TY - JOUR
T1 - Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease
T2 - A Qualitative Study
AU - Tyson, Crystal C.
AU - Svetkey, Laura P.
AU - Lin, Pao Hwa
AU - Granados, Isa
AU - Kennedy, Danielle
AU - Dunbar, Kayla T.
AU - Redd, Cynthia
AU - Bennett, Gary
AU - Boulware, L. Ebony
AU - Fish, Laura J.
N1 - Funding Information:
Support: This work was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health (NIH) under Award Number K01HL143116 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2022 National Kidney Foundation, Inc.
PY - 2023/1
Y1 - 2023/1
N2 - Objective: The Dietary Approaches to Stop Hypertension (DASH) eating plan improves hypertension in Black individuals and is associated with favorable chronic kidney disease (CKD) outcomes. Yet, adherence to DASH is low among US adults in general, particularly among Black Americans. We assessed perceptions about DASH, its cultural compatibility, and barriers and facilitators to DASH adherence in Black adults with CKD. Design and Methods: We conducted focus groups and semistructured individual interviews involving 22 Black men and women with CKD Stages 3-4 from outpatient clinics at a US academic medical center. Transcripts of audio-recorded interviews were analyzed using thematic analysis. Results: Among participants (2 focus groups [N = 8 and 5] and 9 individual interviews), 13 (59%) had CKD Stage 3, 13 (59%) were female, the median age was 61 years, and 19 (90%) had hypertension. After receiving information about DASH, participants perceived it as culturally compatible based on 3 emergent themes: (1) Black individuals already eat DASH-recommended foods (“Blacks eat pretty much like this”), (2) traditional recipes (e.g., southern or soul food) can be modified into healthy versions (“you can come up with decent substitutes to make it just as good”), and (3) diet is not uniform among Black individuals (“I can't say that I eat traditional”). Perceived barriers to DASH adherence included unfamiliarity with serving sizes, poor cooking skills, unsupportive household members, and high cost of healthy food. Eleven (52%) reported after paying monthly bills that they “rarely” or “never” had leftover money to purchase healthy food. Perceived facilitators included having local access to healthy food, living alone or with supportive household members, and having willpower and internal/external motivation for change. Conclusions: Black adults with CKD viewed DASH as a healthy, culturally compatible diet. Recognizing that diet in Black adults is not uniform, interventions should emphasize person-centered, rather than stereotypically culture-centered, approaches to DASH adherence.
AB - Objective: The Dietary Approaches to Stop Hypertension (DASH) eating plan improves hypertension in Black individuals and is associated with favorable chronic kidney disease (CKD) outcomes. Yet, adherence to DASH is low among US adults in general, particularly among Black Americans. We assessed perceptions about DASH, its cultural compatibility, and barriers and facilitators to DASH adherence in Black adults with CKD. Design and Methods: We conducted focus groups and semistructured individual interviews involving 22 Black men and women with CKD Stages 3-4 from outpatient clinics at a US academic medical center. Transcripts of audio-recorded interviews were analyzed using thematic analysis. Results: Among participants (2 focus groups [N = 8 and 5] and 9 individual interviews), 13 (59%) had CKD Stage 3, 13 (59%) were female, the median age was 61 years, and 19 (90%) had hypertension. After receiving information about DASH, participants perceived it as culturally compatible based on 3 emergent themes: (1) Black individuals already eat DASH-recommended foods (“Blacks eat pretty much like this”), (2) traditional recipes (e.g., southern or soul food) can be modified into healthy versions (“you can come up with decent substitutes to make it just as good”), and (3) diet is not uniform among Black individuals (“I can't say that I eat traditional”). Perceived barriers to DASH adherence included unfamiliarity with serving sizes, poor cooking skills, unsupportive household members, and high cost of healthy food. Eleven (52%) reported after paying monthly bills that they “rarely” or “never” had leftover money to purchase healthy food. Perceived facilitators included having local access to healthy food, living alone or with supportive household members, and having willpower and internal/external motivation for change. Conclusions: Black adults with CKD viewed DASH as a healthy, culturally compatible diet. Recognizing that diet in Black adults is not uniform, interventions should emphasize person-centered, rather than stereotypically culture-centered, approaches to DASH adherence.
KW - African American
KW - Barriers and facilitators
KW - Chronic kidney disease
KW - Diet
KW - Qualitative research
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U2 - 10.1053/j.jrn.2022.05.002
DO - 10.1053/j.jrn.2022.05.002
M3 - Article
C2 - 35597318
AN - SCOPUS:85134328378
SN - 1051-2276
VL - 33
SP - 59
EP - 68
JO - Journal of Renal Nutrition
JF - Journal of Renal Nutrition
IS - 1
ER -