title: A multilevel assessment of barriers to adoption of Dietary Approaches to Stop Hypertension (DASH) among African Americans of low socioeconomic status.
abstract: BACKGROUND
  We examined perceptions of Dietary Approaches to Stop Hypertension (DASH) and the food environment among African Americans (AA) with high blood pressure living in two low-income communities and objectively assessed local food outlets.
  
  
  METHODS
  Focus groups were conducted with 30 AAs; participants discussed DASH and the availability of healthy foods in their community. Sessions were transcribed and themes identified. Fifty-four stores and 114 restaurants were assessed using the Nutrition Environment Measures Survey (NEMS).
  
  
  RESULTS
  Common themes included poor availability, quality, and cost of healthy foods; tension between following DASH and feeding other family members; and lack of congruity between their preferred foods and DASH. Food outlets in majority AA census tracts had lower NEMS scores (stores: -11.7, p=.01, restaurants: -8.3, p=.001) compared with majority White areas.
  
  
  CONCLUSIONS
  Interventions promoting DASH among lower income AAs should reflect the food customs, economic concerns, and food available in communities.
authors.affiliation: Division of Public Health Sciences, Wake Forest University School of Medicine, USA. abertoni@wakehealth.edu
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
authors.forename: Capri G
authors.initials: CG
authors.lastname: Foy
authors.forename: Jaimie C
authors.initials: JC
authors.lastname: Hunter
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.forename: Melicia C
authors.initials: MC
authors.lastname: Whitt-Glover
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D004032:Diet / Q000523:psychology; D004041:Dietary Fats; D005260:Female; D017144:Focus Groups; D005502:Food / Q000191:economics; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000208:ethnology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D012111:Residence Characteristics; D012147:Restaurants; D012931:Social Environment; D012959:Socioeconomic Factors; D014675:Vegetables
chemical_list: D004041:Dietary Fats
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