Introduction: Patients of low socioeconomic status (SES) are disproportionately affected by chronic disease, which can often be prevented or treated with healthy lifestyle interventions. Identifying factors preventing healthy lifestyle changes for low SES patients could facilitate the provision of effective counseling to lower their disease burden.
Methods: Undergraduate students at the Washington University in St. Louis trained in motivational interviewing and nutrition counseled uninsured clinic patients on healthy lifestyle changes. The students documented the patients’ perceived barriers to making healthy lifestyle changes, and transtheoretical model (TTM) stage of change for making lifestyle changes. The primary barriers perceived by patients were categorized and analyzed for differences in demographics and TTM stages of change.
Results: Barriers to lifestyle change fell into three categories: health-related, structural (i.e., related to cost, time, or transportation), and information limitations (i.e., limited understanding of healthy diet or how to prepare healthy meals). Overall, the patients (n=64) were most likely to report structural factors; however, Latinx patients were more likely to report information limitations than other patients (OR = 4.2273, 95% CI 1.37-13.07). Patients with information limitations were more likely to be in an earlier TTM stage of change (OR = 3.257, 95% CI 1.012 – 10.485).
Impact: Uninsured clinic patients most often perceived structural factors as their main barrier to making healthy lifestyle change, but Latinx patients were more likely to report informational limitations. Provision of educational nutrition resources to Latinx communities, including Spanish-translated information and healthy culturally relevant foods, should be explored.
Organization – Washington University in St. Louis
Lineback K, Ramesh R, Li J, Change R, Walker K, Linares N, Shi V, Payne C, Kesaraju R, Gaona-Romero A, Naceanceno K, Cruz-Bravo P