A focus group study of fish consumption behaviors among Asian women in Milwaukee, Wisconsin

Consumption of locally caught fish provides health benefits but can be a route of exposure to methylmercury and other persistent environmental contaminants. Previous studies found that Asian women of childbearing age (WCBA) in the Milwaukee area have high levels of exposure through fish consumption but limited awareness of fish advisories. We conducted a focus group project to understand the influence of culture, attitudes, and beliefs on the fish consumption habits of Chinese, Hmong, and Karen WCBA who reside in the Milwaukee area to develop culturally appropriate educational materials. A total of 19 women aged 18-50 years identifying as Chinese, Hmong, or Karen were recruited. Three focus groups were held, each consisting of 6-7 participants from one ethnicity. Focus group transcripts were thematically analyzed and coded based on the integrated behavioral model. Nutritional benefits and availability were the most common reasons to eat locally caught fish. All participants were aware of risks associated with eating fish, yet few knew ways to mitigate risk and maximize benefits. Participants expressed interest in receiving health messages from trusted sources and recommended that messaging target families rather than just individuals. Participants who were confident in their self-efficacy expressed a greater likelihood of following health message guidelines. Results suggest providing culturally appropriate educational materials in preferred languages to Asian communities via local community organizations may increase self-efficacy and adherence to fish advisories. Future projects will evaluate the effectiveness of self-affirmation messaging among Asian WCBA and assess changes in fish consumption based on message content.