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Author ORCID Identifier

https://orcid.org/0000-0003-1668-2379

AccessType

Campus-Only Access for Five (5) Years

Document Type

dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program

Nursing

Year Degree Awarded

2022

Month Degree Awarded

May

First Advisor

Rachel (Rae) Walker

Second Advisor

Favorite Iradukunda

Third Advisor

Airín D. Martínez

Subject Categories

Community Health and Preventive Medicine | International and Community Nutrition | Nursing | Public Health and Community Nursing | Public Health Education and Promotion

Abstract

Due to historical and present oppressions such as structural racism, displacement, inequitable allocation of power and resources, and deliberate marginalization of ancestral foodways, Latino/a/x individuals are subjected to significantly higher rates of cardiometabolic morbidity and mortality such as death from type 2 diabetes mellitus (T2DM). While previous research has often focused on health promotion for persons already diagnosed with T2DM, there is far less knowledge on how to reduce diabetes risk. Whole food plant-based diets (WFPB) have been shown to control blood sugar three times more effectively than a traditional diabetes diet. Latino/a/x individuals can reclaim ancestral foods through use of a WFPB diet, as beef and cheese were introduced during colonization. This study evaluated a remotely-accessible, nurse-led, culturally tailored, WFPB culinary intervention in terms of feasibility, acceptability, and impact on T2DM risk among Latino/a/x adults during the COVID-19 pandemic.

A community advisory board, and theory incorporating the Social-Ecological Model, PRECEED-PROCEED Model, and Lewin’s equation, guided the design of this quasi-experimental mixed methods study. Twenty-one Latino/a/x adults, at risk for or living with prediabetes, were recruited from the Inland Empire of Southern California and self-selected to attend a remote six-week WFPB culinary class (n=15), or standard care class (n=6). Data were generated between November 2021-February 2022 using questionnaires, focus groups, and biometrics.

Intervention arm study volunteers reported the WFPB culinary intervention was acceptable and feasible. Positive changes in self-efficacy, biometrics, perceptions, and WFPB nutrition knowledge were detected following delivery. Study volunteers stated the course’s flexible and online format facilitated participation, increased fruit/vegetable intake, and encouraged use of new WFPB recipes and cooking. Approximately one-third of the study volunteers were men.

Remote delivery of community-engaged culinary interventions is feasible and acceptable. Interventions specifically tailored to the culture and foodways of Latino/a/x communities provide additional options and support while potentially enhancing sustainable health outcomes and overall diet quality. This may result in lower healthcare costs and improved quality of life. By thinking critically about food, we have opportunities to resist oppressive and exploitive foodways while reclaiming ancestral foods and practicing sustainability in the context of the climate emergency and COVID-19 pandemic.

DOI

https://doi.org/10.7275/28480041

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Available for download on Thursday, May 13, 2027

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