact of familial dietary influence. This study aims to deconstruct the mechanisms of AA young adult familial dietary influence through a multi-perspective qualitative assessment. A five-phase method of dyadic analysis adapted from past research was employed to extract nuanced insights from dyadic interviews with AA young adults and family members, and ground findings in behavioral theory (the Social Cognitive Theory, SCT). 37 interviews were conducted: 18 young adults, comprising 10 different AA ethnic subgroups, and 19 family members (10 parents, 9 siblings). Participants described dietary influences that were both active (facilitating, shaping, and restricting) and passive (e.g., sharing foods or environment, mirroring food behaviors). Influences connected strongly with multiple SCT constructs (e.g., behavioral capacity, reinforcements for active influences, and expectations, observational learning for passive influences). Familial influence contributed to changes in the total amount, variety, and healthfulness of foods consumed. Intra-family dynamics were crucial; family members often leveraged each other's persuasiveness or food skills to collaboratively influence diet. AA family-based interventions should consider incorporating both passive and active forms of dietary influence within a family unit, involve multiple family members, and allow for individualization to the unique dynamics and dietary behaviors within each family unit.
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Affiliation(s)
- Shahmir H Ali
- New York University School of Global Public Health, New York, NY, USA
| | - Julia Cai
- New York University School of Global Public Health, New York, NY, USA
| | - Fatema Kamal
- New York University School of Global Public Health, New York, NY, USA
| | - Sian Auer
- New York University School of Global Public Health, New York, NY, USA
| | - Katherine Yang
- New York University School of Global Public Health, New York, NY, USA
| | - Roshan S Parikh
- New York University School of Global Public Health, New York, NY, USA
| | - Niyati Parekh
- New York University School of Global Public Health, New York, NY, USA
- New York University Grossman School of Medicine, New York, NY, USA
- New York University Rory College of Nursing, New York, NY, USA
| | - Nadia S Islam
- New York University Grossman School of Medicine, New York, NY, USA
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Uhlmann K, Ross H, Buckley L, Lin BB. Food in my life: How Australian adolescents perceive and experience their foodscape. Appetite 2023; 190:107034. [PMID: 37690618 DOI: 10.1016/j.appet.2023.107034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/20/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023]
Abstract
Food choice has long been recognized as an interaction between psychological, social, cultural, economic, and biological forces through life course events and experiences. Adolescence is a particularly sensitive life stage during which personal and external environments influence food decisions and attitudes that can have long-term implications. Young people represent future households, yet little is understood about their perspectives on, and experiences of, their foodscape. To address this, a photovoice study with thirty-two students was undertaken at three state high schools with differing foodscapes in South East Queensland (Australia). Adolescent perspectives on foodscapes highlighted the food in front of them (either common or favourite foods), food routines, their emotional relationship with food, and the important role that family has in shaping their relationship with food (in particular mothers). Adolescents demonstrated an astute awareness of healthy/good and unhealthy/bad foods in relation to ingredients, ways of eating and different types of foods. Yet they expressed noticeable confusion on this matter, referring to some foods as "healthy-ish", or describing a "balanced" diet as consuming something healthy followed by something unhealthy. We found that adolescents are inundated by discretionary foods on a daily basis, however, are not particularly cognisant of them. These findings have direct implications for preventative health messages targeting adolescents.
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Affiliation(s)
- Kora Uhlmann
- School of Agriculture and Food Sustainability, The University of Queensland, Hartley Teakle Building, St Lucia QLD 4067, Australia; School of Public Health, The University of Queensland, 266 Herston Rd, Herston QLD 4006, Australia.
| | - Helen Ross
- School of Agriculture and Food Sustainability, The University of Queensland, Hartley Teakle Building, St Lucia QLD 4067, Australia
| | - Lisa Buckley
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston QLD 4006, Australia
| | - Brenda B Lin
- Commonwealth Scientific and Industrial Research Organisation, Environment GPO Box 2583, Brisbane QLD 4001, Australia
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Moura HSD, Berra TZ, Rosa RJ, Silva RVDS, Soares DDA, de Araújo JST, Costa FBP, de Souza RMP, do Nascimento MC, Teibo TKA, Serrano-Gallardo MDP, Arcêncio RA. Health condition, income loss, food insecurity and other social inequities among migrants and refugees during the COVID-19 pandemic in Brazil. BMC Public Health 2023; 23:1728. [PMID: 37670227 PMCID: PMC10481567 DOI: 10.1186/s12889-023-16620-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Brazil is the destination of many international migrants and refugees and, given the circumstances of their entry into the country, many face difficulties due to the absence of targeted policies. Thus, the objective of this study was to survey the social impact of COVID-19 on international migrants and refugees regarding income loss, food insecurity and other social inequities, and to identify explanatory factors on these aspects. METHODS This is a cross-sectional, analytical study. We used a validated instrument applied by trained interviewers. Descriptive analysis and binary logistic regression were performed to identify factors associated with income loss and food insecurity. RESULTS A total of 360 individuals from sub-Saharan African and South American countries participated in the study. Individuals who were white, black/brown, yellow, had an occupation/employment, and earned less than one minimum wage were more likely to lose income. Those who reported no income, received less than one minimum wage, and were diagnosed with COVID-19 were more likely to be food insecure. CONCLUSIONS The study advances knowledge by identifying factors associated with income loss, food insecurity, and individuals' difficulty in accessing health services and social support measures in Brazil.
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Affiliation(s)
- Heriederson Sávio Dias Moura
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902.
| | - Thaís Zamboni Berra
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
| | - Rander Junior Rosa
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
| | - Ruan Víctor Dos Santos Silva
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
| | - Débora de Almeida Soares
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
- Institute of Hygiene and Tropical Medicine, New University of Lisbon, Lisbon, Portugal, Rua da Junqueira, 100, 1349-008
| | - Juliana Soares Tenório de Araújo
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
| | - Fernanda Bruzadelli Paulino Costa
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
| | | | | | - Titilade Kehinde Ayandeyi Teibo
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
| | | | - Ricardo Alexandre Arcêncio
- Avenida dos Bandeirantes, University of São Paulo at Ribeirão Preto School of Nursing, São Paulo, Brazil, 3900, Monte Alegre, Ribeirão Preto, 14040-902
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Ojo AS, Nnyanzi LA, Giles EL, Ells LJ, Awolaran O, Okeke SR, Afaya A, Bolarinwa OA. Perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries: a systematic review of qualitative literature. BMC Nutr 2023; 9:85. [PMID: 37443077 DOI: 10.1186/s40795-023-00743-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Minority ethnic groups are a fast-growing population in many high-income countries, partly due to the increasing population of immigrants and second-generation migrants. The dietary practices of some of these minority ethnic groups might make them to be disproportionately affected by obesity and increase their risks of developing non-communicable diseases. Population-specific interventions and strategies are vital to addressing poor nutritional practices among this population. Thus, this study systematically reviewed the perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries. METHODS This systematic review was conducted in line with the guidelines of the Joanna Briggs Institute (JBI) methodology for systematic reviews, using a meta-aggregative design. This systematic review identified and synthesised qualitative literature on the perceptions of dietary intake amongst BlackAsian and other minority ethnic groups in high-income countries. An extensive and comprehensive database search was conducted between January 2000 - May 2022 and included twenty (20) studies that met the eligibility criteria from six countries. The included studies were assessed for quality using the JBI qualitative assessment and review instrument. The JBI data extraction tools were used to retrieve relevant data from included articles, and the data were thematically analysed. RESULTS We identified eight major themes across this database: (1) "Social and Cultural Factors," (2) "Availability and Accessibility," (3) "Family and Community Influences," (4) "Food Preferences", (5) "Home Country Food Versus Host Country Food" (6) "Dietary Acculturation" (7) "Health and Healthy Eating" (8) "Perception of Nutritional Information." CONCLUSION Overall, Black, Asian, and other minority ethnic groups individuals were found to be aware of the effects of unhealthy eating on their health, and some of them have nutritional knowledge, but social and cultural factors, including structural factors, were deterrents to their healthy eating behaviours. An important finding from this review is that some participants believed that nutritional information, based on bio-medical science, was intended for only White population groups and that it was antagonistic to their cultural and community well-being.
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Affiliation(s)
- Abimbola S Ojo
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Lawrence A Nnyanzi
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Emma L Giles
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Louisa J Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Olusegun Awolaran
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Sylvester R Okeke
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Agani Afaya
- Mo-Im Kin Nursing Research Institute, College of Nursing, Yonsei University, 50‑1, Yonsei‑ro, Seodaemun‑gu, Seoul, Seoul, 03722, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St John University, London, UK.
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
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Ojo AS, Nnyanzi LA, Giles EL, Ells L, Okeke SR, Ajayi KV, Bolarinwa OA. "I am not really into the government telling me what I need to eat": exploring dietary beliefs, knowledge, and practices among ethnically diverse communities in England. BMC Public Health 2023; 23:800. [PMID: 37131140 PMCID: PMC10152749 DOI: 10.1186/s12889-023-15689-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/16/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Communities with diverse ethnicity in high-income countries are disproportionately affected by poor diet-related health outcomes. In England, the United Kingdom's government's healthy eating dietary resources are not well accepted and are underutilised among this population. Thus, this study explored perceptions, beliefs, knowledge, and practices around dietary intake among communities with African and South Asian ethnicity residing in Medway, England. METHODS This qualitative study generated data from 18 adults aged 18 and above using a semi-structured interview guide. These participants were sampled using purposive and convenience sampling strategies. All the interviews were conducted in English over the telephone, and responses were thematically analysed. RESULTS Six overarching themes were generated from the interview transcripts: eating patterns, social and cultural factors, food preferences and routines, accessibility and availability, health and healthy eating, and perceptions about the United Kingdom government's healthy eating resources. CONCLUSION The results of this study indicate that strategies to improve access to healthy foods are required to improve healthy dietary practices among the study population. Such strategies could help address this group's structural and individual barriers to healthy dietary practices. In addition, developing a culturally responsive eating guide could also enhance the acceptability and utilisation of such resources among communities with ethnic diversity in England.
