Abstract

This study aims to investigate food insecurity, attitudes toward sodium-restricted diets, and mental health outcomes among Filipino-Americans with hypertension in a primary care setting.1,2 Additionally, it seeks to explore patient perceptions of dietary restrictions and how nurse practitioners can use this information to enhance clinical management.3,4

A two-phase, mixed-methods approach was employed. In Phase 1, a cross-sectional study was conducted, recruiting a sample of 135 Filipino-American adults with hypertension from a primary care clinic in Southern Nevada. Data collection tools included demographic surveys, the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the Dietary Sodium Restriction Questionnaire (DSRQ), and a food insecurity (FI) questionnaire. Phase 2 involved a qualitative inquiry with a subset of 24 participants from the original sample, using semi-structured interviews conducted in three focus groups. Qualitative data were analyzed using NVivo software.

Statistically significant differences were observed in mental health, general health, and dietary adherence between those experiencing food insecurity and those who were not. Participants without food insecurity reported significantly higher mean mental health scores (t-test: 62.48 vs. 39.49; p < 0.001) and general health scores (t-test: 69.19 vs. 59.14; p = 0.007) compared to their food-insecure counterparts. Moreover, adherence to a sodium-restricted diet was notably better among those without food insecurity (t-test: 20.76 vs. 14.83; p = 0.043). The focus groups revealed themes related to food affordability and inflation, access to cultural foods, and the perception of food as medicine.

The findings suggest that food insecurity significantly impacts mental health and dietary adherence in Filipino-Americans with hypertension. Addressing food insecurity may reduce the prevalence of anxiety and depression, thereby improving overall health outcomes. Understanding the directionality of the relationship between adherence and mental health is critical.5 If food insecurity leads to poor mental health, interventions targeting food security could improve mental health outcomes. Conversely, if poor mental health exacerbates food insecurity, mental health interventions should incorporate food security considerations.

Notes

References:

1. Cain KS, Meyer SC, Cummer E, et al. Association of food insecurity with mental health outcomes in parents and children. Academic Pediatrics. 2022;22(7):1105-1114.

2. Charchar FJ, Prestes PR, Mills C, et al. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. Journal of hypertension. 2024;42(1):23-49.

3. Runkle NK, Nelson DA. The silence of food insecurity: disconnections between primary care and community organizations. Journal of patient-centered research and reviews. 2021;8(1):31.

4. Jordanova KE, Suresh A, Canavan CR, et al. Addressing food insecurity in rural primary care: a mixed-methods evaluation of barriers and facilitators. BMC Primary Care. 2024;25(1):163.

5. Beltrán S, Pharel M, Montgomery CT, Lopez-Hinojosa IJ, Arenas DJ, DeLisser HM. Food insecurity and hypertension: a systematic review and meta-analysis. PloS one. 2020;15(11):e0241628.

Description

This study examines the link between food insecurity, mental health, and adherence to a sodium-restricted diet in Filipino-Americans with hypertension . A mixed-methods approach with 135 survey participants and 24 focus group participants found that food insecurity was associated with poorer mental health and lower dietary adherence. Themes included food affordability, cultural food access, and viewing food as medicine. Addressing food insecurity may improve health outcomes in this population.

Author Details

Reimund Serafica, Ph.D., PMHNP-BC, CNE, FTNSS, FAAN

Sigma Membership

Zeta Kappa at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Mixed/Multi Method Research

Keywords:

Primary Care, Public and Community Health, Implementation Science

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

Share

COinS
 

Food Insecurity, Sodium-Restricted Diet Adherence, and Mental Health in Patients with Hypertension

Seattle, Washington, USA

This study aims to investigate food insecurity, attitudes toward sodium-restricted diets, and mental health outcomes among Filipino-Americans with hypertension in a primary care setting.1,2 Additionally, it seeks to explore patient perceptions of dietary restrictions and how nurse practitioners can use this information to enhance clinical management.3,4

A two-phase, mixed-methods approach was employed. In Phase 1, a cross-sectional study was conducted, recruiting a sample of 135 Filipino-American adults with hypertension from a primary care clinic in Southern Nevada. Data collection tools included demographic surveys, the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the Dietary Sodium Restriction Questionnaire (DSRQ), and a food insecurity (FI) questionnaire. Phase 2 involved a qualitative inquiry with a subset of 24 participants from the original sample, using semi-structured interviews conducted in three focus groups. Qualitative data were analyzed using NVivo software.

Statistically significant differences were observed in mental health, general health, and dietary adherence between those experiencing food insecurity and those who were not. Participants without food insecurity reported significantly higher mean mental health scores (t-test: 62.48 vs. 39.49; p < 0.001) and general health scores (t-test: 69.19 vs. 59.14; p = 0.007) compared to their food-insecure counterparts. Moreover, adherence to a sodium-restricted diet was notably better among those without food insecurity (t-test: 20.76 vs. 14.83; p = 0.043). The focus groups revealed themes related to food affordability and inflation, access to cultural foods, and the perception of food as medicine.

The findings suggest that food insecurity significantly impacts mental health and dietary adherence in Filipino-Americans with hypertension. Addressing food insecurity may reduce the prevalence of anxiety and depression, thereby improving overall health outcomes. Understanding the directionality of the relationship between adherence and mental health is critical.5 If food insecurity leads to poor mental health, interventions targeting food security could improve mental health outcomes. Conversely, if poor mental health exacerbates food insecurity, mental health interventions should incorporate food security considerations.