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How Do African-American Caregivers Navigate a Food Desert to Feed Their Children? A Photovoice Narrative

      Abstract

      Objectives

      To determine how African-American caregivers living in a food desert navigate neighborhood resources to procure foods for their children and to identify actions to improve those resources.

      Design

      Using the Photovoice approach, we conducted two sets of individual in-depth interviews with 16 African-American primary caregivers of children (total of 32 interviews) and one culminating workshop (n=10 participants). Data were systematically analyzed according to the Social Ecological Framework to evaluate the role of different environments in shaping individual decisions.

      Setting

      Urban, low-income and geographically marginalized neighborhoods.

      Results

      Despite the challenges of living in a food desert, caregivers perceived that they were providing the foods that they wanted for their children. These perceptions were based on their own health concerns, food customs, time and convenience, and responses to their children’s food preferences. Caregivers were resourceful in how they procured these foods, searching for quality and better-priced foods. They relied on their friends, family, and local/national programs to mitigate the challenges of the food desert. Caregivers were interested in taking action to improve the underlying determinants of food access and choice (eg, affordable housing, job training, nutrition knowledge, food shopping experience).

      Conclusion

      These African-American caregivers procured foods they thought were best for their children by relying on their strong social relationships and national and local food programs to navigate the food desert. Public health nutrition interventions that aim to reduce diet-related disparities should look beyond the presence or absence of supermarkets in food deserts to address multisectoral determinants of access while shaping food choices.

      Keywords

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      Biography

      U. Colón-Ramos is an assistant professor, Department of Global Health, Milken Institute of Public Health, George Washington University, Washington, DC.

      Biography

      S. Thurman is a research associate, Department of Global Health, Milken Institute of Public Health, George Washington University, Washington, DC.

      Biography

      R. Monge-Rojas is an investigator, Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Rios, San Jose, Costa Rica.

      Biography

      T. R. Stevenson is the CEO and founder of Women Advancing Nutrition, Dietetics, and Agriculture (WANDA), Washington, DC.

      Biography

      At the time of the study, H. Burns was an undergraduate student, George Washington University, Washington, DC.

      Biography

      J. Gittelsohn is a professor, Department of International Health and Department of Health, Behavior and Society. Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD.

      Biography

      T. A. Gurman is research director, Department of International Health and Department of Health, Behavior and Society. Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD.