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Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease: A Qualitative Study.

Publication ,  Journal Article
Tyson, CC; Svetkey, LP; Lin, P-H; Granados, I; Kennedy, D; Dunbar, KT; Redd, C; Bennett, G; Boulware, LE; Fish, LJ
Published in: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
January 2023

The Dietary Approaches to Stop Hypertension (DASH) eating plan improves hypertension in Black individuals and is associated with favorable chronic kidney disease (CKD) outcomes. Yet, adherence to DASH is low among US adults in general, particularly among Black Americans. We assessed perceptions about DASH, its cultural compatibility, and barriers and facilitators to DASH adherence in Black adults with CKD.We conducted focus groups and semistructured individual interviews involving 22 Black men and women with CKD Stages 3-4 from outpatient clinics at a US academic medical center. Transcripts of audio-recorded interviews were analyzed using thematic analysis.Among participants (2 focus groups [N = 8 and 5] and 9 individual interviews), 13 (59%) had CKD Stage 3, 13 (59%) were female, the median age was 61 years, and 19 (90%) had hypertension. After receiving information about DASH, participants perceived it as culturally compatible based on 3 emergent themes: (1) Black individuals already eat DASH-recommended foods ("Blacks eat pretty much like this"), (2) traditional recipes (e.g., southern or soul food) can be modified into healthy versions ("you can come up with decent substitutes to make it just as good"), and ( 3) diet is not uniform among Black individuals ("I can't say that I eat traditional"). Perceived barriers to DASH adherence included unfamiliarity with serving sizes, poor cooking skills, unsupportive household members, and high cost of healthy food. Eleven (52%) reported after paying monthly bills that they "rarely" or "never" had leftover money to purchase healthy food. Perceived facilitators included having local access to healthy food, living alone or with supportive household members, and having willpower and internal/external motivation for change.Black adults with CKD viewed DASH as a healthy, culturally compatible diet. Recognizing that diet in Black adults is not uniform, interventions should emphasize person-centered, rather than stereotypically culture-centered, approaches to DASH adherence.

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Published In

Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation

DOI

EISSN

1532-8503

ISSN

1051-2276

Publication Date

January 2023

Volume

33

Issue

1

Start / End Page

59 / 68

Related Subject Headings

  • Urology & Nephrology
  • Renal Insufficiency, Chronic
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Dietary Approaches To Stop Hypertension
  • Diet
  • Black or African American
 

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Tyson, C. C., Svetkey, L. P., Lin, P.-H., Granados, I., Kennedy, D., Dunbar, K. T., … Fish, L. J. (2023). Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease: A Qualitative Study. Journal of Renal Nutrition : The Official Journal of the Council on Renal Nutrition of the National Kidney Foundation, 33(1), 59–68. https://doi.org/10.1053/j.jrn.2022.05.002
Tyson, Crystal C., Laura P. Svetkey, Pao-Hwa Lin, Isa Granados, Danielle Kennedy, Kayla T. Dunbar, Cynthia Redd, Gary Bennett, L Ebony Boulware, and Laura J. Fish. “Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease: A Qualitative Study.Journal of Renal Nutrition : The Official Journal of the Council on Renal Nutrition of the National Kidney Foundation 33, no. 1 (January 2023): 59–68. https://doi.org/10.1053/j.jrn.2022.05.002.
Tyson CC, Svetkey LP, Lin P-H, Granados I, Kennedy D, Dunbar KT, et al. Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease: A Qualitative Study. Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. 2023 Jan;33(1):59–68.
Tyson, Crystal C., et al. “Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease: A Qualitative Study.Journal of Renal Nutrition : The Official Journal of the Council on Renal Nutrition of the National Kidney Foundation, vol. 33, no. 1, Jan. 2023, pp. 59–68. Epmc, doi:10.1053/j.jrn.2022.05.002.
Tyson CC, Svetkey LP, Lin P-H, Granados I, Kennedy D, Dunbar KT, Redd C, Bennett G, Boulware LE, Fish LJ. Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease: A Qualitative Study. Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. 2023 Jan;33(1):59–68.
Journal cover image

Published In

Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation

DOI

EISSN

1532-8503

ISSN

1051-2276

Publication Date

January 2023

Volume

33

Issue

1

Start / End Page

59 / 68

Related Subject Headings

  • Urology & Nephrology
  • Renal Insufficiency, Chronic
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Dietary Approaches To Stop Hypertension
  • Diet
  • Black or African American