“Ancestral recipes”: a mixed-methods analysis of MyPlate-based recipe dissemination for Latinos in rural communities

Abstract

Background 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. Methods 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. Results 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. Conclusion 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.

A systematic review and narrative synthesis of health literacy interventions among Spanish speaking populations in the United States

“…However, DHL survey scores did not differ between experimental and control group participants with marginal or adequate functional health literacy (STOFHLA scores ≥ 17) South Central Family Health Center. Los Angeles, CA Cheney 2023 [ 56 ] Multimedia education Tailor MyPlate recipes to local food sources and culture, virtual cooking demonstrations, Spanish cookbook (physcial and electronic), and diabetes education Analysis, Design, Develop, Implement, and Evaluate (ADDIE) model Mixed methods Rural low-income Latinx primary care patients and Indigenous Mexican communities American Diabetes Association Diabetes Knowledge Questionnaire and adapted Mediterranean Diet Index Brief exposure to a cooking demo/health education did not increase the total diabetes knowledge score (partly due to high pretest scores). Increased confidence in adherence to two of four components of the Mediterranean diet (baddedsugar = 0.24; 95%CI: 0.02, 0.46; bredmeat = 0.5; 95%CI: 0.02, 0.98) 8 clinics in Eastern Coachella Valley Enguidanos 2022 [ 57 ] Multimedia education Spanish language patient role model video Social Learning Theory and the Theory of Reasoned Action Pretest–Posttest Design Hospitalized Latino/Hispanic patients diagnosed with chronic life-limiting illness 13-item Palliative Care Knowledge Scale (PaCKS) to assess palliative care knowledge Significant improvement in palliative care knowledge (pretest mean 6.4, SD = 3.6; posttest mean 11.4, SD = 2.5; p < 0.001).…”

“…The findings reported DHL survey scores improved significantly more in the experimental group than the control group (adjusted mean = 55% vs 53%, F = 4.7, df = 1, p = 0.03). Additionally, Cheney [ 56 ] studied the application of tailor MyPlate recipes to local food sources and culture, virtual cooking demonstrations, and Spanish cookbook, on diabetes education finding there was an increased confidence in adherence to two of four components of the Mediterranean diet (b added sugar = 0.24; 95%CI: 0.02, 0.46; b redmeat = 0.5; 95% CI: 0.02, 0.98).…”

Latinx and Indigenous Mexican Caregivers’ Perspectives of the Salton Sea Environment on Children’s Asthma, Respiratory Health, and Co-Presenting Health Conditions

“…These unincorporated communities do not have their own government structure and are characterized by poor housing and water infrastructure exposing residents to environmental hazards [13]. These communities reside on the northern part of the Salton Sea, a once booming resort area that swiftly changed to low-income housing for immigrant communities as the agricultural runoff, the main source of water, increased the lake's salinity contributing to disease and infection among the lake's habitat [19,20].…”