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The Diabetes Educator, Vol. 31, No. 5, 719-725 (2005)
DOI: 10.1177/0145721705280941

FEATURES

Barriers to Medical Nutrition Therapy in Black Women With Type 2 Diabetes Mellitus

Pamela Galasso, RD, CD-N, Allison Amend, MSN, APRN, Gail D. Melkus, EdD, FAAN and Genice T. Nelson, MSN

From Yale University School of Nursing, New Haven, Connecticut.

Correspondence to Pamela Galasso, RD, CD-N, Yale University School of Nursing, 117 Jill Lane, Cheshire, CT 06410 (pamela.galasso{at}yale.edu).

Purpose

The purpose of this study was to explore food purchasing, preparation, and consumption among black women with type 2 diabetes mellitus (T2DM) in an urban setting to assess barriers to medical nutrition therapy recommendations.

Methods

A telephone survey was developed to assess shopping habits, the use of community resources for food supplementation, use of restaurant/fast-food establishments, dining habits, food purchasing and consumption, and food preparation methods. This 38-item questionnaire provided both frequencies and trends regarding participants' dietary habits.

Results

Black women identified ways in which their participation in a culturally competent intervention of diabetes care and education helped them to change dietary behaviors. The most common areas of change included purchasing, preparation, and portion size. Barriers to medical nutrition therapy identified included low income, time constraints, competing demands, and knowledge deficits.

Conclusions

Culturally sensitive diabetes interventions are an effective way to overcome some of the barriers to medical nutrition therapy. Feedback provided by this survey sug-gests that identification of more affordable healthy food resources in the community is necessary. In addition, access issues such as transportation to grocery stores should be on the agenda for public policy issues. Finally, alternate sites for nutrition education, such as a supermarket forum, warrant further investigation.


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