A Qualitative Assessment on the Impact of Social Determinants of Health on Diet Changes in the INDIA-WORKS Study Öffentlichkeit
Badani, Almas (Spring 2024)
Abstract
Background: India has one of the highest prevalences of diabetes globally, posing a significant public health challenge. As a response, INDIA-WORKS was launched as a comprehensive worksite intervention program aimed reducing cardiometabolic risk factors associated among people with diabetes/prediabetes.
Problem Statement: To better assess the acceptability and impacts of the INDIA-WORKS intervention, there is a need to describe the reported uptake of diet changes and explore how gender, cultural attitudes, mental health, and social gatherings might have impacted diet changes.
Methods: Eligible participants including worksite managers, peer educators, program ‘completers,’ program ‘dropouts,’ and implementation team members participated in in-depth interviews (IDI) and focus group discussions (FGD). As part of a thematic analysis, code development for all qualitative data was conducted by the researcher team. For this analysis, we reviewed coded segments for pertinent codes, Gender, Cultural Attitudes, Social Gatherings, and Mental Health, and created thick descriptions of the coded data. Structured comparisons of the data comparing different interviewee types was done to look for variability across stakeholder groups.
Results: Cultural attitudes, mental health, social gatherings, and gender strongly influenced diet changes and motivation in INDIA-WORKS, as well as the ability to engage in the program. Intervention participants, both those who completed the program and program dropouts, reported on their personal uptake of the program and what made behavior change successful in addition to different barriers that may have negatively impacted their success in the program. Worksite managers, peer educators, INDIA-WORKS staff members, and implementation team members spoke on their experiences as well.
Conclusion: Integration of social determinants of health, such as the cultural attitudes, gender, mental health, and social gatherings shows the importance of understanding the interplay between social and environmental factors that shape the experiences of participants in the INDIA-WORKS program and how this study can be used in more populations.
Table of Contents
Chapter I: Introduction 1
Introduction and Rationale 1
Problem Statement 2
Purpose Statement 2
Significance Statement 2
Chapter II: Review of Literature 3
Diabetes and Prediabetes 3
Diabetes in India 3
Evidence Based Lifestyle Interventions 5
Interventions Specific to Indians and South Asian 7
Current Literature on Worksite Interventions 9
INDIA-WORKS 12
Research Question 13
Chapter III: Methods 14
Participants 14
In-Depth Interviews and Focus Group Discussions 15
Data Analyses 15
Chapter IV: Results 17
Mental Health 17
Cultural Attitudes 20
Social Gatherings 22
Gender 25
Chapter V: Discussion 30
Key findings 30
Mental Health and Cultural Attitudes 30
Social Gatherings 32
Gender 33
Implications 35
Strengths and Weaknesses 38
Conclusions 40
Chapter VI: References 41
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