Development and feasibility of a community-partnered nutrition intervention targeting rural migrant communities in the Dominican Republic

Culturally Sensitive Health Education in the Caribbean Diaspora: A Scoping Review

Context: The Caribbean diaspora in the United States is a diverse community that is afflicted with high morbidity and mortality due to preventable chronic diseases. Objective: Our goal is to determine which culturally sensitive health and nutrition educational modalities have the highest efficacy for improving general health in the Caribbean diaspora. Methods: A scoping literature review was performed on the MEDLINE, CINAHL, and Web of Science databases using terms related to health and nutrition in the Caribbean population. Original, peer-reviewed research published from 2010 to 2020, which took place in the U.S. and Caribbean countries, were included in our review. Results: We identified a total of nine articles that met our inclusion criteria. Rate differences for individual education program features were calculated to assess the likelihood of a positive impact on diet, physical activity, and diabetes. Conclusion: Our review helps to identify key educational modalities targeting diabetes, diet, and physical activity levels that can be used to meet the health and nutritional needs of the Caribbean diaspora population.

Foot Health Assessment and Problem Identification in a Dominican Batey Community: A Descriptive Study

PURPOSE

Foot problems can adversely impact foot function and quality of life. Foot problems are often overlooked, particularly in populations with limited health care access. Little is known about the foot health of Haitian immigrants who live and work in the bateyes (rural sugarcane villages) of the Dominican Republic. These immigrant workers may experience foot problems that could affect foot function and the ability to work and provide for their families.

DESIGN

Cross-sectional, exploratory, descriptive study design.

SUBJECTS AND SETTING

A convenience sample of adults was recruited from an ongoing community-based participatory research project evaluating a mobile hypertension screening and treatment clinic program in 11 Dominican batey communities.

METHODS

Foot health was assessed using the Foot Problems Checklist, a 24-item survey instrument developed for this study based on a review of the literature and foot clinician expertise. A certified foot care nurse recorded foot health data on the Foot Problems Checklist via visual and physical inspection.

RESULTS

Study participants were 25 females and 16 males, aged 18 to 90 years, and all had at least one foot health problem. The most common foot problems were calluses (78%), dry skin (76%), thick nails (59%), jagged nails (29%), long/overgrown nails (17%), and skin fissures (12%).

CONCLUSIONS

While the foot problems we observed were not considered serious, they could become progressively debilitating and be prevented with proper self-management guided by appropriate knowledge and skills and available supplies. We recommend the development and testing of foot care self-management interventions deliverable via mobile clinics to increase access and improve foot health outcomes.

Living conditions and health care usage of Haitian families in the Dominican Republic: A comparison of urban and rural/peri-urban households

Previous research has drawn attention to the health risks and poor living conditions that families of Haitian descent contend with in the Dominican Republic, particularly in rural, agricultural communities. Less clearly described is whether these problems persist as households transition to non-agricultural work and increasingly urban residence patterns. This study compares the use of health care services and access to water, sanitation, and food for Haitian and Dominico-Haitian families living in the city of Puerto Plata with households located on the rural-urban fringe. Data were collected during household surveys with 61 urban and 30 rural/peri-urban families. Households residing in the rural/peri-urban community had lower incomes, more unmet sanitation needs, and less stable access to water than urban families. Overall, households lacked adequate food, with 74.4% experiencing food insufficiency. Respondents reported using diverse types of health services and treatments, but households in the rural/peri-urban community had higher rates of health care use than urban families. These findings indicate urban families have better access to some resources that promote health than rural/peri-urban households. By identifying health issues and environmental conditions in rural/peri-urban and urban areas, this study aims to provide guidance for policy-makers, agencies, and organisations that serve Haitian migrant communities.