Community-based participatory approach to identify factors affecting diet following migration from Africa: The Hawaash study

Abstract

Introduction: African women who migrate to the USA have a rich tradition of using herbs and spices to promote health. We conducted formative research on nutritional practices among East and North African women in the USA, focusing on whether traditional herbs and spices could support adherence to the Dietary Guidelines for Americans. Methods: In all, 48 adult African women living in San Diego, California participated in focus groups in July 2015. Inclusion criteria were 18\u2009years or older, and able to answer focus group questions in one of five languages: Somali, Arabic, Amharic, Swahili or English. Results: Participants identified 62 unique spices and herbs that are traditionally used in meal preparation for flavour and health benefits. Participants also reported awareness that nutrients, foods, food groups and approaches to growing and preparing foods are important considerations for healthy diet. Barriers to healthy eating included costs, constraints around growing food in a different soil and climate than Africa, family size and the widespread availability of fast food. Groups identified opportunities for collaborations with researchers through educational programmes, and recommended seed and recipe exchanges that promote healthy eating across culturally heterogeneous African communities. Conclusion: A culturally informed behavioural intervention focused on spices and herbs would be feasible and accepted by African women in San Diego. This intervention may support adherence to the Dietary Guidelines for Americans during the nutrition transition and broader dissemination of practices that promote health across heterogeneous communities of Africans living in the USA.