Table 4.

Implications for Diabetes Prevention

Issue/Perception Identified	Intervention Action Required
Healthy eating is expensive and often means salads	• Teach what healthy eating actually is with specific demonstrations and examples. • Emphasize portion measurement skills and use motivational interviewing for portion control, which is cost saving.
Fast food is more available and convenient	• Teach skills for making good food choices when eating out or buying fast foods, e.g., healthier options, portion control. • Use motivational interviewing to change frequency of eating fast foods, reduce portions, or make different, but cost neutral food choices.
Incongruity of traditional food preferences and readily available fast foods	• Teach skills for healthier preparation of traditional foods as opposed to replacing traditional foods, e.g., substituting lard with healthier alternatives (cost neutral).
Exercise has negative connotations; exercise recommendations not taken seriously	• Focus on incorporating an increase of “physical activity” within usual daily activities. • Reinforce that physical work is good for your health; monitor baseline physical activity levels to determine and give credit for physical activity that people are already getting at worksite or during work in the home. • Support the desire for exercises that can be done at home by engaging in simple exercises during the group classes. • Teach ways to increase physical activity at home and at work. • Invite a family member to group sessions and involve the family member in recommended exercise strategies.
Desire for personalized dietary instructions	• Teach menu planning skills using food models and giving specific examples of food plans. • Review and offer feedback on planned vs. implemented menus.
Promotoras as support, but not as program instructors	• Health workers (promotoras) should be hired for program support activities, e.g., keeping attendance, preparations for and assisting with food demonstrations, distributing program materials, providing transportation when necessary, making weekly reminder telephone calls, etc.
Support from men tend to be limited	• Invite spouses to project meetings. • Teach healthier preparation of favorite recipes that will satisfy family members. • Teach physical activities/exercises that can be done in the home.
Family involvement	• Invite family members to project meetings. • Hold food taster session(s) where all family members are invited to test traditional foods prepared the conventional way versus a healthier way.