Qualitative research study on addressing barriers to healthy diet among low-income individuals at an urban, safety-net hospital

• Authors: Erin Cahill, Emory University; Stacie Schmidt, Emory University; Tracey Henry, Emory University; Gayathri Kumar, Emory University; Sara Berney, North Carolina State University; Jada Bussey-Jones, Emory University; Amy Girard, Emory University
• Journal Title: BMJ Nutrition, Prevention and Health
• Volume: Volume 3, Number 2
• Publisher: BMJ | 2020-12-01, Pages 383-386
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1136/bmjnph-2020-000064
• Subjects: Health Sciences, Nutrition; Health Sciences, Public Health; Sociology, Public and Social Welfare
• Keywords: malnutrition; nutrition assessment; nutritional treatment

Abstract

Background Some American households experience food insecurity, where access to adequate food is limited by lack of money and other resources. As such, we implemented a free 6-month Fruit and Vegetable Prescription Program within a large urban safety-net hospital. Methods 32 participants completed a baseline and postintervention qualitative evaluation about food-related behaviour 6 months after study completion. Deductive codes were developed based on the key topics addressed in the interviews; inductive codes were identified from analytically reading the transcripts. Transcripts were coded in MAXQDA V.12 (Release 12.3.2). Results The information collected in the qualitative interviews highlights the many factors that affect dietary habits, including the environmental and individual influences that play a role in food choices people make. Participants expressed very positive sentiments overall about their programme participation. Conclusions A multifaceted intervention that targets individual behaviour change, enhances nutritional knowledge and skills, and reduces socioeconomic barriers to accessing fresh produce may enhance participant knowledge and self-efficacy around healthy eating. However, socioeconomic factors remain as continual barriers to sustaining healthy eating over the long term. Ongoing efforts that address social determinants of health may be necessary to promote sustainability of behaviour change.