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Effectiveness and Acceptability of a Nutrition Intervention Targeting Chinese Adult Immigrants With Type 2 Diabetes in Canada: A Study Using Mixed Methods Analysis

Published:April 26, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.04.006

      Abstract

      Objectives

      Although culturally tailored diabetes treatment is recommended, there is a lack of relevant dietary resources for the Chinese population in Canada. In this study we assessed the feasibility and efficacy of a culturally tailored menu plan combined with nutrition education on clinical outcomes, diet quality and qualitative outcomes among Chinese immigrants with type 2 diabetes.

      Methods

      Participants were 17 Chinese immigrants living with type 2 diabetes in Edmonton, Alberta, Canada. The design was a 12-week, single-arm intervention that included weekly nutrition education supported by a culturally tailored menu plan with mixed methods evaluation. Diet quality, clinical and other outcomes were assessed pre- and postintervention. One-on-one interviews were conducted postintervention to identify program feasibility and obstacles to adherence.

      Results

      Waist circumference (mean ± standard deviation: −2.0±2.5 cm; p=0.004), total cholesterol (−21.4±28.2 mg/dL; p=0.007) and low-density lipoprotein cholesterol (−18.4±24.6 mg/dL; p=0.007) were decreased when compared with baseline. No significant change was detected in glycated hemoglobin. Postintervention, the Healthy Eating Index (p=0.01) and diabetes knowledge score (p=0.009) also increased. Participants reported that the program was culturally acceptable, easily understood and feasible to implement. Participants indicated the program helped them to improve their diabetes knowledge, adhere to the dietary guidelines, choose low glycemic index food and read food labels when shopping.

      Conclusions

      A flexible, culturally tailored menu plan was a feasible and effective tool for improving diabetes knowledge, diet quality and metabolic outcomes among Chinese immigrants with type 2 diabetes.

      Résumé

      Objectifs

      Bien qu’un traitement du diabète culturellement adapté soit recommandé, les ressources pertinentes en matière d’alimentation qui sont destinées à la population chinoise du Canada sont insuffisantes. Dans la présente étude, nous avons évalué la faisabilité et l’efficacité de la combinaison d’un plan de repas culturellement adapté et d’une éducation nutritionnelle sur les résultats cliniques, la qualité du régime alimentaire et les résultats qualitatifs chez les immigrants chinois atteints du diabète de type 2.

      Méthodes

      Les 17 participants étaient des immigrants chinois atteints du diabète de type 2, d’Edmonton, en Alberta, au Canada. Le devis était une intervention à volet unique de 12 semaines qui consistait en des séances hebdomadaires d’éducation nutritionnelle accompagnée d’un plan de repas culturellement adapté utilisant l’évaluation à méthodes mixtes. Nous avons évalué la qualité du régime alimentaire, les résultats cliniques et les autres résultats avant et après l’intervention. Nous avons effectué des entretiens individuels après l’intervention pour établir la faisabilité du programme et cerner les obstacles qui nuisent à son observance.

      Résultats

      La circonférence de la taille (moyenne ± écart type : −2,0 ± 2,5 cm; p = 0,004), le cholestérol total (−21,4 ± 28,2 mg/dl; p = 0,007) et le cholestérol à lipoprotéines de faible densité (−18,4 ± 24,6 mg/dl; p = 0,007) avaient diminué par rapport aux données initiales. Nous n’avons noté aucun changement significatif de l’hémoglobine glyquée. Après l’intervention, les scores à l’Indice de saine alimentation (p = 0,01) et sur les connaissances en matière de diabète (p = 0,009) avaient aussi augmenté. Les participants ont signalé que le programme était culturellement acceptable, facile à comprendre et réalisable. Les participants ont indiqué que le programme les avait aidés à améliorer leurs connaissances en matière de diabète, à respecter les lignes directrices en matière d’alimentation, à choisir les aliments à faible indice glycémique et à lire les étiquettes nutritionnelles lors des courses.

      Conclusions

      Un plan de repas flexible et culturellement adapté était un outil faisable et efficace pour améliorer les connaissances en matière de diabète, la qualité du régime alimentaire et les résultats métaboliques des immigrants chinois atteints du diabète de type 2.

      Keywords

      Mots clés

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