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Barriers and Facilitators to Healthy Eating: A Transnational Comparison of Central American Communities in a Socio‐Ecological Framework
Author(s) -
Fuster Melissa,
ColónRamos Uriyoán
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.408.5
Subject(s) - photovoice , focus group , immigration , interpersonal communication , geography , qualitative research , environmental health , gerontology , psychology , medicine , sociology , social psychology , economic growth , social science , archaeology , anthropology , economics
Objective To understand how barriers and facilitators to healthy eating may change during the process of migration, we compare and contrast these factors among immigrants from Central America (El Salvador and Guatemala) in Washington, DC, and residents of two rural communities in El Salvador. Methods Secondary analysis of qualitative data (verbatim transcripts of two data sources and photography). Data from El Salvador were collected using focus groups conducted among adults (n=28) and unstructured observation recoded through field notes and photography. Data from recent Salvadoran and Guatemalan immigrants residing in Washington DC were from a photovoice study, using semi‐structured interviews with mothers of young children (< 10 years) (n=12) and photos from the food environment taken by participants. Transcripts and photographs were analyzed deductively following the social ecological framework to identify barriers and facilitators to healthy eating at the individual, interpersonal (family and social relationships), community/neighborhood, and policy levels, using Atlas.ti. Results Individual and interpersonal factors were similar in the two settings. In both settings, participants discussed children food preferences for highly‐processed food (sodas, pre‐prepared meals, fried chicken, hamburgers, pizza), contrasting with their preference as parents to providing traditional, home‐cooked foods, which were considered healthy (soups, local/native fruits and vegetables). In both settings participants reported great availability of high‐processed and fast foods and they discussed the high cost of healthy food options as barrier to their acquisition. In the US‐based community, participants also reported availability of fresh produce. Participants in Central America discussed access to locally grown foods (either at home or in the community) as a facilitating factor for healthy eating – which was not addressed in the US‐based sample. Government food assistance programs (in specific, WIC) increased access to healthy eating in the US‐sample. The analysis also includes an overview of national/local food policies that may relate to healthy eating in these two samples and a comparison of beliefs concerning healthy eating. Conclusions The results from this study underscores the importance of acknowledging the changing food environment in immigrant sending countries where people are already being exposed to unhealthy dietary patterns. This knowledge can help better target nutrition messages to the growing Central American community in the US.