Objectives: Hispanic Americans have a higher prevalence of Type 2 Diabetes (T2DM) compared to non-Hispanic whites, and are at greater risk for developing diabetes-related complications. Barriers and facilitators to dietary managment of T2DM among this population may be particularly influenced by culture and gender, where traditional gender roles and values prevent Hispanic men from engaging in healthy dietary self-management behaviors. Despite this, research focusing on dietary management of T2DM among Hispanic men is scant. This study aimed to assess perceived barriers and facilitators, as well as perceived influences of culture and gender on the dietary management of T2DM among Hispanic men, as reported by health care professionals.
Methods: Key informant interviews (n=17) with health professionals working with Hispanic men were conducted to examine perceived barriers and facilitators when addressing the dietary needs of this population. Interviews were transcribed and analyzed using a content analysis approach to identify themes related to culture and gender influences of T2DM dietary management.
Results: Barriers and facilitators surrounding culture, gender, socioeconomic status and structural policies within the healthcare system emerged as dominant themes. Barriers relating to culture and gender were identified by participants, with many perceiving Hispanic men's dependency on others to prepare their food as a primary barrier. Cultural foods and values and traditional gender roles were also perceived to influence dietary management of T2DM. Factors relating to socioeconomic status and the complexities within the healthcare system were also identified as barriers. Implementing cultural competency and relationship-building strategies were perceived facilitators for health professionals to implement. Many believed systemic changes within the healthcare system are needed to facilitate increased engagement and adherence among Hispanic men. Increasing coordination among health professionals involved in diabetes care, as well as the support available to Hispanic men to ensure this population receives sufficient access to health care, were among the most desired facilitators identified.
Conclusions: Hispanic men face multiple challenges to dietary management of T2DM due to their unique circumstances created by the intersecting roles of culture, gender, and socioeconomic status. To address the underlying causes of diet-related health disparities, future research should focus on the intersectionality of these barriers. Health professionals and institutions would benefit from increased funding which supports training in cultural competency and behavior change counseling strategies, in addition to the implementation of patient-centered care coordination initiatives, to ultimately allow for increased knowledge of diabetes, dietary management, and self-efficacy in skills related to preparing healthy foods among Hispanic men.