Culturally-Based Communication about Health, Eating, and Food: Development and validation of the CHEF scale

Ethnic minority populations in the United States are disproportionately affected by obesity. To address this disparity, research has begun to investigate the role of culture, ethnicity, and experiences with racism on food choices and health interventions. The aim of the current study was to develop and evaluate a new scale measuring the extent to which individuals' culture, as they perceive it, influences perceptions of food-related health messages. A diverse sample of 422 college students responded to the item pool, as well as surveys on race-related stress, self-efficacy in making healthy food choices, ethnic identity, and social support for health-related behaviors. Exploratory and confirmatory factor analyses produced a five-factor model: Connection (the extent to which food connected individuals with their culture), Authority (beliefs that health care providers were familiar with individuals' cultural foods), Unhealthy Food Perceptions (beliefs that individuals' cultural foods were perceived as unhealthy), Healthy Food Perceptions (beliefs that others perceive individuals' cultural foods to be healthy), and Social Value (the extent to which social relationships are improved by shared cultural food traditions). Authority and Healthy Food Perceptions were related to individuals' confidence in their ability to make healthy food choices. Authority was inversely correlated with negative coping with racism-related events. Ethnic identity was significantly correlated with all but Unhealthy Food Perceptions. Race/ethnicity differences were identified for Healthy Food Perceptions, Unhealthy Food Perceptions, Social Value, Connection, but not Authority. Applications and suggestions for further research using the Culturally-based Communication about Health, Eating, and Food (CHEF) Scale are proposed.