Title:

Opportunities to Improve Nutrition Access in Hispanic/ Latino Communities with Multi-Level, Cultural-Tailored Approaches

Background: US Hispanics/Latino communities face limited access to nutritious foods, leading to high rates of chronic disease and food insecurity. Current nutrition access programs in New Hampshire incorporate minimal cultural tailoring and have not adapted to the rising Hispanic/Latino population. Multi-level approaches, which target systemic, social, and individual health influences, have been effective at improving nutrition access in vulnerable populations, and are warranted in NH Hispanic/Latino communities. Therefore, assessing opportunities for multi-level, culturally-tailored interventions can help address food insecurity and chronic disease in Hispanics/Latinos in NH and the US. Objective: To identify barriers and opportunities for multi-level, culturally-tailored interventions that increase nutrition access in NH Hispanic/Latino communities. Study Design, Settings, Participants: This cross-sectional qualitative study consisted of six semi-structured focus group discussions conducted over Zoom. The participants included representatives from the food system (n=5), public health (n=3), community-based/ nonprofit (n=6), and community nutrition education (n=6) sectors. Measurable Outcome/Analysis: Participants were asked to reflect on barriers and opportunities in their work pertaining to cultural tailoring of their nutrition access programs. Zoom audio recordings were transcribed verbatim and coded using inductive thematic analysis, which led to the identification of overarching themes. Data were managed using NVivo12 software. Results: Themes related to cultural tailoring emerged within three categories: Current Practices, Barriers, and Concerns. Current practices included “expanding existing program offerings” and “seeking partnerships.” The barriers that emerged were “limited capacity,” “low workplace competence,” and “low demand.” Additionally, there were concerns that program-wide cultural tailoring practices may suggest homogeneity within a population and interfere with efforts to support clients individually. Conclusion: The current practices, barriers, and concerns identified in this qualitative study should be considered to enhance nutrition access among Hispanic/Latino adults. These findings may guide nutrition access stakeholders to take steps towards multi-level, culturally-tailored practices to address chronic disease and food insecurity in the NH Hispanic/Latino population. These findings also revealed opportunities for cross-sector collaboration, further supporting the feasibility of multi-level solutions.

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