NEGOTIATING DIET-RELATED BEHAVIOR CHANGES IN THE RELATIONAL CONTEXT: THE EXPERIENCES OF BLACK AND LATINO ADULTS

Abstract

Black and Latino adults are at increased risk for diet-related chronic health conditions, related complications, and mortality. It is important to understand how black and Latino adults experience and manage diet-related chronic health conditions to develop research, policies and healthcare practices to promote health equity. Chronic illness management experiences are embedded within the social relational context, however the role of social relationships in chronic illness is understudied among minority groups. This research aimed to qualitatively explore how social relationships shape experiences making diet-related behavior changes to manage chronic conditions among minority adults. Two separate, related studies were conducted to understand how participants constructed their experiences with diet-related behavior changes in the context of their social relationships. The first study qualitatively explored how overweight black and Latino adults in a low-income urban setting experienced making diet-related behavior changes in a pilot weight loss intervention. The objective was to explore the feasibility of small eating behavior changes in this population. The second study explored, in the context of a recent diagnosis with type II diabetes, how social relationships shaped black women’s day-to-day diabetes experiences, how they experienced the effect of diabetes on their social relationships, and how relational experiences changed over a year. Findings of both studies demonstrate the value of investigating social relationships to explore interactors, content, process, and dynamics of health behavior-related interactions in minority populations; some findings stand out. First, diverse and unexpected social network members, such as sister-friends, adult children, and family with diabetes, were identified as salient to diet-related behavior change experiences. Second, participants described actively managing their relationships to selectively assemble desired help, navigate conflict, and preserve relationships while attempting diet-related behavior changes. Third, health behavior-related interactions were described as changeable, particularly through relationship management processes. Findings demonstrate how relational dynamics among black and Latino adults managing diet-related chronic conditions may act as pathways to reinforce and/or disrupt health inequalities. Findings suggest that research and health promotion approaches that consider a variety of network members and mechanics and development of health behavior-related interactions may be important to better understand how relationships shape making changes to manage diet-related chronic health conditions among these underrepresented and at-risk populations.