Use of qualitative methods to study diet, acculturation, and health in Chinese-American women

Improving the health status of minority populations in the United States is a major public health challenge. This report describes an anthropological approach to obtaining information needed for designing and evaluating a culturally appropriate dietary intervention for Chinese-Americans. Ninety-minute qualitative interviews were conducted with 30 less-acculturated Chinese-American women in their native language (Cantonese or Mandarin), soliciting information from participants regarding usual food consumption; knowledge, attitude, and beliefs about diet and disease; and factors that influence food choices. Interviews were recorded, translated, transcribed, and coded for themes. Two focus groups with 6 participants each were conducted to cross-validate the interview findings. Among our participants, breakfast was usually the first meal to be "Westernized," largely for reasons of convenience. Food quality, cost, and availability were some of the most important predictors of dietary change after immigration to the United States. Respondents said that there was a strong connection between diet and disease. However, they were not familiar with US dietary guidelines, food labels, or other sources of dietary information, but reported that friends and Chinese newspapers were their primary source of nutrition information. We used these findings to develop quantitative dietary survey instruments adapted for Chinese-Americans. This type of qualitative groundwork is an important precursor to the design, implementation, and evaluation of dietary interventions for minorities.