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Affiliation(s)
- Abimbola S Ojo
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Lawrence A Nnyanzi
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Emma L Giles
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Louisa Ells
- School of Health, Leeds Beckett University, Leeds, UK
| | - Sylvester R Okeke
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Kobi V Ajayi
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, United States
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health & Well-being, Faculty of Health & Social Care, University of Chester, Castle Drive, Chester, CH1 1SL, UK.
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
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Bhawra J, Kirkpatrick SI, Hall MG, Vanderlee L, White CM, Hammond D. Patterns and correlates of nutrition knowledge across five countries in the 2018 international food policy study. Nutr J 2023; 22:19. [PMID: 36922823 PMCID: PMC10018957 DOI: 10.1186/s12937-023-00844-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Nutrition knowledge is an important determinant of diet-related behaviour; however, the use of disparate assessment tools creates challenges for comparing nutrition knowledge levels and correlates across studies, geographic contexts, and populations. Using the Food Processing Knowledge (FoodProK) score - a measure of nutrition knowledge based on consumers' ability to understand and apply the concept of food processing in a functional task - nutrition knowledge levels and associated correlates were assessed in five countries. METHODS Adults, aged ≥18 years, were recruited through the Nielsen Consumer Insights Global Panel in Australia (n = 3997), Canada (n = 4170), Mexico (n = 4044), the United Kingdom (UK) (n = 5363), and the United States (US) (n = 4527). Respondents completed web-based surveys in November-December 2018. Functional nutrition knowledge was measured using the FoodProK score. Linear regression models examined associations between FoodProK score and sociodemographic, dietary behaviours, and knowledge-related characteristics. RESULTS FoodProK scores (maximum, 8 points) were highest in Canada (mean: 5.1) and Australia (5.0), followed by the UK (4.8), Mexico (4.7), and the US (4.6). Health literacy and self-rated nutrition knowledge were positively associated with FoodProK scores (p < .001). FoodProK scores were higher among those who reported vegetarian/other dietary practices (p < .001); made efforts to consume less sodium, trans fats, or sugars (p < .001); ≥60 years (p = 0.002), female (p < .001), and 'majority' ethnic group respondents in their respective countries (p < .001). CONCLUSIONS This study found differences in consumers' ability to distinguish levels of food processing for common foods, with somewhat lower levels of nutrition knowledge in countries with the highest intake of highly processed foods. Nutrition knowledge differences based on consumer characteristics highlight the need for accessible policy interventions that support uptake of healthy eating efforts across populations to avoid exacerbating nutrition-related disparities. Tools such as the FoodProK can be used to evaluate the impact of policies targeting nutrition knowledge across contexts.
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Affiliation(s)
- Jasmin Bhawra
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
| | | | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - Lana Vanderlee
- École de Nutrition, Centre nutrition, santé et société (Centre NUTRISS) and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
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12
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Vasconcelos TMD, Monteiro LS, Sichieri R, Pereira RA. Psychosocial aspects related to fruit and vegetable consumption in adolescents. CIENCIA & SAUDE COLETIVA 2023; 28:609-618. [PMID: 36651411 DOI: 10.1590/1413-81232023282.05112022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/22/2022] [Indexed: 01/18/2023] Open
Abstract
This study aimed at assessing the association between psychosocial aspects and fruit and vegetable consumption in adolescents. Cross-sectional study developed with 327 adolescents from a public school in Brazil. A questionnaire developed for adolescents was applied to assess the influence of self-efficacy, family, peers, and body image on the consumption of fruits and vegetables. Specific questions assessed the intake frequency of fruits and vegetables, and the mean consumption was estimated using two 24-hour recalls. Scores related to psychosocial aspects were described as mean and median and the weight status was classified based on the body mass index. The average daily consumption of fruits and vegetables was 36.2 g and 45.4 g, respectively. Self-efficacy and the influence of peers were associated with an increase in the amount and frequency of fruits and vegetables consumption. Adolescents with higher scores of self-efficacy had greater average consumption of fruits and vegetables when compared to those with lower scores. The same was observed for the influence of peers. Self-efficacy and the influence of peers were the factors that most influenced the consumption of fruits and vegetables in adolescents.
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Affiliation(s)
- Thaís Meirelles de Vasconcelos
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Edifício do Centro de Ciências da Saúde, Bloco J, 2º andar, Cidade Universitária. 21941-590 Rio de Janeiro RJ Brasil.
| | | | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Rosângela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Edifício do Centro de Ciências da Saúde, Bloco J, 2º andar, Cidade Universitária. 21941-590 Rio de Janeiro RJ Brasil.
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13
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Oliveira B, Bicho M, Valente A. Development and Implementation of a Nutritional Education Program Aimed at Improving the Integration Process of Young Orphan Refugees Newly Arrived in Portugal. Nutrients 2023; 15:408. [PMID: 36678279 PMCID: PMC9863648 DOI: 10.3390/nu15020408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
(1) Background: Refugees are a population group at imminent risk of death, being forced to migrate to countries with different cultures. Many of the refugees are at great risk of malnutrition, especially adolescent orphans. The aim of the study was to establish a nutritional and food education program to improve the integration process of young orphan refugees newly arrived in Portugal. (2) Methods: A nutrition and food education program with nine sessions of food and nutrition education over 12 weeks was carried out by a nutritionist from March to June 2016, in 15 young residents of the Reception Center for Refugee Children. The program included the application of a nutritional knowledge questionnaire, an anthropometric assessment, and the collection of data on food habits and lifestyle. The evaluation of the program was carried out by comparing the initial and final scores of the nutritional knowledge questionnaire. (3) Results: There was an improvement in nutritional knowledge among the adolescents, and a direct relationship between attendance at the sessions and improvement of this knowledge was found. Non-significant changes were observed in some anthropometric measurements between the beginning and the ending of the program. (4) Conclusions: This food education program contributed to a better understanding by young orphan refugees newly arrived in Portugal of the foods available in Portugal and of the Portuguese gastronomy.
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Affiliation(s)
| | - Manuel Bicho
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
- Scientific Research Institute Bento da Rocha Cabral (IICBRC), 1250-047 Lisbon, Portugal
| | - Ana Valente
- ATLANTICA—University Institute, 2730-036 Barcarena, Portugal
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
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Alsubhi M, Epton T, Goldthorpe J, Peters S. A qualitative investigation of the health behaviours of young children from refugee families using photo elicitation interviews. Health Psychol Behav Med 2022; 10:1086-1109. [PMID: 36388870 PMCID: PMC9645284 DOI: 10.1080/21642850.2022.2141245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives To explore the experiences and perspectives of refugee parents regarding health behaviour changes among their children (i.e. changes in diet, levels of physical activity) and the impact of these changes on the health of their children aged 2–12 years. Design A qualitative approach using semi-structured interviews supported by photo-elicitation. Methods Parents of 2–12 years old children who had relocated to the UK within the past three or more years were recruited from two refugee organisations in the UK. Semi-structured face-to-face interviews and photo-elicitation were used to stimulate face-to-face in-depth discussions with participants. Data were analysed using an inductive and latent thematic analysis approach. Results Twenty-seven parent refugees were recruited. Participants were primarily mothers (85%) and from Syria (70%). Other countries of origin were Sudan, Eritrea, Iraq, Kuwait, Libya and Tunisia. Twenty-six interviews were conducted in Arabic and one in English. The analysis identified three themes: (1) Reflection on acculturation, (2) Changed parental role, and (3) Environmental barriers to being healthy. Participants described facing substantial changes to their lifestyle and personal context, including a restricted living space, restricted neighbourhood/community and inclement weather. These differences in the environment required parents to adjust their roles, and practices around their own and their child’s eating habits. These changes influenced refugee children’s health behaviours. Of particular concern to parents were increased sedentary behaviour and consumption of unhealthy snacks. Conclusions Multiple factors were identified relating to changes in family circumstances and environments that influenced refugee children’s health behaviours. Targeting these behaviours in tailored interventions may help improve refugee children’s health.
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Affiliation(s)
- Maha Alsubhi
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Tracy Epton
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Joanna Goldthorpe
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
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15
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Agedew E, Abebe Z, Ayelign A. Exploring barriers to diversified dietary feeding habits among adolescents in the agrarian community, North West Ethiopia. Front Nutr 2022; 9:955391. [PMID: 36570147 PMCID: PMC9768322 DOI: 10.3389/fnut.2022.955391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Adolescence is a critical and neglected age group of the population in any form of nutritional intervention. A comprehensive study that assesses barriers that influence their diversified feeding habit is not well investigated in qualitative approaches. Therefore, this study was conducted to fill this gap by providing evidence on exploring barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia. Objective The aim of the study was to explore barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia. Methods A phenomenological qualitative study design was conducted among adolescents in the age group of 10-19 years, and adults in the age range of 25 to 64 years (representatives of farmers, agricultural, health, and education sectors). We conducted 24 in-depth interviews (12- adolescents, 4-health, 2- agricultural extension, 3-education, and 3-farmer representative) among purposively selected community groups. In-depth interview guides and observation checklist were utilized for data collection. The audio-recorded qualitative data were transcribed word by word into English. Finally, the translated data were exported to ATLAS ti version 7.1 software for thematic analysis based on inductive content analysis. All coded quotations, including memos written throughout the coding process, were then analyzed to identify themes inductively. Results Dietary habit of adolescents in the study area was predominantly plant-based cereals with low protein, vitamins, and mineral contents. Adolescents have limited consumption of fruits, vegetables, and animal source foods. Adolescents with these feeding habits had suboptimal intake of micronutrients and proteins, which are crucial for their rapid growth stage. Individual-level barriers, family-level influence, dietary tradition of community, agricultural practice (poor agroforestry practice of the community, and poor agricultural practice to produce year-round diverse food items), and week multi-sectorial collaboration for nutritional intervention all influenced adolescent dietary habits. Conclusion Multiple layers of barriers influenced the diverse dietary habits of adolescents in the study setting. These multiple and interconnected influences ranged from individual level to multi-sectorial collaboration. Nutritional interventions should be implemented at the individual, family, agricultural, and multi-sectorial levels to improve adolescents' diverse dietary habits.
