Culture and food practices of African-American women with type 2 diabetes

African-American women (AAW) have had the largest increase in diagnosed diabetes in the US. Few studies have focused solely on dietary changes (one of the foundations for diabetes self-care), particularly in the context of family and the role of AAW. The purpose of this descriptive ethnographic study was to explicate cultural influences on food practices of AAW with type 2 diabetes (T2DM) in order to inform the health care community as well as future development of culturally-tailored interventions. Specific aims were to describe typical daily food practices and identify cultural influences on food practices of AAW with T2DM. Symbolic Interactionism, a sensitizing framework for viewing AAW with T2DM as a subculture, guided this study. Purposeful sampling was used to recruit 20 AAW who: were between 35 and 70 years of age, had been diagnosed with T2DM, shopped and prepared meals for their families, and attended church functions where food was served . Data collection consisted of one-one-one interviews and participant observation of church fellowship dinners, grocery shopping, and food preparation. A social anthropological approach to content analysis was used to describe behavioral regularities in food practices. Trustworthiness was maintained by an audit trail. Findings indicate that for informants in this study, who had diabetes ranging from 2 to 30+ years, there is a constant struggle between cultural food practices and eating healthier because of diabetes, particularly within the home setting where a majority of daily food practices take place. Difficulties in making dietary modifications result from conflicts between the need to change dietary practices to control diabetes and personal food preferences, as well as the preferences of people within the participants' social network. In addition, difficulties derive from AAW's emotional dedication to the symbolism of food and traditional cultural food practices. AAW are the gatekeepers for family food practices and are the keys to healthy dietary practices. This study begins to fill the research gap regarding cultural dietary food practices of this population. With increased knowledge, researchers and health care providers will be better able to improve AAW food practices, and ultimately improve diabetes control in this high-risk population.