Identification of Facilitators and Barriers of Healthy Living and Type 2 Diabetes Prevention Among Latinx Families

Public Significance Statement This qualitative focus groups study explored barriers/facilitators of healthy living and type 2 diabetes (T2D) prevention preferences reported by Latinx adolescents/parents. Themes revealed a successful intervention should incorporate the family, include stress/depression management, build on adolescents' foundation of healthy attitudes/behaviors and support their autonomy, and address accessibility issues like food insecurity. This qualitative focus group study explored Latinx adolescents'/parents' beliefs, attitudes, and behaviors to delineate considerations for healthy living and diabetes prevention. Results address a gap in the scientific literature by identifying knowledge about barriers and facilitators to health, and program preferences needed for evidence-based, culturally tailored interventions for Latinx youth at risk of developing T2D. Youth-onset type 2 diabetes (T2D) is on the rise and may be associated with more adverse health outcomes than adult onset. Latinx adolescents are disproportionately at risk for T2D yet are underrepresented in prevention efforts. Extant interventions to prevent T2D in Latinx adolescents show limited effectiveness. Comprehensive understanding of Latinx adolescent/family needs is lacking, but necessary for cultural tailoring of T2D prevention. Researchers conducted focus groups with 32 Latinx adolescents (age 10-18 years) from Northern Colorado and 31 Spanish-speaking parents/caregivers, with 2.5-hr semistructured youth-specific and parent-specific discussions, respectively. No participants included in this study had T2D. Qualitative data were analyzed for emergent themes about barriers/facilitators of healthy living and T2D prevention preferences. Thematic content analysis yielded eight themes within three categories: barriers to healthy living, facilitators of healthy living, and program preferences. Barriers to healthy living included individual motivational factors/food preferences; financial cost and time demands of healthy eating/exercise; negative emotions; and external/relational factors such as parent feeding pressure and peer pressure/bullying. Facilitators of healthy living included individual motivational factors/enjoyment of healthy living and supportive family structure. Program preferences were for family-based programming with adolescent breakout sessions and for facilitation by culturally competent facilitators. T2D is recognized as a serious health concern among Latinx families. There is a need for culturally tailored prevention programming that, in order to be acceptable, should address cultural and socioeconomic considerations, provide coping skills for adolescent-specific psychosocial stressors, and utilize a family-based programming framework with adolescent breakout sessions and culturally competent facilitators.