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Nisar M, Khan A, Kolbe‐Alexander TL. 'Cost, culture and circumstances': Barriers and enablers of health behaviours in South Asian immigrants of Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3138-e3149. [PMID: 35181973 PMCID: PMC9543603 DOI: 10.1111/hsc.13759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/30/2021] [Accepted: 02/06/2022] [Indexed: 05/10/2023]
Abstract
The health behaviours related to chronic diseases experienced by South Asian immigrants are interrelated with their culture and socioeconomic conditions. South Asian immigrants experience a disproportionate burden of chronic disease compared with non-immigrants Australian-born general population. The primary aim of this study was to gain an in-depth understanding of health behaviours and healthcare access in the South Asian immigrant population of Australia. Five focus group discussions (FGDs) were conducted with South Asian immigrants (n = 29; 18 females) aged 27-50 years in Brisbane, Australia. Separate FGDs were conducted for males and females in the English language. Semi-structured guided questions related to the perception, barriers and facilitators of health behaviours. Data were analysed with Nvivo-12 following a thematic analysis. A conceptual model is proposed to provide a summarised understanding of barriers and facilitators of health behaviours in South Asian immigrants. The major reported constraints for participating in physical activity were cultural beliefs, lack of time, work stress and high fees of fitness activities, while parks and peer modelling were mentioned as a strong motivator for walking, cycling and participating in group sports activities. The cultural and religious connections, cost of cigarettes and drink driving penalties were the most mentioned facilitators for a healthy lifestyle. The important factors related to unhealthy eating habits were the traditional cooking methods, social interactions and the high cost of fruits and vegetables. Community perceptions and language barriers were also acknowledged as the main factors for the decrease in accessing health care services. This study illustrates that cultural beliefs, high cost of healthy food and facilities and social circumstances are mainly linked with the health behaviours and healthcare access in South Asian immigrant's lifestyles.
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Affiliation(s)
- Mehwish Nisar
- School of Health & Rehabilitation SciencesThe University of QueenslandBrisbaneAustralia
| | - Asaduzzaman Khan
- School of Health & Rehabilitation SciencesThe University of QueenslandBrisbaneAustralia
| | - Tracy L. Kolbe‐Alexander
- School of Health & WellbeingUniversity of Southern QueenslandIpswichAustralia
- Division of Exercise Science and Sports MedicineDepartment of Human BiologyFaculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneAustralia
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Zavala GA, Ainscough TS, Jimenez‐Moreno AC. Barriers to a healthy diet and physical activity in Mexican adults: results from the Mexican Health and Nutrition Survey. NUTR BULL 2022; 47:298-306. [DOI: 10.1111/nbu.12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
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Gangrade N, St Fleur K, Leak TM. Factors That Influence Snacking Behaviors of Adolescents From Urban Communities: A Qualitative Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:521-531. [PMID: 35351357 DOI: 10.1016/j.jneb.2021.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To qualitatively explore factors that influence snacking behaviors of adolescents from urban communities. DESIGN One-time, semistructured phone interviews based on Social Cognitive Theory. SETTING Boys and Girls Club in New York City. PARTICIPANTS A total of 30 adolescents (aged 12-18 years; mean age 15.2 years, mostly female [57%], and Black or African American [83%]) were purposively recruited. This sample is representative of adolescent members at this Boys and Girls Club in New York City. PHENOMENON OF INTEREST Adolescents were asked about personal, environmental, and behavioral factors influencing snacking. ANALYSIS Interviews were audio-recorded, transcribed, and transcripts were analyzed using the thematic analysis approach in NVivo (version 12). RESULTS In terms of personal factors, adolescents' snacking was influenced by preference (eg, taste and brand), health benefits, and health concerns. Regarding the social environment, adolescents remarked that snacking with peers promoted unhealthy snacking, while snacking, with family promoted healthier snacking. The family culture was also a salient factor. In addition, adolescents discussed how proximity to corner stores in their physical environment fostered unhealthy snacking. Finally, behavioral factors that influenced frequent snacking were high self-efficacy and food autonomy. CONCLUSIONS AND IMPLICATIONS Snacking among adolescents from urban communities is influenced by preference, health, family/peer influence, neighborhood availability/access, and high autonomy. These factors can be targeted in interventions to improve snacking among this demographic.
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Affiliation(s)
- Navika Gangrade
- Division of Nutritional Sciences, Cornell University, Ithaca, NY.
| | | | - Tashara M Leak
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
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Associations of clustered health risk behaviors with diabetes and hypertension in White, Black, Hispanic, and Asian American adults. BMC Public Health 2022; 22:773. [PMID: 35428232 PMCID: PMC9013099 DOI: 10.1186/s12889-022-12938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background The clustering of Big Four contributors to morbidity and mortality—alcohol misuse, smoking, poor diet, and physical inactivity—may further elevate chronic health risk, but there is limited information about their specific combinations and associated health risks for racial/ethnic minority groups. We aimed to examine patterns of clustering in risk behaviors for White, Black, Hispanic, and Asian American adults and their associations with diabetes and hypertension. As these behaviors may be socioeconomically-patterned, we also examined associations between clustering and socioeconomic status (SES). Methods Latent class analyses and multinomial and logistic regressions were conducted using a nationally-representative sample of United States (US) adults ages 40–70 (N = 35,322) from Waves 2 (2004–2005) and 3 (2012–2013) of the National Epidemiologic Survey on Alcohol and Related Conditions. Obesity was used as a proxy for unhealthy diet. The outcomes were diabetes and hypertension. Results A relatively-healthy-lifestyle class was found only among White adults. Common patterns of unhealthy clustering were found across groups with some variations: the obese-inactive class among White, Black, and Hispanic adults (and the inactive class among Asian adults); the obese-inactive-smoking class among White, Black, and Hispanic adults; the smoking-risky-drinking class among White and Hispanic adults; and the smoking-risky-drinking-inactive class among Black and Asian adults. Positive associations of unhealthier clustering (having a greater number of risk behaviors) with lower SES (i.e., family income and education) and with health conditions were more consistent for Whites than for other groups. For racial minority groups, lower education than income was more consistently associated with unhealthy clusters. The associations between unhealthier clustering and diabetes and hypertension were less clear for Blacks and Asians than for Whites, with no significant association observed for Hispanics. Conclusion Concerted efforts to address clustered risk behaviors in most US adults, particularly in racial/ethnic minority groups given the high prevalence of unhealthy clustering, are warranted.
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Melnic I, Alvarado AE, Claros M, Martinez CI, Gonzalez J, Gany F. Tailoring nutrition and cancer education materials for breast cancer patients. PATIENT EDUCATION AND COUNSELING 2022; 105:398-406. [PMID: 34140197 PMCID: PMC8636528 DOI: 10.1016/j.pec.2021.05.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/22/2021] [Accepted: 05/29/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Many breast cancer patients are vulnerable to poor nutritional status and may benefit from nutrition education, but existing materials are not generally tailored to the needs of low-literacy immigrant and minority patients. METHODS With nutritionist guidance, we developed a nutrition presentation for breast cancer patients. English- (n = 29) and Spanish-speaking (n = 19) patients were recruited from 5 safety-net hospitals, an academic cancer center, and a Latina cancer support organization. Materials were tested using multiple rounds of cognitive interviewing (with an adapted USDA interview guide), followed by study team reviews and modifications, until saturation. RESULTS Seven rounds of interviews per language were needed. Approximately 25% of interviewees had less than a high school education. Changes included adapting to regional lexicons and resolving vague/confusing phrasing. Specific food examples needed cultural tailoring. Text color coding (red/bad, green/good) was requested. Labeled images enhanced participants' understanding of concepts. Spanish speakers expressed a desire to understand nutrition labeling, and this was emphasized in the Spanish slides. CONCLUSION Cognitive interviews were an important tool for creating a nutrition curriculum tailored to the needs of low-literacy, mostly immigrant patients. PRACTICE IMPLICATIONS Cultural and linguistic factors should be considered for nutritional education materials in diverse patient populations.
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Affiliation(s)
- Irina Melnic
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Angelica E Alvarado
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria Claros
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chanel I Martinez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Javier Gonzalez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
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Ngoubene-Atioky AJ, Case J, Tokplo L, Baur C. Migration trends and dietary patterns in Sub-Saharan African adult immigrants: A comparative analysis of populations in France, the UK, and the USA. MIGRATION STUDIES 2021. [DOI: 10.1093/migration/mnz038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Sub-Saharan African (SSA) communities are part of a diverse and evolving African diaspora dispersed all over the world. Few studies have examined changes in eating habits of SSA communities who migrated in Western regions of the world. A critical review was conducted on the migration trends, dietary patterns, and dietary acculturation of SSA immigrants residing in the USA, the UK, and France. A comparative analysis revealed historical and contemporary influences of migration trends, the salience and significance of preserving traditional African diet post-migration, and the leading factors to and consequences of dietary acculturation. Limitations and recommendations for research and practice are described.
