Development and assessment of a culturally tailored dietary intervention for adolescent obesity

Thesis Abstract

The rising prevalence of adolescent obesity poses significant public health challenges worldwide, necessitating culturally sensitive interventions tailored to the unique dietary behaviors and socio-cultural contexts of diverse populations. This study aimed to develop and empirically assess a culturally tailored dietary intervention to promote healthy eating and reduce obesity among adolescents. The specific objectives were to identify cultural dietary practices influencing adolescent nutrition, design an intervention integrating these cultural elements, evaluate its effectiveness on dietary behaviors and anthropometric measures, and explore participants’ perceptions of its relevance and acceptability. Employing a mixed-methods research design, the study combined a quasi-experimental approach with qualitative components. The quantitative phase involved a sample of 300 adolescents aged 12–17 years from two secondary schools, randomly assigned to intervention and control groups, with 150 participants in each. The qualitative component comprised focus group discussions and in-depth interviews with 30 students, parents, and key community stakeholders to contextualize cultural dietary preferences and barriers. Data collection instruments included a structured dietary assessment questionnaire, standardized anthropometric measurement protocols, and interview guides. The intervention was developed based on the Social Cognitive Theory and the Cultural Dimensions Theory, ensuring that cultural norms, beliefs, and practices were integrated into dietary messaging and activities. The intervention group received a 12-week culturally tailored nutritional education program, while the control group continued with standard dietary advice. Quantitative data were analyzed using descriptive statistics, paired t-tests, and Analysis of Covariance (ANCOVA) to assess differences within and between groups concerning dietary intake patterns, body mass index (BMI), and waist circumference. Qualitative data underwent thematic analysis using NVivo software to extract key themes related to cultural relevance, acceptability, and perceived impact of the intervention. The study hypothesized that participants exposed to the culturally tailored program would demonstrate statistically significant improvements in dietary quality, reductions in BMI and waist circumference, and higher satisfaction and engagement levels compared to controls. Expected findings indicate that the culturally tailored intervention will lead to a significant increase in the consumption of healthy traditional foods, reduced intake of high-calorie processed foods, and meaningful anthropometric improvements. Participants are anticipated to report increased confidence in making healthy dietary choices within their cultural context. The qualitative insights are expected to reveal the importance of cultural appropriateness in behavioral change and identify facilitators and barriers to sustainable dietary modifications. This research contributes novel evidence demonstrating the effectiveness of culturally tailored dietary interventions in pediatric obesity management, bridging an important gap in existing nutrition programs predominantly based on generalized guidelines. It advances theoretical understanding by applying and testing the Cultural Dimensions Theory and Social Cognitive Theory within an adolescent population. The study offers practical insights for clinicians, educators, and policymakers to design culturally sensitive programs that resonate with adolescents’ lifestyles and beliefs, thereby improving engagement and outcomes. The main conclusion underscores the efficacy of integrating cultural elements into dietary interventions for adolescent obesity, emphasizing the importance of community and family involvement in reinforcing behavioral change. Recommendations include scaling up culturally tailored programs across diverse settings, incorporating family-centered approaches, and conducting longitudinal studies to evaluate long-term sustainability. Future research should explore digital adaptations of such interventions and their impact across different cultural groups to enhance the generalizability and reach of culturally responsive nutritional strategies.