Developing a culturally tailored brain healthy diet intervention for older midwestern African Americans: a qualitative and quantitative study

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AbstractBackgroundEmerging evidence suggests that up to half of Alzheimer’s disease (AD) cases are a result of modifiable risk factors related to poor diet such as blood pressure, obesity, and diabetes, all of which disproportionately affect African Americans (Johansen, Langton‐Frost, & Gottesman, 2020). Adherence to brain healthy diets has consistently been reported to be low among African Americans due to the lack of cultural considerations, such as soul food traditions (Epstein et al., 2012). Therefore, it is important to understand barriers and incorporate culture into a brain healthy diet design to improve adherence and reduce the risk of AD among African Americans.MethodWe conducted 6 semi‐structured focus groups (n = 40) to understand how older AA specific food preferences, preparation preferences, and community cooking class topics specific to the development and delivery of the intervention. Also, we conducted a needs assessment using surveys to further understand barriers and facilitators of dietary behaviors among older AA to further inform the development of a culturally tailored brain healthy dietary intervention.ResultA total of 40 African Americans participated in the study. The 6 focus groups generated 5 main themes including knowledge of dementia, practices shaping food choices and consumption, barriers impacting healthy dietary consumption, external instrumental support, and elements of culturally tailored brain healthy dietary intervention. The Mediterranean‐DASH Intervention for Neurodegenerative delay (MIND) diet model was most favored and seen more feasible to follow due to alignment with current lifestyle practices within the African American community. However, adjustments in the MIND diet are need increase acceptability. Findings from the needs assessment indicated that taste (30.8%) and cost (20.5%) were perceived barriers to eating healthy. Facilitators to eating healthy eating included nutrition education focused on eating healthy on a budget, meal planning and prepping that is delivered using virtual formats.ConclusionFindings from this study inform the development of a culturally tailored MIND diet incorporating soul food traditions (MIND‐SOUL) for African Americans.