Cultural models of CVD risk factors: Understanding diet change and changing diets in St. Lucia

Chronic disease is on the rise in middle income countries like St. Lucia which is undergoing epidemiological and nutritional transitions.  Cardiovascular disease is currently the number one cause of death in St. Lucia and associated risk factors like obesity are increasing in the population. An estimated 74% of St. Lucians are overweight or obese. Reducing CVD requires understanding how socio-cultural contexts shape lifestyle choices and behaviors. This study centers on a fundamental research question in public health which is to explain how culturally based beliefs and practices may increase risk for CVD. Cultural models represent shared understandings that guide health behaviors.  Focus groups using photovoice were conducted in St. Lucia with 15 participants in order to elicit cultural beliefs, perceptions, and practices concerning CVD risk factors. The data were coded inductively and prominent themes were organized and analyzed using NVivo. Group participants identified the changing diet of St. Lucians as one of the most important risk factors for CVD. They also identified it as the easiest factor to change. However, with costs of fish, fruits and vegetables rising, eating these more traditional foods is considered prohibitively expensive.

Study results will be used to construct a culturally-informed survey to be disseminated widely in St. Lucia. Although this study focuses on the local context in St. Lucia, its methods and perspectives can be used to consider how cultural beliefs shape health behaviors in other populations around the world and the US.