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Affiliation(s)
- Arlette J. Ngoubene-Atioky
- Graduate Psychology, Chatham University, Pittsburgh, 15206 PA, USA
- Center for Psychology, Goucher College, Baltimore, MD 21204 USA
| | - John Case
- Graduate Psychology, Chatham University, Pittsburgh, 15206 PA, USA
| | - Laetitia Tokplo
- Human Services, University of Arkansas, Little Rock, 72204 AR, USA
| | - Christine Baur
- Graduate Psychology, Chatham University, Pittsburgh, 15206 PA, USA
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How Does the Family Influence Adolescent Eating Habits in Terms of Knowledge, Attitudes and Practices? A Global Systematic Review of Qualitative Studies. Nutrients 2021; 13:nu13113717. [PMID: 34835973 PMCID: PMC8624651 DOI: 10.3390/nu13113717] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
Promoting healthy eating habits can prevent adolescent obesity in which family may play a significant role. This review synthesized findings from qualitative studies to identify family barriers and facilitators of adolescent healthy eating in terms of knowledge, attitudes, and practices (KAP). A literature search of four databases was completed on 31 July 2020; qualitative studies that explored family factors of adolescent (aged 10 to 19 years) eating habits were included. A total of 48 studies were identified, with the majority being from North America and sampled from a single source. Ten themes on how family influences adolescent dietary KAP were found: Knowledge—(1) parental education, (2) parenting style, and (3) family illness experience; Attitudes—(4) family health, (5) cultivation of preference, and (6) family motivation; Practices—(7) home meals and food availability, (8) time and cost, (9) parenting style, and (10) parental practical knowledge and attitudes. This review highlights five parental characteristics underlying food parenting practices which affect adolescents’ KAP on healthy eating. Adolescents with working parents and who are living in low-income families are more vulnerable to unhealthy eating. There is a need to explore cultural-specific family influences on adolescents’ KAP, especially regarding attitudes and food choices in Asian families.
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Horlyck-Romanovsky MF, Huang TTK, Ahmed R, Echeverria SE, Wyka K, Leung MM, Sumner AE, Fuster M. Intergenerational differences in dietary acculturation among Ghanaian immigrants living in New York City: a qualitative study. J Nutr Sci 2021; 10:e80. [PMID: 34616551 PMCID: PMC8477345 DOI: 10.1017/jns.2021.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 08/05/2021] [Accepted: 08/19/2021] [Indexed: 11/06/2022] Open
Abstract
Dietary acculturation may explain the increasing risk of diet-related diseases among African immigrants in the United States (US). We interviewed twenty-five Ghanaian immigrants (Youth n 13, Age (Mean ± sd) 20 y ± 5⋅4, Parents (n 6) and Grandparents (n 6) age 58⋅7 ± 9⋅7) living in New York City (NYC) to (a) understand how cultural practices and the acculturation experience influence dietary patterns of Ghanaian immigrants and (b) identify intergenerational differences in dietary acculturation among Ghanaian youth, parents and grandparents. Dietary acculturation began in Ghana, continued in NYC and was perceived as a positive process. At the interpersonal level, parents encouraged youth to embrace school lunch and foods outside the home. In contrast, parents preferred home-cooked Ghanaian meals, yet busy schedules limited time for cooking and shared meals. At the community level, greater purchasing power in NYC led to increased calories, and youth welcomed individual choice as schools and fast food exposed them to new foods. Global forces facilitated nutrition transition in Ghana as fast and packaged foods became omnipresent in urban settings. Adults sought to maintain cultural foodways while facilitating dietary acculturation for youth. Both traditional and global diets evolved as youth and adults adopted new food and healthy social norms in the US.
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Affiliation(s)
- Margrethe F. Horlyck-Romanovsky
- Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, Brooklyn, NY, USA; Center for Systems and Community Design, New York, NY, USA
| | - Terry T.-K. Huang
- Department of Health Policy and Management, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA; Center for Systems and Community Design, New York, NY, USA
| | | | - Sandra E. Echeverria
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Katarzyna Wyka
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - May May Leung
- Nutrition Program, Hunter College, City University of New York, New York, NY, USA
| | - Anne E. Sumner
- Section on Ethnicity and Health, National Institute of Diabetes and Digestive and Kidney Diseases, and the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Melissa Fuster
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Center for Systems and Community Design, New York, NY, USA
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Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries. Public Health Nutr 2021; 25:136-158. [PMID: 34509180 PMCID: PMC8825972 DOI: 10.1017/s1368980021003943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objective: To map and characterise the interactions between the food environment and immigrant populations from low- and middle-income countries living in high-income countries. Design: A scoping review was carried out following the framework outlined by Arksey and O’Malley, as well as Levac et al. Peer-reviewed studies in English published between 2007 and 2021 were included. Two reviewers screened and selected the papers according to predefined inclusion criteria and reporting of results follows the PRISMA-ScR guidelines. A ‘Best fit’ framework synthesis was carried out using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. Setting: High-income countries. Participants: Immigrants from low- and middle-income countries. Results: A total of sixty-eight articles were included, primarily based in the USA, as well as Canada, Australia and Europe, with immigrants originating from five regions of the globe. The analysis identified three overarching themes that interconnected different aspects of the food environment in addition to the four themes of the ANGELO framework. They demonstrate that in valuing fresh, healthy and traditional foods, immigrants were compelled to surpass barriers in order to acquire these, though children’s demands, low incomes, time scarcity and mobility influenced the healthiness of the foods acquired. Conclusion: This study brought together evidence on interactions between immigrant populations and the food environment. Immigrants attempted to access fresh, traditional, healthier food, though they faced structural and family-level barriers that impacted the healthiness of the food they acquired. Understanding the food environment and interactions therein is key to proposing interventions and policies that can potentially impact the most vulnerable.
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Using Community-Based Prevention Marketing to Generate Demand for Healthy Diets in Jordan. Nutrients 2021; 13:nu13093068. [PMID: 34578946 PMCID: PMC8464799 DOI: 10.3390/nu13093068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/03/2022] Open
Abstract
Jordan has been experiencing a nutrition transition with high rates of micronutrient deficiencies and rising overweight and obesity rates. This highlights the need to generate demand for healthy diets. This study used a community-based prevention marketing approach and worked with local communities as partners to develop a set of behavior change interventions to improve healthy eating within vulnerable communities. Individual, family, and paired-friendship interviews, and co-creation workshops were conducted with 120 people. The aim of these interviews was to gain an in-depth understand of school-aged children and their families’ nutrition knowledge, attitudes, and practices, including social and cultural norms and behavioral determinants, and then use this information to co-create interventions, activities and materials targeted at supporting school-aged child nutrition. Analysis of the interviews revealed that dietary habits are both deeply personal and profoundly entwined by emotions and social norms, and that parents often gave in to their children’s demands for unhealthy foods and beverages due to their perception of what a ‘good parent’ looks like and the desire to see their child ‘smile’. These key insights were then shared during the co-creation workshops to develop behavior change interventions—ensuring that interventions were developed by the community, for the community.
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Sauter A, Kikhia S, von Sommoggy J, Loss J. Factors influencing the nutritional behavior of Syrian migrants in Germany - results of a qualitative study. BMC Public Health 2021; 21:1334. [PMID: 34229649 PMCID: PMC8262055 DOI: 10.1186/s12889-021-11268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Syrian migrants represent the third-largest group of foreigners in Germany and are therefore potential users of health promotion initiatives, including nutrition programs. It is little known how (healthy) nutrition is understood and implemented by this group and which factors influence their experiences related to food and eating in the host country. Thus, this study aimed to explore the importance of (healthy) nutrition, facilitators, and barriers of a preferred diet; nutritional changes in relation to the country of origin; and how nutrition may change with increasing length of stay. Methods Thirty semi-structured qualitative interviews with Syrian migrants (male = 16, female = 14, 18–35 years, length of stay 10–68 months) were conducted in 2018. Seventeen migrants could be followed-up after 12 months and were interviewed in 2019 again and were asked for changes in their nutritional behavior. Interviews were conducted in German, English, or Arabic, transcribed and translated into English if necessary. For analysis, an abbreviated version of the Grounded Theory was used. Results We identified six overarching themes that described influencing factors on a favored diet in Germany over the course of stay: (1) managing everyday life; (2) intercultural contact with local residents; (3) social context of cooking and eating; (4) ambiguity toward Arabic food; (5) mistrust toward certain types of food; and (6) influence of postmigration stressors. In general, the importance of nutrition is high among Syrian migrants. However, daily stressors, the lack of practical knowledge of how to cook favored dishes, and food insecurity in the new food environment make it difficult to obtain a preferred diet. With increasing stay, many developed a higher awareness of healthy eating, mainly due to a new independence or influences from the social environment in Germany. Conclusion Results highlight the need for health promotion interventions to be more responsive to the specific needs of Syrian migrants, including nutrition. Syrian migrants differ in their capabilities, needs, and aims, and they should be addressed differently by health professionals, social services or migrant specific services. Future research should continue to focus on the living conditions of Syrian migrants and its influence on nutrition.
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Affiliation(s)
- Alexandra Sauter
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany.
| | - Salma Kikhia
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Julia von Sommoggy
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Julika Loss
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
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Kumar GS, Beeler JA, Seagle EE, Jentes ES. Long-Term Physical Health Outcomes of Resettled Refugee Populations in the United States: A Scoping Review. J Immigr Minor Health 2021; 23:813-823. [PMID: 33515162 PMCID: PMC8233239 DOI: 10.1007/s10903-021-01146-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 12/22/2022]
Abstract
Several studies describe the health of recently resettled refugee populations in the US beyond the first 8 months after arrival. This review summarizes the results of these studies. Scientific articles from five databases published from January 2008 to March 2019 were reviewed. Articles were included if study subjects included any of the top five US resettlement populations during 2008-2018 and if data described long-term physical health outcomes beyond the first 8 months after arrival in the US. Thirty-three studies met the inclusion criteria (1.5%). Refugee adults had higher odds of having a chronic disease compared with non-refugee immigrant adults, and an increased risk for diabetes compared with US-born controls. The most commonly reported chronic diseases among Iraqi, Somali, and Bhutanese refugee adults included diabetes and hypertension. Clinicians should consider screening and evaluating for chronic conditions in the early resettlement period. Further evaluations can build a more comprehensive, long-term health profile of resettled refugees to inform public health practice.
