Abstract
Introduction: Punjabi Sikhs are disproportionally affected by chronic diseases in the United States. Public health interventions such as MyPlate have failed to reach marginalized groups due to cultural and linguistic barriers. Given the absence of a formal adaptation or translation of MyPlate in Punjabi, this study aimed to develop a culturally adapted MyPlate visual tool for the Punjabi Sikh community of Greater Sacramento area.
Methods: Employing a mixed methods research design, the study consisted of two phases informed by the cultural adaptation process. In Phase 1, a quantitative survey was administered to a convenience sample of 36 Punjabi Sikh adults from a local Sikh Temple to assess barriers to adhering to the USDA MyPlate. Descriptive analyses of key variables informed the initial adaptation of MyPlate in Phase 2, followed by two rounds of qualitative interviews with nine Punjabi Sikh adults. Interview data was analyzed through an iterative process by continuously revising the adaptation and then finalizing the tool.
Results: Survey results revealed that key barriers to MyPlate adherence were that 53% of participants ate their meals in a plate & bowl combination and 64% of participants consumed Punjabi food daily. Additionally, 42% preferred the Punjabi language for nutrition & health education and 67% recommended showcasing examples of cultural food sources for each food group to make MyPlate easier to comprehend. Findings from Phase 1 informed the preliminary adaptation design of the MyPlate visual. Feedback from interviews emphasized simplifying text, integrating color coding to highlight the connection to the original MyPlate, and including an animal-based protein in the visuals. This iterative process led to the development of the Healthy Punjabi Plate, a five-page, double-sided visual tool featuring five digital photographs of traditional Punjabi meals, bilingual text, and a list of culturally relevant foods for each food group.
Conclusion: The Healthy Punjabi Plate addresses the dietary preferences and cultural needs of the Punjabi Sikh community of Greater Sacramento area. Future research should evaluate this tool’s effectiveness in promoting dietary change and consider it as a potential model for adapting MyPlate for other racial and ethnic communities.