A Qualitative Analysis of Mexican-Origin Men’s Knowledge and Cultural Attitudes Toward Non-Alcoholic Fatty Liver Disease and Interest in Risk Reduction

Abstract

Mexican-origin men are at increased risk of developing non-alcoholic fatty liver disease (NAFLD). The purpose of this qualitative research was to assess Mexican-origin men’s knowledge and cultural attitudes toward NAFLD and their interest in risk reduction. Semi-structured interviews were conducted with 11 Spanish-speaking Mexican-origin men who were considered high-risk of having NAFLD according to transient elastography (FibroScan®) continuous attenuation parameter (CAP) scores (≥280). Audio recordings of these interviews were transcribed and interpreted in their respective language to facilitate data analysis using NVivo 12. A thematic codebook was developed, from which the research team identified emerging themes. Findings demonstrated limited knowledge about NAFLD and in general chronic liver disease among Mexican-origin men. Cultural attitudes appeared to both enhance and mitigate their perceived risk for NAFLD. Interviews also revealed high interest levels for reducing NAFLD risk, with family and loved ones acting as the main motivators for engagement in healthier behaviors. Inclination toward family-based interventions was reported as a subject of interest for this high-risk population. This qualitative study suggests that the development of a NAFLD-specific intervention approach for Mexican-origin men may be feasible and should consider a familial and cultural context centered in improving lifestyle health behaviors.

Living in the non‐alcoholic fatty liver disease silent epidemic: a qualitative systematic review of patients' perspectives

“…There was a general lack of insight on the functions of a liver and patients wished they had more education on the potential implications of NAFLD 29,31,36 . They were unaware of the homeostatic role of the liver and were often unaware that liver damage could occur in the absence of viral hepatitis and alcohol use 29 . Most patients attributed liver cirrhosis to alcohol use 29,31 .…”

“…Patients voiced their self‐motivation to improve dietary habits and physical activity after a diagnosis of NAFLD with many citing supportive family as a major proponent for change 29,35,36 . A diagnosis of NAFLD resulted in some participants reducing their intake of unhealthy foods and cutting down on fat, sugar, salt, carbohydrate and red meat consumption 29,35 . Patients also reported increase in physical activity both intentionally and opportunistically 29,36 …”

“…When asked for their perspectives on the changes they would want in the care of NAFLD, there was a general consensus on the need for clearer quantification in lifestyle modifications and tailored medical advice 32,33 . Patients also suggested that these lifestyle and dietary changes should be culture specific and respectful of individualise patient concerns 29 . Concerningly, most patients felt that their efforts to actively partake in lifestyle modifications to lose weight went unnoticed and wanted physicians to acknowledge their efforts and actions 32,35 .…”

“…After a primary screening of articles, a final eight articles were included in the qualitative review (Figure 1). Majority of included studies were conducted in the United States [29][30][31][32] and United Kingdom [32][33][34] with one study from Korea 35 and Portugal, 36 respectively. The settings of the included studies were conducted both in primary and tertiary centres and the mean age ranged from 46.3 to 65 years old.…”

“…29,35,36 A diagnosis of NAFLD resulted in some participants reducing their intake of unhealthy foods and cutting down on fat, sugar, salt, carbohydrate and red meat consumption. 29,35 Patients also reported increase in physical activity both intentionally and opportunistically. 29,36…”