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Affiliation(s)
- Gayathri S Kumar
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA.
| | - Jenna A Beeler
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Emma E Seagle
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Emily S Jentes
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
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Sastre LR, Haldeman L. Food Selection Factors and Perceived Influence on Household Foods Post-Arrival to the U.S. of Newcomer Immigrant and Refugee Adolescents. Ecol Food Nutr 2021; 60:394-406. [PMID: 33475007 DOI: 10.1080/03670244.2021.1872023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The objective of this study was to examine food selection factors and influence on household food selection by newcomer immigrant and refugee adolescents. Participants (n = 68) reported healthfulness (70.1%) and taste (44.2%) as their primary influencing factors. Adolescents' Refugee camp experience, BMI, sex, and ethnicity were associated with reported influences on food selection. Most (85.3%) had tried new foods, reported influence on household food selection (81%) and new food consumption was associated with adolescents' influence on the overall household's food selection. In summary, a variety of factors influence adolescent newcomer's food selection and influence on household food selection is high.
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Affiliation(s)
- Lauren R Sastre
- Department of Nutrition Science, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Lauren Haldeman
- Department of Nutrition Science, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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Dawson-Hahn E, Koceja L, Stein E, Farmer B, Grow HM, Saelens BE, Mendoza J, Pak-Gorstein S. Perspectives of Caregivers on the Effects of Migration on the Nutrition, Health and Physical Activity of their Young Children: A Qualitative Study with Immigrant and Refugee Families. J Immigr Minor Health 2021; 22:274-281. [PMID: 31222478 DOI: 10.1007/s10903-019-00905-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
To explore perspectives on nutrition, health and physical activity among immigrant parents with young children before and after migration. We conducted focus groups in five languages (Arabic, Somali, Dari, Burmese and Nepali), then conducted a phenomenological analysis of the transcripts. Fifty caregivers participated; 42% spent time in a refugee camp. Within the domain Change in Environment, four themes emerged: (1) food access; (2) family experiences with weight and growth; (3) differences in physical activity and perceptions of safety; and (4) health care experience. Within the domain of Parenting Behaviors and Experiences, two themes emerged: (1) Sociocultural differences in early feeding behaviors and (2) concern about feeding behaviors. To support health outcomes for refugee and immigrant families with young children, key focus areas for programming would include access to fresh foods, safe places for physical activity, and feeding practices following a family history of food scarcity.
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Affiliation(s)
- Elizabeth Dawson-Hahn
- Department of Pediatrics, University of Washington, Seattle, WA, USA.
- Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA, 98145, USA.
| | | | - Elizabeth Stein
- Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA, 98145, USA
| | - Beth Farmer
- Refugees Northwest, Lutheran Community Services Northwest, Seatac, WA, USA
| | - H Mollie Grow
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA, 98145, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Jason Mendoza
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA, 98145, USA
- Cancer Prevention Program, Fred Hutch/UW Cancer Consortium, Seattle, WA, USA
| | - Suzinne Pak-Gorstein
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
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Alsubhi M, Goldthorpe J, Epton T, Khanom S, Peters S. What factors are associated with obesity-related health behaviours among child refugees following resettlement in developed countries? A systematic review and synthesis of qualitative and quantitative evidence. Obes Rev 2020; 21:e13058. [PMID: 32608177 DOI: 10.1111/obr.13058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/30/2022]
Abstract
Refugee children are likely to become less active and eat more unhealthily after their resettlement in developed countries. This review aims to identify and synthesize research about factors that influence unhealthy behaviours related to obesity in this population. Six electronic databases were searched systematically to identify studies that sampled refugee children or parents of refugee children aged 2 to 16 years who have resettled in a developed country. Methodological and cultural study quality was assessed and factors associated with obesity-related health behaviours investigated. Twenty studies fulfilled the inclusion criteria. Five major themes, representing factors influencing health behaviours, were identified from the data synthesis process: Acculturation, Environmental, Socioeconomic, Cognitive, and Family. The analysis revealed that refugee's health behaviours are influenced by several complex factors that are common to immigrant groups but have a greater influence among refugees. The review also revealed parental practices influence the health behaviours of children, especially those aged 2 to 10 years. Research is needed to understand further the role that parents have in influencing health behaviours and weight trajectories of children following resettlement.
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Affiliation(s)
- Maha Alsubhi
- Manchester Centre for Health Psychology, Division of psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, UK
| | - Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, Division of psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, UK
| | - Sonia Khanom
- Centre for Epidemiology Versus Arthritis, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Sarah Peters
- Manchester Centre for Health Psychology, Division of psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, UK
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Adolescent diet and physical activity in the context of economic, social and nutrition transition in rural Maharashtra, India: a qualitative study. Public Health Nutr 2020; 24:5299-5308. [PMID: 32981556 DOI: 10.1017/s1368980020002220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore the perceptions of adolescents and their caregivers on drivers of diet and physical activity in rural India in the context of ongoing economic, social and nutrition transition. DESIGN A qualitative study comprising eight focus group discussions (FGD) on factors affecting eating and physical activity patterns, perceptions of health and decision-making on food preparation. SETTING Villages approximately 40-60 km from the city of Pune in the state of Maharashtra, India. PARTICIPANTS Two FGD with adolescents aged 10-12 years (n 20), two with 15- to 17- year-olds (n 18) and four with their mothers (n 38). RESULTS Dietary behaviour and physical activity of adolescents were perceived to be influenced by individual and interpersonal factors including adolescent autonomy, parental influence and negotiations between adolescents and caregivers. The home food environment, street food availability, household food security and exposure to television and digital media were described as influencing behaviour. The lack of facilities and infrastructure was regarded as barriers to physical activity as were insufficient resources for public transport, safe routes for walking and need for cycles, particularly for girls. It was suggested that schools take a lead role in providing healthy foods and that governments invest in facilities for physical activity. CONCLUSIONS In this transitioning environment, that is representative of many parts of India and other Lower Middle Income Countries (LMIC), people perceive a need for interventions to improve adolescent diet and physical activity. Caregivers clearly felt that they had a stake in adolescent health, and so we would recommend the involvement of both adolescents and caregivers in intervention design.
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Amstutz D, Gonçalves D, Hudelson P, Stringhini S, Durieux-Paillard S, Rolet S. Nutritional Status and Obstacles to Healthy Eating Among Refugees in Geneva. J Immigr Minor Health 2020; 22:1126-1134. [PMID: 32940816 PMCID: PMC7683482 DOI: 10.1007/s10903-020-01085-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2020] [Indexed: 12/02/2022]
Abstract
Refugees face various nutritional challenges during and after migration. This cross-sectional, mixed-methods study seeks to investigate the prevalence of undernutrition and obesity among refugees in Geneva, and to identify barriers to healthy eating. Anthropometric measurements of 354 adult refugees were collected between 2017 and 2019 by trained nurses and dietitians. Seven focus group discussions totaling 51 participants, refugees and social workers, investigated conceptions and needs regarding diet. The mean Body Mass Index is 24.6 ± 4.8 kg/m2. Women are disproportionately affected by obesity compared to men (p < 0.001). Weight gain post-migration is correlated positively with length of stay in Geneva (p < 0.001). Major obstacles to healthy eating are economic and linguistic. For participants, cooking workshops and free physical activities are highly needed interventions. Post-migration lifestyle interventions should be implemented to prevent weight gain in this population. Such interventions must be multi-level, to overcome structural, social and behavioral barriers to healthy eating.
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Affiliation(s)
- Delphine Amstutz
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Daniela Gonçalves
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Patricia Hudelson
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sophie Durieux-Paillard
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sylvie Rolet
- Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland.,Care Directorate, Geneva University Hospitals, Geneva, Switzerland
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Rabiee Khan F, Alzeidan R, Tharkar S, Ullah A, Hersi AS. Food and Migration: Dietary Acculturation among Migrants to the Kingdom of Saudi Arabia. J Prim Care Community Health 2020; 11:2150132720949771. [PMID: 32783583 PMCID: PMC7425243 DOI: 10.1177/2150132720949771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The Kingdom of Saudi Arabia has a large migrant workforce particularly from North Africa, other Gulf states and South Asia. Migration influences food behavior; however, the change is not often health conducive. This study aimed to investigate the dietary acculturation among 880 migrants and their families in a large University in the Kingdoms’ capital city, Riyadh.
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Affiliation(s)
- Fatemeh Rabiee Khan
- Professor in Public Health Promotion, Faculty of Health, Education & life Sciences, Birmingham City University (BCU), Birmingham, UK
| | - Rasmieh Alzeidan
- Clinical researcher, Department of Cardiac Sciences, College of Medicine, King Saud University, and King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Shabana Tharkar
- Prince Sattam Chair Epidemiology and Public Health Research, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Anhar Ullah
- Biostatistician, Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University
| | - Ahmed S Hersi
- Professor and Director of Cardiac Sciences Department, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia
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Fowokan A, Vincent K, Punthakee Z, Waddell C, Rosin M, Sran N, Lear SA. Exploring Knowledge and Perspectives of South Asian Children and Their Parents Regarding Healthy Cardiovascular Behaviors: A Qualitative Analysis. Glob Pediatr Health 2020; 7:2333794X20924505. [PMID: 32656300 PMCID: PMC7331759 DOI: 10.1177/2333794x20924505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 11/17/2022] Open
Abstract
South Asian children and parents have been shown to have a higher risk for cardiovascular disease (CVD) relative to white individuals. To design interventions aimed at addressing the comparatively higher burden in South Asians, a better understanding of attitudes and perspectives regarding CVD-associated behaviors is needed. As a result, we sought to understand knowledge about CVD risk in both children and parents, and attitudes toward physical activity and diet in both the children and parents, including potential cultural influences. In-depth interviews were conducted with 13 South Asian child-and-parent dyads representing a range of child body mass index (BMI) levels, ages, and with both sexes. South Asian children and parents demonstrated good knowledge about CVD prevention; however, knowledge did not always translate into behavior. The influence of social and cultural dynamics on behavior was also highlighted. To ensure that interventions aimed at this population are effective, an understanding of the unique social dynamics that influence diet and physical activity-related behaviors is needed.
