Design and implementation of a culturally tailored diet and lifestyle intervention for African and Caribbean people residing in Manchester: Insights from a process evaluation

ABSTRACT

African and Caribbean populations are at higher risk of developing obesity and more likely than the average United Kingdom national to suffer from type 2 diabetes, cardiovascular disease and now COVID-19. Despite limited progress to date, we now see a growing political commitment to address the high rates of overweight and obesity in the UK. A clear understanding of what works for these populations is warranted in order to support their needs and develop effective interventions. A culturally tailored diet and lifestyle intervention was delivered for African and Caribbean people residing in Manchester to modify lifestyles and promote healthy eating. This paper presents insight from a reflection and qualitative process evaluation of the intervention. Participants received tailored nutrition and health education and participated in healthy cooking lessons/demonstrations every Tuesday for 90 minutes over 24 weeks (November 2021-March 2022). On a daily basis, 107 participants interacted by sharing photos of their meals, asking questions and sharing experiences of dietary changes on a social media platform. Participants also participated in daily 10,000 steps challenge as part of the intervention package, which was monitored using a fitness mobile application. The weekly group discussions (n = 24) involving 20-35 participants helped to explore the views of participants regarding the enablers, facilitators and challenges guided by a semi structured interview guide. All session were conducted via zoom and recorded. Thematic analysis was used to analyse the findings. Five main themes emerged 1. motivation (e.g., chronic illness of participant or a close relation, or the desire to maintain a healthy weight);2. goal setting that was reviewed periodically;3. the regular contact with nutritionists and dietitians through social media platform;4. shared practices which was encouraged through a competitive edge;4. the unexpected advantage of reducing food expenditure;5. the use of an all African delivery team. Culturally tailored dietary interventions are beneficial and could potentially help African and Caribbean populations to adapt healthy dietary and lifestyle practices if it is co- produced and the implementation is led by people from African and/or Caribbean ancestry.