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Abstract: FR-PO1079

Qualitative Perspectives on Community-Based Fruit and Vegetable Promotion from African American Adults with CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Kitzman, Heather, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Dodgen, Leilani, Baylor Scott & White Health, Dallas, Texas, United States
  • Ajoku, Brittany A, Baylor Scott & White Health, Dallas, Texas, United States
  • Montgomery, Aisha H, Premier, Inc, Charlotte, North Carolina, United States
  • Strauss, Anne Marie, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Allison, Patricia, Baylor Scott & White Health, Dallas, Texas, United States
  • Wesson, Donald E., The University of Texas at Austin Dell Medical School, Austin, Texas, United States
Background

African Americans (AA) have a greater risk for chronic kidney disease (CKD) and for its faster progression compared to other U.S. population groups. Diets high in fruits and vegetables (F&V) are associated with lower CKD risk and its progression. In a pre-specified qualitative study component of the Fruits and Vegetables for Kidney Health Randomized Controlled Trial (R21DK113440), we sought to identify program components that contributed to F&V intake and to help inform future studies.

Methods

We held focus groups virtually and in-person with focus group questions informed by Social Cognitive Theory (SCT) to evaluate study participation, changes to self-efficacy, and barriers and benefits to individual and community-level F&V intake. We utilized an applied thematic analysis approach for data analysis with trained staff using MAXQDA.

Results

Six focus groups were conducted (n=40, 100% AAs, mean age 64 years, 81% female, and 50% had annual incomes < $25,000). Although access to F&V for both study groups, the one given F&V alone and the one given F&V with cooking classes, reported increased F&V intake, participants who also received cooking classes reported greater benefits. Primary themes included 1) Exposure to new knowledge, skills, and foods helped build capacity to engage in healthy food behaviors; 2) Care, consideration, and accountability shown by study community health workers (CHWs) helped overcome participant hesitancy to join and remain in the study; 3) Lasting barriers including limited finances to afford F&V, travel time to acquire quality F&V, and lack of convenience for F&V preparation limited continued F&V intake after study conclusion; and 4) Need to promote and enhance the F&V program, including through intergenerational social connections and social media.

Conclusion

Sustainability of changes including learned healthy behaviors after study conclusion was challenged by social factors including limited finances to support new healthy behaviors. Regarding gained insights to help inform future research studies, encouragement and support by CHWs was critically important for recruitment and retention of participants, supporting their inclusion in community-based studies of vulnerable populations with historic mistrust of research participation.

Funding

  • NIDDK Support

Digital Object Identifier (DOI)