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Affiliation(s)
| | - Kaitey Vincent
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Zubin Punthakee
- McMaster University and Population Health Research Institute, Hamilton, Ontario, Canada
| | | | - Miriam Rosin
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Navjot Sran
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott A Lear
- Simon Fraser University, Burnaby, British Columbia, Canada.,Providence Health Care, Vancouver, British Columbia, Canada
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Abstract
Human immunodeficiency virus-1 (HIV-1) is characterised by a vast genetic diversity classified into distinct phylogenetic strains and recombinant forms. We describe the HIV-1 molecular epidemiology and evolution of 129 consecutive HIV-1 positive migrants living in Milan (northern Italy). Polymerase gene sequences of 116 HIV-1 subtype-B positive patients were aligned with HIV-1 reference sequences (https://www.ncbi.nlm.nih.gov/) by using MAFFT alignment and edited by using Bioedit software. A maximum likelihood (ML) phylogenetic tree was performed by MEGA7 and was visualised by using FigTree v1.4.3. Of 129 migrants, 35 were born in Europe (28 in Eastern Europe), 70 in the Americas (67 in South America), 15 in Africa and nine in Asia; 76.4% were men who have sex with men (MSM). The serotype HIV-1-B prevailed (89.9%), followed by -C, -F1, -D and -A. Compared with 116 HIV-B patients, the 13 with HIV-non-B showed lower Nadir of CD4+ cell/mmc (P = 0.043), more frequently had sub Saharan origin (38.5 vs. 1.72%, P = 0.0001) and less frequently were MSM (40 vs. 74.5%, P = 0.02). The ML phylogenetic tree of the 116 HIV-1 subtype-B positive patients showed 13 statistically supported nodes (bootstrap > 70%). Most of the sequences included in these nodes have been isolated from male patients from the Americas and the most common risk factor was MSM. The low number of HIV-1 non-B subtype patients did not allow to perform this analysis. These results suggest a shift of HIV-1 prevention projects' focus and a continuous monitoring of HIV-1 molecular epidemiology among entry populations. Prevention efforts based on HIV molecular epidemiology may improve public health surveillance setting.
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Sastre LR, Haldeman L. Diet, Physical Activity and Weight-Related Behaviors, Changes and Risks with Newly-Arrived (< 1 Year) Immigrant and Refugee Adolescents (Ages 12-17). J Immigr Minor Health 2020; 22:282-290. [PMID: 31927708 DOI: 10.1007/s10903-020-00970-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adolescent immigrants and refugees are at elevated risk for obesity, however, gaps remain regarding specific diet and lifestyle changes. This study examined: (1) weight status, behaviors and perceptions, (2) diet patterns and changes, (3) sociodemographic and dietary factors associated with BMI. Cross sectional survey, anthropometric measures were conducted at a school for newcomer youth in North Carolina. Data analysis included descriptive, frequency, bivariate and linear regression. Participants (n = 68, 55% female, < 1 year US) included immigrants and refugees ages 12-17. Thirty-one percent were overweight or obese. Forty-seven percent had attempted to lose weight. Positive weight perceptions were associated with normal BMI (p = 0.010). Fruit, milk, fruit juice, soda, and meat consumption increased post-arrival (p = 0.037, p = 0.010, p = 0.003, p = 0.044, p = 0.014, respectively). Dietary change was positively associated with BMI (p = 0.002). Adverse diet and lifestyle changes occur rapidly, are associated with obesity, and weight control behaviors and concerns warrant early intervention.
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Affiliation(s)
- Lauren R Sastre
- Department of Nutrition Science, East Carolina University, Greenville, NC, 27858, USA.
| | - Lauren Haldeman
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, 27412, USA
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Morrill KE, Lopez-Pentecost M, Ballesteros G, Pfander JL, Hingle MD, Klimentidis YC, Thomson CA, Garcia DO. Weight loss interventions for Hispanic women in the USA: a protocol for a systematic review. Syst Rev 2019; 8:301. [PMID: 31787110 PMCID: PMC6886178 DOI: 10.1186/s13643-019-1213-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/23/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In the U.S., Hispanic women experience a disproportionate rate of obesity and obesity-related chronic diseases. At the same time, Hispanic women remain considerably underrepresented in behavioral weight loss interventions. The purpose of this review is to systematically evaluate the evidence related to the effectiveness of weight loss interventions among Hispanic women in the U.S. This review will identify elements of successful weight loss interventions as well as areas for future research. METHODS/DESIGN The following databases will be searched to identify all relevant articles (from inception onwards): PubMed, Embase, Scopus, Web of Science (Science Citation Index and Social Sciences Citation Index), PsycINFO, CINAHL, Chicano Database, SPORTDiscus, CAB Abstracts, and Google Scholar. We will include randomized controlled trials and quasi-experimental studies of adult women (> 18 years) from Hispanic/Latino background living in the United States. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or their combinations). The review's primary outcome will be weight change (expressed as change in lbs/kg or body mass index (BMI) (kg/m2)). Three reviewers will independently screen and select data and two will extract data. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. A narrative synthesis will describe quality and content of the evidence. DISCUSSION The aim of this systematic review is to critically examine existing weight loss interventions for Hispanic women in the U.S. and provide quality evidence for the effectiveness of these interventions on weight loss. Further, this review seeks to identify characteristics of effective interventions and suggest future directions for research efforts targeting weight loss in this population. This review will inform the development of future weight loss interventions for this population. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019119094.
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Affiliation(s)
- Kristin E. Morrill
- Department of Nutritional Sciences, College of Agriculture & Life Sciences, University of Arizona, Tucson, AZ USA
| | - Melissa Lopez-Pentecost
- Department of Clinical and Translational Sciences, College of Medicine, University of Arizona, Tucson, AZ USA
| | - Guadalupe Ballesteros
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ USA
| | | | - Melanie D. Hingle
- Department of Nutritional Sciences, College of Agriculture & Life Sciences, University of Arizona, Tucson, AZ USA
| | - Yann C. Klimentidis
- Department of Epidemiology and Biostatistics, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ USA
| | - Cynthia A. Thomson
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ USA
| | - David O. Garcia
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ USA
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Guerra JVV, Alves VH, Rachedi L, Pereira AV, Branco MBLR, Santos MVD, Schveitzer MC, Carvalho BF. Forced international migration for refugee food: a scoping review. CIENCIA & SAUDE COLETIVA 2019; 24:4499-4508. [PMID: 31778500 DOI: 10.1590/1413-812320182412.23382019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/12/2019] [Indexed: 11/22/2022] Open
Abstract
Recent crisis and conflicts in African countries, the Middle East and the Americas have led to forced population migration and rekindled concern about food security. This article aims to map in the scientific literature the implications of forced migration on food and nutrition of refugees. Scoping Review, and database search: databases: PubMed Central, LILACS, SciElo, Science Direct and MEDLINE. Languages used in the survey were: English, Portuguese and Spanish, with publication year from 2013 to 2018. 173 articles were obtained and after removing of duplicates and full reading, 26 articles were selected and submitted to critical reading by two reviewers, resulting in 18 articles selected. From the analysis of the resulting articles, the following categories emerged: Food Inequity; Cultural Adaptation and Nutrition; Emerging Diseases and Strategies for the Promotion of Nutritional Health. Food insecurity is a marked consequence of forced international migration, and constitutes an emerging global public health problem, since concomitant with increasing population displacements also widens the range of chronic and nutritional diseases.
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Affiliation(s)
- Juliana Vidal Vieira Guerra
- Programa Acadêmico em Ciências do Cuidado em Saúde da Escola de Enfermagem Aurora Afonso Costa, Universidade Federal Fluminense. R. Dr. Celestino 74, 6º andar. 24020-091 Niterói RJ Brasil.
| | - Valdecyr Herdy Alves
- Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminense. Niterói RJ Brasil
| | - Lilyane Rachedi
- Escola de Serviço Social, l'Université du Québec à Montréal. Centre Ville Quèbec Montréal Canada
| | - Audrey Vidal Pereira
- Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminense. Niterói RJ Brasil
| | - Maria Bertilla L Riker Branco
- Programa Acadêmico em Ciências do Cuidado em Saúde da Escola de Enfermagem Aurora Afonso Costa, Universidade Federal Fluminense. R. Dr. Celestino 74, 6º andar. 24020-091 Niterói RJ Brasil.
| | - Márcia Vieira Dos Santos
- Programa Acadêmico em Ciências do Cuidado em Saúde da Escola de Enfermagem Aurora Afonso Costa, Universidade Federal Fluminense. R. Dr. Celestino 74, 6º andar. 24020-091 Niterói RJ Brasil.
