“Because I don’t come from the culture:” Examining dietitian’s experience promoting healthy dietary behaviors among Hispanic Caribbean clients in New York City

Abstract

Dietitians are key in addressing existing diet-related health inequities, yet, research is lacking concerning how dietitians’ experiences working within culturally diverse communities. Addressing this gap, we interviewed fifteen dietitians working with Hispanic Caribbean (HC) communities in New York City, an understudied community with high incidence of diet-related conditions, to assess the best practices and experienced barriers when working with these communities. The best practices identified included building rapport, incorporating cultural values, and addressing food access. However, the interviews revealed important barriers that prevented successful implementation of these best practices. These included personal factors (language, food culture knowledge, food preferences), lack of culturally-relevant resources, cultural challenges that prevented engaging clients in participatory decision making, and institution-related constraints (time scarcity and funding). The findings underscore the need for improved training for dietitians to be better equipped to work with communities with different cultural and economic backgrounds from their own, for more culturally-relevant resources and funding to address underlying causes of diet-related health disparities in minority populations, and for increased diversity in the profession. Furthermore, our focus on Hispanic Caribbean communities expands existing research promoting cultural competence in the profession, presenting experiences working in with this large segment of the Hispanic community in the United States.