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James Plumb, MD, MPH, Chair

Rickie Brawer, PhD, Committee

Ellis Owusu-Dabo, MD, PhD, Preceptor


This study aims to identify themes in food preferences, knowledge, attitudes and behaviors (KAB) among a mix of rural and urban Ghanaians in the greater Kumasi region; to inform health interventions targeting better patient management of type II diabetes in a rapidly urbanizing region of Ghana; and to inform social marketing strategies by providing insight into consumption patterns. Urban centers in Sub-Saharan Africa have been especially impacted by the persistence of infectious disease and accompanying rise in non-communicable disease prevalence, including type II diabetes. In fact, type II diabetes recently registered as tenth among top causes of death in Kumasi, Ghana. To develop effective intervention programs, the World Health Organization recommends more research to understand the relationship between food consumption and the escalation of non-communicable disease. In this qualitative study, focus groups and semi-structured, individual interviews were used to assess KABs of people with diabetes as well as caregivers responsible for food preparation of such individuals. Additionally, hospital-based health talks were observed, a hospital dietician was interviewed, and educational documents were collected. A Ghanaian research assistant facilitated interpretation throughout the study, and checked the transcripts for accuracy. Prior to analysis stage, themes were identified and coded using Nvivo software. Findings suggest that certain messages regarding sugar-sweetened foods, fats, use of Maggi seasoning and meal timing are understood and followed. However, some confusion appears to exist regarding the impact of certain fruits, food portioning, plantains and processed foods on health outcomes for diabetic patients. Results also revealed a problem-solving approach to increasing vegetable consumption, and a concern about unhealthy food preferences among younger generations. Recommendations include consistent messaging on portion size, impact of plantains and other fruit, and processed foods; a campaign to promote local vegetable consumption; and a research-informed prevention campaign targeting food preferences among younger generations.

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