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Olaya-Contreras P, Balcker-Lundgren K, Siddiqui F, Bennet L. Perceptions, experiences and barriers to lifestyle modifications in first-generation Middle Eastern immigrants to Sweden: a qualitative study. BMJ Open 2019; 9:e028076. [PMID: 31630098 PMCID: PMC6803114 DOI: 10.1136/bmjopen-2018-028076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The prevalence of type 2 diabetes (T2D) among Iraqi immigrants to Sweden is high and partly related to sedentary physical activity and calorie dense food. The aim of the present study was to explore perceptions, experiences and barriers concerning lifestyle modifications (LSM) in Iraqi immigrants to Sweden at risk for T2D. DESIGN A qualitative thematic analysis was conducted on data collected from gender-specific focus group interviews which took place during a culturally adapted randomised controlled intervention study addressing motivation to lifestyle change, self-empowerment, behavioural modifications and sociocultural barriers to LSM. Seven focus groups were held, with an interval of 1-4 weeks between January and May of 2015; each session lasted approximately 1.5 hours. SETTING The city of Malmö, Sweden. PARTICIPANTS Out of 27 women and 23 men assigned to the intervention group, 19 women and 14 men who attended at least one focus group session were included in the study. RESULTS Participants expressed awareness of the content of healthy lifestyle practices. They also expressed numerous social and cultural barriers to LSM connected to irregular meals, overeating, food and drinking preferences and family expectations. Overeating was described as a consequence of social and cultural norms and expectations and of poor mental well-being. Facilitators for reaching successful LSM were connected to family involvement and support. CONCLUSION Our study reports that facilitators for LSM are connected to presence of family support. Preventive actions addressing family involvement may benefit Middle Eastern immigrants at high risk for T2D to consider healthier lifestyles practices. Identification of sociocultural barriers and facilitators for LSM are crucial for successful health promotion in minority populations at risk for T2D. TRIAL REGISTRATION Trial registration number: NCT01420198 for the MEDIM-study; Pre-results.
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Affiliation(s)
- Patricia Olaya-Contreras
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenborg, Sweden
| | | | - Faiza Siddiqui
- Center for Primary Health Care Research, Region Skåne and Lund University, Malmö, Sweden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Louise Bennet
- Center for Primary Health Care Research, Region Skåne and Lund University, Malmö, Sweden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
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Balestracci K, Sebelia L, Greene G, Moore A, Chappell K, Tovar A. Perceptions of Low-Income Students Completing a Nutrition Education Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:834-842. [PMID: 30824199 DOI: 10.1016/j.jneb.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To capture students' perceptions of participating in a nutrition education program. DESIGN Focus groups (n = 16). SETTING Low-income schools in Rhode Island. PARTICIPANTS A total of 64 low-income, ethnically and racially diverse third-grade students, 93.5% of whom were eligible for free or reduced-price meals, 62% of whom were Hispanic, and 16% of whom were black. MAIN OUTCOME MEASURE(S) Perceptions about the program's impact on food and beverage consumption, the value of the program, potential changes for improvement, and barriers to change. ANALYSIS Focus groups were recorded, transcribed, and coded using a hybrid approach of inductive and deductive thematic analysis. Interrater agreement was calculated. RESULTS Students perceived that the program positively influenced their attitudes toward making healthy choices and what they and their families were eating. Students reported increased empowerment, bravery to try new foods, and knowledge. Students enjoyed the program but suggested increasing the duration and frequency of lessons and including peer-to-peer education. Students felt that the tastiness of unhealthy food was a barrier to choosing healthier food. CONCLUSIONS AND IMPLICATIONS Findings suggest that the program may have improved students' knowledge, empowerment, and bravery, and that this had a positive influence on healthy food consumption for students and their families. Input from students will help inform future modifications to the curriculum.
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Affiliation(s)
- Kate Balestracci
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI.
| | - Linda Sebelia
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Geoffrey Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Adam Moore
- Department of Education, Roger Williams University, Bristol, RI
| | - Kelsi Chappell
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
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Mandelbaum J, Pérez-Escamilla R, Sandow A, Gallego-Pérez DF, Lartey A, Hromi-Fiedler A. Factors Influencing Dietary Practices Among Ghanaian Residents and Liberians Living in a Protracted Refugee Situation in Ghana. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:567-577. [PMID: 30442569 DOI: 10.1016/j.jneb.2018.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 09/15/2018] [Accepted: 09/21/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Examine dietary practices among Liberian refugees living in a protracted refugee situation and Ghanaians living among them. DESIGN Qualitative data were collected via audio-taped in-depth interviews as part of a larger mixed-methods cross-sectional study. SETTING Buduburam Refugee Settlement and neighboring villages, Ghana. PARTICIPANTS Twenty-seven Liberian and Ghanaian women aged ≥16 years, who lived with ≥1 other female generation. PHENOMENON OF INTEREST Similarities and differences in factors influencing dietary practices among Liberian refugees living in Buduburam Refugee Settlement and Ghanaians living in and around this settlement. ANALYSIS Domains, themes, and subthemes were confirmed through a highly iterative coding and consensus process. ATLAS.ti (version 7.5.10) was used to finalize coding and extract quotations. RESULTS Seven domains emerged forming direct and indirect pathways influencing dietary patterns among Liberian refugees and Ghanaians: social support, food availability, nutrition knowledge, cultural food beliefs, food access, food preparation, and national identity. CONCLUSIONS AND IMPLICATIONS Findings provide important insights into crucial factors driving dietary practices among refugees and local communities in and around a former protracted refugee settlement. Results strongly suggest that nutrition education, food availability, and access issues should be addressed with culturally sensitive programs targeting both the refugee and host communities.
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Affiliation(s)
- Jennifer Mandelbaum
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.
| | | | - Adam Sandow
- Buduburam Nutrition Program, National Catholic Secretariat, Accra, Ghana
| | - Daniel F Gallego-Pérez
- Buduburam Nutrition Program, National Catholic Secretariat, Accra, Ghana; Boston University School of Public Health, Boston, MA
| | - Anna Lartey
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Amber Hromi-Fiedler
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
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College Students and Eating Habits: A Study Using An Ecological Model for Healthy Behavior. Nutrients 2018; 10:nu10121823. [PMID: 30477101 PMCID: PMC6315356 DOI: 10.3390/nu10121823] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 10/19/2018] [Accepted: 11/20/2018] [Indexed: 12/13/2022] Open
Abstract
Overweightness and obesity rates have increased dramatically over the past few decades and they represent a health epidemic in the United States (US). Unhealthy dietary habits are among the factors that can have adverse effects on weight status in young adulthood. The purpose of this explorative study was to use a qualitative research design to analyze the factors (barriers and enablers) that US college students perceived as influencing healthy eating behaviors. A group of Cornell University students (n = 35) participated in six semi-structured focus groups. A qualitative software, CAQDAS Nvivo11 Plus, was used to create codes that categorized the group discussions while using an Ecological Model. Common barriers to healthy eating were time constraints, unhealthy snacking, convenience high-calorie food, stress, high prices of healthy food, and easy access to junk food. Conversely, enablers to healthy behavior were improved food knowledge and education, meal planning, involvement in food preparation, and being physically active. Parental food behavior and friends’ social pressure were considered to have both positive and negative influences on individual eating habits. The study highlighted the importance of consulting college students when developing healthy eating interventions across the campus (e.g., labeling healthy food options and information campaigns) and considering individual-level factors and socio-ecological aspects in the analysis.
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Stang J, Bonilla Z. Factors Affecting Nutrition and Physical Activity Behaviors of Hispanic Families With Young Children: Implications for Obesity Policies and Programs. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:959-967. [PMID: 28969899 DOI: 10.1016/j.jneb.2017.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/14/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine preferred policies and programs to prevent obesity and diabetes as identified by parents and caregivers of 3- to 5-year-old Latino children. DESIGN Constructs from the Social Ecological Model were used to develop 10 focus group and key informant interview questions. SETTING Community venues and schools in St Paul, MN. PARTICIPANTS A total of 64 parents and caregivers and 20 key informants provided comments. INTERVENTION(S) Community-based participatory research methods were used to gather opinions regarding appropriate and preferred methods to prevent obesity and diabetes among Latino youth. Native Spanish-speaking investigators who were members of the community conducted 7 focus groups (60-90 minutes each) and 20 key informant interviews. MAIN OUTCOME MEASURES Themes and subthemes of preferences based on participant comments. ANALYSIS Transcript-based, long-table qualitative analysis. RESULTS Five themes were identified: (1) cultural beliefs and practices are inconsistent with obesity prevention; (2) cost and convenience; (3) positive parenting practices; (4) we want to learn more about being healthy; and (5) gardens, parks, gyms, and school meals. At least 1 theme fell within each of the Social Ecological Model domains. CONCLUSIONS AND IMPLICATIONS Our results suggest that parents of young Hispanic children prefer that obesity and diabetes prevention programs address multiple levels of influence.
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Affiliation(s)
- Jamie Stang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Zobeida Bonilla
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Kamimura A, Sin K, Pye M, Meng HW. Cardiovascular Disease-related Health Beliefs and Lifestyle Issues Among Karen Refugees Resettled in the United States From the Thai-Myanmar (Burma) Border. J Prev Med Public Health 2018; 50:386-392. [PMID: 29207451 PMCID: PMC5717330 DOI: 10.3961/jpmph.17.098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 11/02/2017] [Indexed: 01/28/2023] Open
Abstract
Objectives Refugees resettled in the US may be at risk for cardiovascular disease (CVD). However, little is known about CVD-related issues among Karen refugees who have migrated to the US from the Thai-Myanmar border. The purpose of this study was to examine CVD-related health beliefs and lifestyle issues among Karen refugees resettled in the US. Methods Karen refugees resettled in the US from the Thai-Myanmar border (n=195) participated in a survey study on health beliefs related to CVD, salt intake, physical activity (PA), and smoking in the fall of 2016. Results A high-salt diet, physical inactivity, and smoking were major lifestyle problems. Participants who adhered to a low-salt diet considered themselves to be susceptible to CVD. Most participants did not engage in regular PA. Regular PA was associated with less perceived susceptibility to CVD and greater perceived benefits of a healthy lifestyle for decreasing the likelihood of CVD. Conclusions Each refugee population may require individualized strategies to promote PA and a healthy diet. Future studies should develop health education programs that are specifically designed for Karen refugees and evaluate such programs. In addition to health education programs on healthy lifestyle choices, tobacco cessation programs seem to be necessary for Karen refugees. At the same time, it is important to foster strategies to increase the utilization of preventive care among this population by promoting free or reduced-fee resources in the community to further promote their health.
