https://doi.org/10.4081/hls.2021.10002
Barriers to dietary modifications for people living with type 2 diabetes in a rural indigenous Guatemalan community
Submitted: 27 July 2021
Accepted: 1 September 2021
Published: 16 September 2021
Accepted: 1 September 2021
Abstract Views: 2215
PDF: 291
HTML: 49
HTML: 49
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
In Guatemala, the prevalence of diabetes continues to increase with a disproportionate burden falling on indigenous rural communities. In this study, we assessed barriers to making dietary modifications for people living with type 2 diabetes in a rural indigenous Guatemalan population. Structed interviews (n=32) were conducted with participants selected from a convenience sample of adults with type 2 diabetes living in villages in and around San Lucas Tolimán, Guatemala. Frequencies were calculated for closed-ended questions and content analysis was used to evaluate open-ended questions. Most participants (81%) were women with low-levels of formal education and average daily food expenditure of just over $1 USD. The majority of participants were able to identify foods important in a diabetic diet, however, with significant barriers to making dietary modifications. Commonly cited perceived barriers included high costs of food due to travel and storage, inadequate local access to fresh fruits and vegetables and incompatibility with traditional diet. Several structural and cultural barriers exist to prevent dietary modifications for people living with type 2 diabetes in this rural indigenous population.
World Health Organization. Diabetes. World Health Organization. Accessed: August 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes
Liu G, Li Y, Hu Y, et al. Influence of lifestyle on incident cardiovascular disease and mortality in patients with diabetes mellitus. J Am Coll Cardiol 2018;71:2867-76.
Nagelkerk J, Reick K, Meengs L. Perceived barriers and effective strategies to diabetes self‐management. J Am Nursing 2006;54:151-8.
Juarez-Ramirez C, Theodore F, Villalobos A, et al. The importance of cultural dimension of food in understanding the lack of adherence to diet regimens among Mayan people with diabetes. Public Health Nutr 2019;17:3238-49.
Dean M, Bendfeldt G, Lou H, et al. Increased incidence and disparity of diagnosis of retinoblastoma patients in Guatemala. Cancer Lett 2014;351:59-63.
Ippolito M, Chary A, Daniel M, Barnoya, et al. Expectations of health care quality among rural Maya villagers in Sololá Department, Guatemala: a qualitative analysis. Int J Equity Health 2017;16:51.
Chomat AM, Solomons NW, Montenegro G, et al. Maternal health and health-seeking behaviors among indigenous Mam mothers from Quetzaltenango, Guatemala. Rev Panam Salud Publica 2014;35:113-20.
Ministry of Food and Nutritional Security (SESAN). Análisis de Situación, nutricional de Guatemala 2014. Accessed: Jan 2020. Available from: http://www.sesan.gob.gt/wordpress/wp-content/uploads/2017/07/PESAN-2016-2020.pdf
World Health Organization Ministry of Public Health and Social Assistance. Plan de acción 2008–2012 para la prevención y el control integral de las enfermedades crónicas y sus factores de riesgo. World Health Organization. Available from: https://www.mindbank.info/item/4622
Duffy S, Norton D, Kelly M, et al. Using Community Health Workers and a Smartpohne Application to Improve Diabetes Control in Rural Guatemala. Glob Health Sci Pract 2020;8:699-720.
Friends of San Luca. Health Promoter Program. Accessed: June 2020. Available from: https://sanlucasmission.org/programs/healthcare/
Creswell J, Plano Clark V. Designing and conducting mixed methods research. 2nd ed. Sage. Thousand Oaks, CA; 2011.
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008;62:107-15.
Chary A, Greiner M, Bowers C, et al. Determining adult type 2 diabetes-related health care needs in an indigenous population from rural Guatemala: a mixed-methods preliminary study. BMC Health Serv Res 2012;12:476.
Webb M, Chary A, De Vries T, et al. Exploring mechanisms of food insecurity in indigenous agricultural communities in Guatemala: a mixed methods study. BMC Nutr 2016;2:55.
Fry C. Health on the Shelf: A Guide to Healthy Small Food Retailer Certification Programs. Accessed: June 2020. Available from: http://changelabsolutions.org/sites/default/files/Health_on_the_Shelf_FINAL_20130322-web.pdf
Gittelsohn J, Laska M, Karpyn A, et al. Lessons learned from small store programs to increase healthy food access. Am J Health Behav 2014;38:307-15.
Barnidge E, Baker E, Schootman M, et al. The effect of education plus access on perceived fruit and vegetable consumption in a rural African American community intervention. Health Educ Res 2015;30:773-85.
Luna-González D and Sørensen M. Higher agrobiodiversity is associated with improved dietary diversity, but not child anthropometric status, of Mayan Achí people of Guatemala. Public Health Nutr 2018;2:2128-41.
Bodzio J, Nemeth E, DellaValle D. Assessing Food Insecurity and Family Gardens in Rural Indigenous Guatemala. J Acad Nutr Diet 2018;118:A81.
Flood D, Mux, S, Martinez, et al. Implementation and outcomes of a comprehensive type 2 diabetes program in rural Guatemala. PLoS One 2016;11:e0191152.
Manning K, Senekal M, Harbron J. Group-based intervention in a primary healthcare setting was more effective for weight loss than usual care. Health SA 2019;24:1172.
Thankappan K, Sathish T, Tapp R, et al. A peer-supported lifestyle intervention for preventing type 2 diabetes in India: A cluster-randomized controlled trial of the Kerala Diabetes Prevention Program. PLoS Med 2018;15:e1002575.
How to Cite
Wilson, J., Svenson, J., Duffy, S., & Schmidt, J. (2021). Barriers to dietary modifications for people living with type 2 diabetes in a rural indigenous Guatemalan community. Healthcare in Low-Resource Settings, 9(1). https://doi.org/10.4081/hls.2021.10002
Similar Articles
- Rizki Andriani, Aghnia Kamila, Roofi Asma Putri, Arif Fadhillah, Sabrina Helmi, Delia Septiani, The effect of mindful eating on dietary behaviour and fasting blood glucose in type 2 diabetes mellitus patients , Healthcare in Low-resource Settings: Vol. 12 No. 3 (2024): Transforming Healthcare in Low-Resource Settings: a Multidisciplinary Approach Towards Sustainable Solutions, Part III
You may also start an advanced similarity search for this article.