Culturally tailored diabetes prevention in the workplace: focus group interviews with Hispanic employees

Determinants of nutrition practice and food choice in UK construction workers

The workplace is considered an effective setting for health and wellbeing interventions, including programmes focusing on nutrition, and provides opportunities to tailor programmes to meet the specific needs of industry and employees. This study explored nutrition practices amongst construction workers and managers to inform the design of a nutrition intervention. Five focus groups were conducted on three construction sites: two with managers (n = 11) and three with workers (n = 27). Construction workers and managers identified several unhealthy nutrition-related behaviours, including high consumption of convenient and fast foods, excessive coffee, alcohol, energy drinks and low fruit and vegetable intake. These behaviours were often attributed to high workloads, long working hours and physically demanding jobs. Snacking and skipping meals were repeatedly reported, attributed to short breaks and poor accessibility to food outlets. The nutritional quality of meals differed between individuals (homemade vs fast food), depending on the type of sites (temporary vs permanent) and site location. Nutrition knowledge, establishing routines, meal planning and preparation were recognized as important in sustaining healthy nutrition habits. However, meal preparation depended on the facilities available, which differed between managers and workers, highlighting the complex relationship between the workplace context and eating behaviours. Construction workers were interested in learning about nutrition and improving their eating habits through nutrition intervention. However, they highlighted that better cooking and storage facilities on site, together with fewer job demands and longer break times, would enhance the sustainability of the intervention and their ability to make healthier food choices.

Culturally Tailoring Plant-Based Nutrition Interventions for Hispanic/Latino Adults at Risk for or With Type 2 Diabetes: An Integrative Review

Introduction: Type 2 diabetes mellitus (T2DM) prevalence continues to increase among Hispanic/Latino adults. The purpose of this study was to explore and analyze literature on culturally tailored nutrition interventions to identify how to best implement a whole food plant-based (WFPB) culinary intervention to improve health outcomes for Hispanic/Latino adults at risk for developing or diagnosed with T2DM. Methods: A methodological review was performed by searching PubMed, CINAHL Complete, PsycINFO, and Food Science and Technology Abstracts. Inclusion criteria consisted of peer-reviewed articles in English, from January 2009 to January 2020, using the search terms: “Hispanic adults or Latino adults”, “culturally tailored or ethnic”, “diabetes”, “dietary or nutrition”, “intervention”, and “vegan or plant based”. Studies included adults at risk for/diagnosed with T2DM. Results: Of 1,474 articles retrieved, 15 met the inclusion criteria. Four main themes were identified: participant interest, feasibility of intervention, development and implementation of intervention, and impact of the intervention. Conclusion: Further research should focus on culturally tailored nutrition interventions and use of a WFPB diet to reduce risk for T2DM in Hispanic/Latino adults. Continued discussion should be patient- and community-centered to promote equity, health, and disease prevention through the use of culturally tailored methods and design, not only limited to curriculum and language.

Culturally-tailored interventions for chronic disease self-management among Chinese Americans: a systematic review

Objectives: Literature review evaluating the effectiveness and cultural surface and deep structures of interventions designed to improve Chinese Americans' chronic disease self-management.Method: PubMed, PsycINFO, CINAHL, and Health Source databases were searched for research conducted from 1990 to 2016 on self-management interventions for Chinese Americans with chronic disease.Results: Ten articles comprised eight interventions, which each addressed a dimension of cultural surface structure, all providing linguistically appropriate messages delivered via bilingual staff. Five interventions also addressed cultural deep structure dimensions by providing culturally congruent counsellors or educators, or incorporating Chinese cultural values and social customs. Six interventions resulted in significant improvements in major outcome variables. Participants also reported high satisfaction and retention rates were high.Conclusion: Culturally-tailored interventions that incorporate surface and deep structural elements of culture are sensitive and generally effective for Chinese Americans to improve access to health care, disease awareness, social environment, and participants' ability to practice self-management skills.

Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence

PURPOSE

The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM.

METHODS

Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017.

RESULTS

The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions-healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors-were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24 weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive.

CONCLUSION

The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes.

PRACTICE IMPLICATIONS

Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered.

Diet modification challenges faced by marginalized and nonmarginalized adults with type 2 diabetes: A systematic review and qualitative meta-synthesis

Objectives Diet modification is an important part of the prevention and treatment of type 2 diabetes, but sustained dietary change remains elusive for many individuals. This paper describes and interprets the barriers to diet modification from the perspective of people with type 2 diabetes, paying particular attention to the experiences of people who experience social marginalization. Methods A systematic review of primary, empirical qualitative research was performed, capturing 120 relevant studies published between 2002 and 2015. Qualitative meta-synthesis was used to provide an integrative analysis of this knowledge. Results Due to the central role of food in social life, dietary change affects all aspects of a person's life, and barriers related to self-discipline, emotions, family and social support, social significance of food, and knowledge were identified. These barriers are inter-linked and overlapping. Social marginalization magnifies barriers; people who face social marginalization are trying to make the same changes as other people with diabetes with fewer socio-material resources in the face of greater challenges. Discussion A social-ecological model of behavior supports our findings of challenges at all levels, and highlights the need for interventions and counseling strategies that address the social and environmental factors that shape and sustain dietary change.

Barriers to Diabetes Self-Management Among Rural Individuals in the Workplace

Higher rates of type 2 diabetes mellitus (T2DM) are found in rural populations and barriers lessen the ability of these individuals to effectively manage diabetes. By lessening potential barriers to self-care management, health professionals, especially occupational health nurses, can assist individuals confidently manage T2DM. In this article, the authors provide an overview of diabetes self-management barriers for rural populations and implications for health professionals who assist individuals with T2DM in the workplace.