Exploring CALD and Non-CALD Women's Behavioral and Dietary Responses to a Low-Intensity Intervention for Gestational...

Cultural backgrounds can shape dietary beliefs, food preferences, and attitudes toward health interventions. However, limited research has explored adherence or behavioral responses following a dietary intervention in women from culturally and linguistically diverse (CALD) backgrounds. This secondary analysis of a randomized controlled feasibility trial in women with gestational diabetes (GDM) explored differences in adherence, satisfaction, and behavior change between CALD and White (non-CALD) women.

Thirty-eight participants were randomized to the dietary intervention (individualized, culturally tailored dietary advice) or standard care. Data collected at baseline (26-32 weeks' gestation) and end of study (close to delivery) included a behavior change questionnaire, a 10-point Likert scale for adherence and satisfaction with the intervention, and 24-h dietary recall.

Eighteen participants self-reported as CALD and 20 self-reported as non-CALD. All intervention group participants, irrespective of cultural background, were motivated to make dietary changes, with similar mean [95% CI] adherence scores (CALD: 8.10 [7.27, 8.94] vs. non-CALD: 7.58 [6.66, 8.51]), and satisfaction scores to the intervention (CALD: 7.85 [6.96, 8.74] vs. non-CALD 6.88 [5.89, 7.86]). Within the intervention or standard care groups there were no differences in dietary intake between CALD and non-CALD participants.

A low-intensity individualized dietary intervention for GDM was similarly acceptable and feasible for our small group of CALD and non-CALD participants. Findings support the potential for broadly applicable dietary strategies in antenatal care but also highlight the need for more culturally nuanced research to ensure inclusive interventions.