Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine, 900 University Ave, Riverside, CA, 92521, USA.
University of California Los Angeles Fielding School of Public Health, California, Los Angeles, USA.
BMC Public Health. 2023 Feb 1;23(1):216. doi: 10.1186/s12889-022-14804-3.
The Latinx population experiences some of the highest rates of chronic disease, including obesity and type II diabetes. Such conditions may be especially burdensome in rural Latinx communities that often face barriers to accessing disease prevention resources and public health programs.
Diverse stakeholders (i.e., patients, community members, system of healthcare clinics, community food bank) tailored an existing cookbook, based on the U.S. Department of Agriculture MyPlate healthy eating and dietary guidelines, for local ingredients, health literacy, and language for rural Latinx and Indigenous Latin Americans. The cookbook recipes were disseminated widely via virtual cooking demonstrations, food distribution events, and social media. Pre- and posttest surveys were used to assess changes in diabetes knowledge measured by the 24-item American Diabetes Association Diabetic Knowledge Questionnaire and confidence in dietary behavior change over time measured by 4 questions of the 17-item Mediterranean Diet Index. A mixed effects, repeated measures analysis was conducted with gender ID, age range and educational attainment included as covariates and assessment interval as the predictor (pretest vs posttest) and change in confidence about adhering to four specific components of the Mediterranean diet. Focus groups elicited information on participants' motivation and ability to use the recipes and eat healthy foods following the virtual cooking demonstration participation.
A total of 20 virtual cooking demonstrations were conducted and 60 participants completed a pretest survey and 54 a posttest survey, a subsample (n = 19) participated in one of three focus groups. Most participants were female, identified as Latinx/Hispanic, were between the ages of 40-49, and spoke Spanish. 17% identified as Indigenous Latin American specifically as Purépecha, an indigenous group from Michoacán, Mexico. Survey and focus group findings indicated at posttest an increase in diabetes knowledge among participants with no prior diagnosis of chronic health conditions and more confidence in limiting sugary beverages and refined wheat pasta/white rice among indigenous participants. Focus group discussions explicated the quantitative findings.
This study brought together patients and key stakeholders committed to addressing the social determinants of health and it mobilized the community to develop culturally vetted health education materials. The findings indicate the need for increased access to evidence-based nutrition education and to culturally appropriate food products that can be easily incorporated into daily food preparation.
拉丁裔人群患慢性病的比例较高，包括肥胖症和 2 型糖尿病。这些疾病在农村拉丁裔社区可能尤其严重，这些社区往往面临获取疾病预防资源和公共卫生计划的障碍。
多元化的利益相关者（即患者、社区成员、医疗诊所系统、社区食品银行）根据美国农业部的 MyPlate 健康饮食和饮食指南，为当地食材、健康素养和农村拉丁裔和土着拉丁裔的语言定制了一本现有的食谱。该食谱通过虚拟烹饪示范、食品分发活动和社交媒体广泛传播。使用 24 项美国糖尿病协会糖尿病知识问卷评估糖尿病知识的变化，使用 17 项地中海饮食指数的 4 个问题评估对饮食行为改变的信心，对预测试和后测试进行了分析。采用混合效应重复测量分析，将性别 ID、年龄范围和教育程度作为协变量，评估间隔作为预测因子（预测试与后测试），并对遵守地中海饮食的四个具体组成部分的信心变化进行分析。焦点小组收集了有关参与者动机和使用食谱的能力以及在参与虚拟烹饪示范后食用健康食品的信息。
共进行了 20 次虚拟烹饪示范，60 名参与者完成了预测试调查，54 名参与者完成了后测试调查，19 名参与者参加了三个焦点小组中的一个。大多数参与者是女性，是拉丁裔/西班牙裔，年龄在 40-49 岁之间，说西班牙语。17%的参与者明确表示自己是土着拉丁裔，特别是来自墨西哥米却肯州的 Purépecha。调查和焦点小组的结果表明，在后测试中，患有慢性健康状况的参与者的糖尿病知识有所增加，而土着参与者对限制含糖饮料和精制小麦面食/白米的信心有所增强。焦点小组讨论详细说明了定量研究结果。
本研究汇集了致力于解决健康决定因素的患者和主要利益相关者，并动员社区开发经过文化审查的健康教育材料。研究结果表明，需要增加获得循证营养教育的机会，并提供文化上合适的食品，以便能够轻松融入日常食品准备。
