Nutrition-Related Experiences and Perceptions of Pacific Islanders With Diabetes in the United States: A Qualitative...

Pacific Islanders (PI) have a greater risk of developing type 2 diabetes compared with the non-Hispanic White population. Little is known about PIs' culture, experiences, and perceptions related to diabetes, especially regarding nutritional health care.

The primary purpose of this study was to explore the experience and perceptions of PIs living in the mainland United States regarding diabetes, diabetes management, and nutrition interventions.

Researchers conducted a qualitative study using semistructured interviews to gain cultural knowledge about the mainland PI population based on Campinha-Bacote's framework of cultural competence. Researchers analyzed data using reflexive thematic analysis.

PIs with prediabetes or type 2 diabetes living in the mainland United States were recruited through email and social media in Utah, California, and the Pacific Northwest.

Most of the participants (24 out of 26) lived in the United States for more than 10 years. Although 9 participants were not born in the United States, all lived in the United States for 6 years or more. Most of the participants were Tongan (11 out of 24) or Samoan (10 out of 24). Slightly more participants were aged 18 to 49 years (n = 14) and were men (n = 14), compared with participants older than 50 years (n = 12) and women (n = 12). Researchers identified 4 main themes: eating approaches, responses to diabetes diagnosis, perspectives on diabetes education, and navigating health care services. Price, convenience, family food practices, and taste influenced day-to-day food choices. Participants reported a tug-of-war trying to adopt a new culture, manage their diabetes, and retain their PI culture. Education for participants lacked cultural awareness and could be improved by focusing on PI communities and families rather than PI individuals. The health care system was difficult to navigate, and there were cultural and language barriers.

These study results provide an opportunity for registered dietitian nutritionists and other health care practitioners to gain knowledge about PI experiences and be better equipped to provide culturally sensitive care to individuals with prediabetes or type 2 diabetes.