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

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

Annals of Global Health
Volume 86 (2020): Issue 1
By: Farzanna S. Haffizulla,  Anjali Ramoutar,  Alyssa Eason and  Patrick Hardigan  
Open Access
|Feb 2020
Figures & tables

Figures & Tables

Table 1

Food and Exercise Themes Identified by Focus Groups in Broward County, FL.

CategoryFood Item
Fruits

  • Mango

  • Guava

  • Avocado

  • Papaya

  • Soursop

  • Pineapple

Meat and Seafood

  • Chicken (stew, curry)

  • Goat

  • Oxtail

  • Pork

  • Salami

  • Snapper

  • Cod

  • Eggs

  • Shrimp

Vegetables and Beans

  • Cabbage

  • Plantains

  • Corn

  • Pumpkin (butternut squash)

  • Kidney beans

  • Beans

  • Pigeon peas

Wheat and Grains

  • Bread

  • Roti

  • Cream of wheat

  • Baked mac & cheese (pasta)

  • Rice (Jasmine, Basmati)

Drinks

  • Fresh fruit juice (natural, with added milk or condensed milk and brown sugar)

  • Coffee (sometimes black, sometimes with cream and sugar)

  • Colas (respective to island and/or American brands such as Pepsi and Coca-Cola products)

  • Malta

Exercise

  • American football and swimming in pools are unrelatable and/or unpopular for exercise

  • Dancing, baseball, cricket, and soccer are common for exercise and for entertainment

  • Walking (in groups, with families, outdoors) is favored by all groups for exercise

Table 2

Cultural Themes Gathered from Focus Group Participants in Broward County, FL 2018.

ThemeDetails
Organization

  • Colors: participants value bright colors and color-coded information

  • Layout: bulleted information is easier to understand and more attractive; cluttered information is useless and can be easily ignored; logos repeatedly reduce visual fluidity

  • Phrases: key terms should be bolded, and catchy slogans/phrases are favorable to participants

Information

  • Exclude overused material (apple equals health, food pyramid, etc.)

  • Calorie counts and nutritional information are highly valued

  • Food equations (ex. 1 donut hole = 27 grapes) should be comparable (snacks compared to snacks, meals compared to meals, etc.)

  • Include culturally appropriate exercises

  • Swimming among Afro-Caribbean American women is uncommon

  • Walking is favored by all groups and is extremely popular

Illustrations, Pictures, and Graphics

  • Participants from all groups favor depictions of families (exercising) and happy children

  • Crowded graphics are disliked (ex: My Plate Planner)

  • Graphics should be clear and easy to understand (Page 2 of My Plate Planner was often mistaken for sign language)

  • Doughnut holes (Colors of Health packet), candy bar (Soda? Think Again packet), and soda cans (Soda? Think Again packet) are not easily recognizable to many participants

  • Inclusion of cultural items (dominos, wooden spoons) is encouraging and more representative

  • Some items (i.e. hockey pucks) are uncommon in Caribbean culture

Cultural Insights

  • Eggs are common in Caribbean cuisine, but the nutritional value of eggs is often misinterpreted. Many believe that eggs are bad for you, so nutritional information about eggs is useful

  • Almonds aren’t popular – peanuts are more popular

  • Portion size/control isn’t popular or widely understood

  • Canned food isn’t considered healthy

  • Consider using more culturally appropriate foods for comparison and inclusion

  • Colors of Health Packet – blueberries can be equated to sickness/medicine and negatively received

  • Sports and exercise: baseball, cricket, dancing, and soccer are more popular than American football

  • Some cultures commonly indulge in spicy foods (especially use of scotch bonnet peppers) and others are impartial

Table 3

Participant Demographics and Social Determinants of Health Reported by Focus Group Participants in Broward County, FL.

