Cultural Influences of Diet and Physical Activity by Mexican-Americans with Type 2 Diabetes

Abstract

The objective of this study was to identify and characterize patient perceived cultural influences on diet and physical activity (PA) behaviors relevant to type 2 diabetes (T2DM) self-management education for Mexican-American adults. A qualitative synthesis was conducted to identify research studies that met the following criteria: >50% of participants included self-identified Mexican-Americans, and findings were related to culturally relevant T2DM self-management diet and/or PA behaviors. Two coders used a content analysis protocol to identify and define cultural elements in the findings of the 19 applicable studies, all guided by the Health Belief Model and Resnicow’s theory of cultural sensitivity in public health. Coders identified and characterized 38 cultural elements. Using Cohen’s Kappa coefficient, interrater reliability for cultural elements between the coders ranged from 0.67-1. Cultural elements were categorized as surface or deep level dimensions. The most common surface level elements were food habits (n=15/19), food preferences (n=14/19), use or acquisition of nutrition knowledge (11/19) and healthcare provider preferences (11/19). The top three deep level elements were general health beliefs or attitudes (n=19/19), general beliefs or attitudes about foods (n=17/19) and family turmoil (n=14/19). PA related elements were rare. Findings highlight patient/client-identified cultural elements relevant to nutrition and PA behaviors for efforts targeting Mexican-Americans with T2DM. These findings have implications for developing and adapting culturally sensitive T2DM self-management education relative to nutrition and PA behaviors.