Caribbean Diaspora Healthy Nutrition Outreach Project (CDHNOP): A Qualitative and Quantitative Approach to Caribbean Health

Abstract

Background: Obesity prevention and its associated co-morbidities such as diabetes require a multi-tiered, culturally sensitive, population-based approach. South Florida’s tri-county area is home to approximately 75% of Florida’s total Caribbean immigrant population. This project is the first Caribbean-focused intervention using the 'Go-Slow-Whoa' or 'GSW format' which designates whether a food or beverage should be chosen frequently ('Go' – green), less often ('Slow' – yellow), or rarely ('Whoa' – red) based on the content of nutrients, sodium, fat, and sugar. Specific Aims: 1. To create and evaluate culturally appropriate nutrition materials for the Caribbean diaspora population in Broward County (i.e. tailor existing GSW evidence-based materials for this population). 2. To quantify which social determinants of health are most relevant to this population. Methods: Mixed methods were utilized in this study. The qualitative, exploratory arm consisted of semi-structured focus groups that included 38 subjects from five Caribbean countries most represented in South Florida: Jamaica, Haiti, Trinidad and Tobago, Cuba and Dominican Republic. The quantitative arm employed descriptive and inferential statistics to analyze social determinants of health (SDOH) obtained from a modified National Association of Community Health Centers’ PRAPARE survey. Intercept survey data was also collected from a convenience sample of 24 Caribbean immigrants in Broward County. Findings: Analysis revealed a lack of culturally appropriate foods and exercise examples in the current 'GSW' materials. At 92% and 82% respectively, an overwhelming majority of our intercept surveys indicated that our revised, culturally appropriate materials were helpful in making positive food and beverage choices. Further study is required to determine which SDOH variables are relevant to this population. Conclusions: Health disparities and inequity in the healthy living education of our Caribbean subpopulation are best addressed using an inclusive research frame that captures the cultural essence and preferences of this understudied community.

Keywords

• caribbean
• health disparities
• cultural research
• health equity
• minority health