CountryGenderP-Value
FemaleMale
Cuba6 (75.0)2 (25.0)p = 0.714
Dominican Republic6 (85.7)1 (14.3)
Haiti7 (87.5)1 (12.5)
Jamaica6 (85.7)1 (14.3)
Trinidad and Tobago5 (62.5)3 (37.5)
CountryRaceP-Value
Black/AAOther
Cuba1 (14.3)6 (85.7)p = 0.019
Dominican Republic2 (28.6)5 (71.4)
Haiti6 (75.0)2 (25.0)
Jamaica5 (71.4)2 (28.6)
Trinidad and Tobago1 (12.5)7 (87.5)
CountryEducationP-Value
High School/GEDMore than High School
Cuba1 (12.5)7 (87.5)p = 0.400
Dominican Republic0 (0.0)7 (100.0)
Haiti0 (0.0)8 (100.0)
Jamaica1 (16.7)5 (83.3)
Trinidad and Tobago2 (25.0)6 (75.0)
CountryEmploymentP-Value
EmployedUnemployed
Cuba8 (100.0)0 (0.0)p = 0.015
Dominican Republic7 (100.0)0 (0.0)
Haiti5 (62.5)3 (37.5)
Jamaica7 (100.0)0 (0.0)
Trinidad and Tobago4 (50.0)4 (50.0)
CountryStressed1P-Value
NoYes
Cuba6 (75.0)2 (25.0)p = 0.594
Dominican Republic3 (42.9)4 (57.1)
Haiti6 (75.0)2 (25.0)
Jamaica4 (66.7)2 (33.3)
Trinidad and Tobago4 (50.0)4 (50.0)
CountryJobsP-Value
ZeroOneTwo
Cuba0 (0.0)6 (75.0)2 (25.0)p = 0.134
Dominican Republic0 (0.0)6 (85.7)1 (14.3)
Haiti3 (37.5)4 (50.0)1 (12.5)
Jamaica0 (0.0)5 (71.4)2 (28.6)
Trinidad and Tobago4 (50.0)3 (37.5)1 (12.5)
CountrySummary Statistics (Continued) Talking2P-Value
2 or less per week3–5 Times Week5+ Times a Week
Cuba2 (25.0)3 (37.5)3 (37.5)p = 0.704
Dominican Republic1 (14.3)3 (42.9)3 (42.9)
Haiti3 (37.5)3 (37.5)2 (25.0)
Jamaica2 (33.3)0 (0.0)4 (66.7)
Trinidad and Tobago1 (12.5)3 (37.5)4 (50.0)

[i] 1 “Stressed” here refers to the PRAPARE survey item that asked participants the following: Are you stressed (Yes vs No)?

2 “Talking” here refers to the PRAPARE survey item that asked participants the following: How often do you talk to people that you care about and feel close to (2 or less per week, 3–5 times per week, 5+ times per week)?

Figure 1

Insurance.

Figure 2

How Participants Access Health Information.

Figure 3

Barriers to Accessing Health Care.

Table 4

Intercept Survey Data.

Question 1 ResponseOn average, how many times do you go to the restaurant/store for food and beverages per week?
HaitiJamaicaDominican RepublicTrinidad & TobagoCubaTotal
Less than once per week112225%
1–2 times/week2213346%
3–5 times/week4225%
>5 times/week14%
Question 2 ResponseWhat is most important to you when making your food or beverage selections in the restaurant/store?[*]
HaitiJamaicaDominican RepublicTrinidad & TobagoCuba
Taste2515
Cost122
Low Fat Content1
Low Sugar Content11
High Nutritional Content12212
Question 3 ResponseDid you find the Go, Slow, Whoa posters or brochures helpful in making beverage choices?
HaitiJamaicaDominican RepublicTrinidad & TobagoCubaTotal
Yes3736392%
No118%
Maybe0%
Question 4 ResponseDid the Go, Slow, Whoa posters or brochures influence your beverage choices?
HaitiJamaicaDominican RepublicTrinidad & TobagoCubaTotal
Yes3725384%
No118%
Maybe118%
Question 5 ResponseDid you find the Go, Slow, Whoa posters or brochures helpful in making food choices?
HaitiJamaicaDominican RepublicTrinidad & TobagoCubaTotal
Yes3745392%
No28%
Maybe0%
Question 6 ResponseDid the Go, Slow, Whoa posters or brochures influence your food choices?
HaitiJamaicaDominican RepublicTrinidad & TobagoCubaTotal
Yes3734383%
No1317%
Maybe0%

[i] [*] Multiple Response Question.

DOI: https://doi.org/10.5334/aogh.2657 | Journal eISSN: 2214-9996
Journal RSS Feed
Language: English
Published on: Feb 4, 2020
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
Caribbean,
health disparities,
cultural research,
health equity,
minority health

© 2020 Farzanna S. Haffizulla, Anjali Ramoutar, Alyssa Eason, Patrick Hardigan, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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