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Affiliation(s)
- Akiko Kamimura
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Kai Sin
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Mu Pye
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Hsien-Wen Meng
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
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Zhang Y, Hurtado GA, Flores R, Alba-Meraz A, Reicks M. Latino Fathers' Perspectives and Parenting Practices Regarding Eating, Physical Activity, and Screen Time Behaviors of Early Adolescent Children: Focus Group Findings. J Acad Nutr Diet 2018; 118:2070-2080. [PMID: 29945853 DOI: 10.1016/j.jand.2018.03.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 03/30/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Involvement of Latino fathers in food and activity parenting practices has implications for child obesity prevention yet remains largely unknown. OBJECTIVE To explore Latino fathers' perspectives and parenting experiences regarding early adolescents' eating, physical activity, and screen-time behaviors using the focus group method. DESIGN Twenty-six fathers (primarily Mexican-American men) of 10- to 14-year-old children participated in one of four focus groups between March and October 2016. Focus groups were conducted in Spanish by male moderators. PARTICIPANTS/SETTINGS A convenience sample was recruited from three community centers and one charter school in Minneapolis/St Paul, MN. ANALYSIS Audiotaped focus groups were transcribed verbatim in Spanish and translated to English; transcripts were coded and analyzed for themes based on the grounded theory approach. RESULTS Three themes emerged including 1) paternal beliefs and concerns about early adolescents' diet, physical activity, and screen time; 2) paternal food and activity parenting practices; and 3) factors that may influence paternal involvement in promoting healthy lifestyle behaviors. Father-reported food and activity parenting practices included setting expectations and limits, role modeling, managing availability and accessibility, teaching and reasoning, monitoring, motivating, and doing things together. Factors influencing paternal involvement were identified at intrapersonal, interpersonal, and social-environmental levels, which included paternal dietary and activity behaviors, self-efficacy, time and financial constraints, parental congruency, child resistance, perceived gender role, and environmental challenges. CONCLUSIONS Fathers identified eight major food and activity parenting practices they use to promote a healthy lifestyle for their adolescent children and factors that influence their involvement. Health care professionals can use this information to provide culturally appropriate and specific interventions for Latino American fathers of young adolescents.
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Who Cares? The Importance of Emotional Connections with Nature to Ensure Food Security and Wellbeing in Cities. SUSTAINABILITY 2018. [DOI: 10.3390/su10061844] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jonsson L, Larsson C, Berg C, Korp P, Lindgren EC. What undermines healthy habits with regard to physical activity and food? Voices of adolescents in a disadvantaged community. Int J Qual Stud Health Well-being 2018; 12:1333901. [PMID: 28585483 PMCID: PMC5510232 DOI: 10.1080/17482631.2017.1333901] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This study aimed to illuminate factors that undermine the healthy habits of adolescents from a multicultural community with low socioeconomic status (S.E.S.) in Sweden with regard to physical activity (P.A.) and food, as stated in their own voices. Adolescents (n = 53, 12–13 y/o) were recruited from one school situated in a multicultural community characterized by low S.E.S. Embracing an interpretive approach, 10 focus-group interviews were conducted to produce data for the study. The focus-group interviews were audio recorded, transcribed verbatim, and analysed using qualitative content analysis. The analysis resulted in two major themes: (1) the availability of temptations is large, and support from the surroundings is limited; and (2) norms and demands set the agenda. The adolescents’ voices illuminate a profound awareness and the magnitude of tempting screen-based activities as undermining their P.A. and healthy food habits. Moreover, several gender boundaries were highlighted as undermining girls’ P.A. and healthy food habits. The adolescents’ stories illuminated that it is difficult for them, within their environment, to establish healthy habits with regard to P.A. and food. To facilitate the adolescents’ healthy habits, we suggest that support from family, friends, the school, and society at large is essential.
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Affiliation(s)
- Linus Jonsson
- a Department of Food and Nutrition, and Sport Science , University of Gothenburg , Gothenburg , Sweden
| | - Christel Larsson
- a Department of Food and Nutrition, and Sport Science , University of Gothenburg , Gothenburg , Sweden
| | - Christina Berg
- a Department of Food and Nutrition, and Sport Science , University of Gothenburg , Gothenburg , Sweden
| | - Peter Korp
- a Department of Food and Nutrition, and Sport Science , University of Gothenburg , Gothenburg , Sweden
| | - Eva-Carin Lindgren
- a Department of Food and Nutrition, and Sport Science , University of Gothenburg , Gothenburg , Sweden.,b School of Health and Welfare , Halmstad University , Halmstad , Sweden
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Somali, Latino and Hmong parents' perceptions and approaches about raising healthy-weight children: a community-based participatory research study. Public Health Nutr 2018; 21:1079-1093. [PMID: 28803597 PMCID: PMC9931373 DOI: 10.1017/s1368980017001719] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Immigrants in the USA are confronted with health disparities, including childhood obesity and obesity-related chronic diseases. We aimed to identify perceptions of childhood body weight, approaches to raising healthy children and desires for supportive programmes of Somali, Latino and Hmong (SLM) parents in the Twin Cities, Minnesota, USA. DESIGN Using community-based participatory research, ten focus groups (FG) were conducted with sixty-seven parents (n 28 Somali, three FG; n 19 Latino, four FG; n 20 Hmong, three FG) of 3-12-year-old children in their native language. Demographic information was collected. RESULTS SLM parents perceived that health is not necessarily weight-based; childhood obesity is caused by overeating, eating unhealthy foods and sedentary activities; traditional foods are generally healthy while American foods are generally unhealthy; and healthy children are inherently physically active. Parents identified their goals as feeding children so they would be healthy and happy, helping them be active and safe, and teaching them to cook traditional foods to be self-sufficient and maintain their cultural identity. Parents were challenged by children's unhealthy food and sedentary preferences, their own uncertainties about healthy foods and behaviours, and structural factors. Parents thought interventions could help them with these challenges, including information about healthy foods, age-appropriate portion sizes, safe places to be active and strategies tailored to their cultural norms. CONCLUSIONS SLM parents are trying to raise healthy-weight children based on their understanding of children's health, weight, diet and physical activity, while dealing with social, economic and environmental challenges and trying to maintain cultural identity and traditions.
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Wieland ML, Hanza MMM, Weis JA, Meiers SJ, Patten CA, Clark MM, Sloan JA, Novotny PJ, Njeru JW, Abbenyi A, Levine JA, Goodson M, Capetillo GDP, Osman A, Hared A, Nigon JA, Sia IG. Healthy Immigrant Families: Randomized Controlled Trial of a Family-Based Nutrition and Physical Activity Intervention. Am J Health Promot 2017; 32:473-484. [PMID: 29186984 DOI: 10.1177/0890117117733342] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate a healthy eating and physical activity intervention for immigrant families, derived through community-based participatory research. DESIGN The Healthy Immigrant Families study was a randomized controlled trial with delayed intervention control group, with families as the randomization unit. SETTING US Midwest city. PARTICIPANTS Participants were recruited by community partners from Hispanic, Somali, and Sudanese immigrant communities. INTERVENTION Family health promoters from participating communities delivered 6 healthy eating modules, 4 physical activity modules, and 2 modules synthesizing information in 12 home visits (60-90 minutes) within the first 6 months. Up to 12 follow-up phone calls to each participant occurred within the second 6 months. MEASURES Primary measures were dietary quality measured with weekday 24-hour recall and reported as Healthy Eating Index score (0-100) and physical activity measured with accelerometers (14 wear days) at baseline, 6, 12, and 24 months. RESULTS In total, 151 persons (81 adolescents and 70 adults; 44 families) were randomly assigned. At 12 months, significant improvement occurred in Healthy Eating Index scores for adults in the intervention group compared with controls (change, +8.6 vs -4.4; P < .01) and persisted at 24 months (+7.4 from baseline; P < .01). No differences were observed for adolescents and no significant differences occurred between groups for physical activity. CONCLUSION This intervention produced sustained dietary quality improvement among adults but not among adolescents. Program outcomes are relevant to communities working to decrease cardiovascular risk among immigrant populations.
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Affiliation(s)
- Mark L Wieland
- 1 Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Jennifer A Weis
- 3 Department of Research Administration, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Sonja J Meiers
- 4 Department of Graduate Nursing, Winona State University, Rochester, MN, USA
| | - Christi A Patten
- 5 Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- 5 Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Jeff A Sloan
- 6 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Paul J Novotny
- 6 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Jane W Njeru
- 1 Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Adeline Abbenyi
- 7 Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA
| | - James A Levine
- 8 Division of Endocrinology, Mayo Clinic, Scottsdale, AZ, USA
| | - Miriam Goodson
- 9 Alliance of Chicanos, Hispanics and Latin Americans, Rochester, MN, USA
| | | | - Ahmed Osman
- 11 Somali Community Resettlement Services, Rochester, MN, USA
| | - Abdullah Hared
- 11 Somali Community Resettlement Services, Rochester, MN, USA
| | | | - Irene G Sia
- 13 Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
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Perceptions of healthy eating amongst Indian adolescents in India and Canada. Appetite 2017; 116:471-479. [DOI: 10.1016/j.appet.2017.05.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 04/15/2017] [Accepted: 05/16/2017] [Indexed: 11/18/2022]
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