Use of qualitative methods to study diet, acculturation, and health in Chinese-American women

Improving the health status of minority populations in the United States is a major public health challenge. This report describes an anthropological approach to obtaining information needed for designing and evaluating a cul turally appropriate dietary intervention for Chinese-Americans. Ninety-minu te qualitative interviews were conducted with 30 less-acculturated Chinese- American women in their native language (Cantonese or Mandarin), soliciting information from participants regarding usual food consumption; knowledge, attitude, and beliefs about diet and disease; and factors that influence f ood choices. Inter-views were recorded, translated, transcribed, and coded for themes. Two focus groups with 6 participants each were conducted to cro ss-validate the interview findings. Among our participants, breakfast was u sually the first meal to be "Westernized," largely for reasons of convenien ce. Food quality, cost, and availability were some of the most important pr edictors of dietary change after immigration to the United States. Responde nts said that there was a strong connection between diet and disease. Howev er, they were not familiar with US dietary guidelines, food labels, or othe r sources of dietary information, but reported that friends and Chinese new spapers were their primary source of nutrition information. We used these f indings to develop quantitative dietary survey instruments adapted for Chin ese-Americans. This type of qualitative groundwork is an important precurso r to the design, implementation, and evaluation of dietary interventions fo r minorities.