{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:28:32Z","timestamp":1793320112455,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T00:00:00Z","timestamp":1635465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100001017","name":"California Community Foundation","doi-asserted-by":"publisher","award":["CMCH-14-111663"],"award-info":[{"award-number":["CMCH-14-111663"]}],"id":[{"id":"10.13039\/100001017","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["CTSI grant UL1TR000124"],"award-info":[{"award-number":["CTSI grant UL1TR000124"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Educ Behav"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>\n                    Patients report that adhering to diet is the most challenging aspect of diabetes management. Provision of diet education is often delegated to health care providers, despite a lack of nutrition education and training and limited awareness of environmental and cultural challenges faced by patients. Aim. We examined perceived barriers to diet self-management among low-income minority patients with type 2 diabetes and their health care providers within a single ecosystem, to test whether providers understood patient barriers. Method. We surveyed 149 members of a safety-net clinic (99 patients, 50 providers), using barriers derived from the literature. Binomial logistic regression was applied to investigate relationships between barriers and patients\u2019 sociodemographic variables and Pearson\u2019s \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    was used to compare differences in perceived barriers between patients and providers. Results. Providers expressed divergent perceptions of patients\u2019 barriers to healthy eating, including more total barriers and little agreement with patients on their relative importance. Largest differences in providers\u2019 perceptions of patient barriers included poor motivation, high use of fast food, inadequate family support, and lack of cooking skills\u2014all suggesting patient inadequacy. In contrast, patients showed evidence of high motivation\u2014in rate of blood glucose measurement and desire for diet education. Patients identified primary care providers as a main source of nutrition education, yet providers indicated lack of time for diet discussion and preferred other staff do the teaching. Conclusion. The findings from this study strongly suggest that health systems need to consider patient, provider, and system barriers when implementing nutrition education and management programs.\n                  <\/jats:p>","DOI":"10.1177\/10901981211052241","type":"journal-article","created":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T08:14:02Z","timestamp":1635495242000},"page":"658-666","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Barriers to Healthy Eating and Diabetes Diet Education: Divergent Perspectives of Patients and Their Providers"],"prefix":"10.1177","volume":"49","author":[{"given":"Rachelle","family":"Bross","sequence":"first","affiliation":[{"name":"Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1154-1921","authenticated-orcid":false,"given":"Pauline","family":"Genter","sequence":"additional","affiliation":[{"name":"Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Lu","sequence":"additional","affiliation":[{"name":"California State University Long Beach, Long Beach, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Serpas","sequence":"additional","affiliation":[{"name":"Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Campa","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Health Services, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Ipp","sequence":"additional","affiliation":[{"name":"Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"key":"bibr1-10901981211052241","doi-asserted-by":"publisher","DOI":"10.1111\/nbu.12320"},{"key":"bibr2-10901981211052241","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-Sint01"},{"key":"bibr3-10901981211052241","unstructured":"Baker E. A., Schootman M., Barnidge E., Kelly C. (2006). The role of race and poverty in access to foods that enable individuals to adhere to dietary guidelines. Preventing Chronic Disease, 3(3), A76. https:\/\/www.researchgate.net\/publication\/7006583_The_Role_of_Race_and_Poverty_in_Access_to_Foods_That_Enable_Individuals_to_Adhere_to_Dietary_Guidelines"},{"key":"bibr4-10901981211052241","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmv067"},{"key":"bibr5-10901981211052241","unstructured":"Bleich S. N., Dunn C. G. (2018). Better clinical care for obesity and diet-related diseases requires a focus on social determinants of health. NEJM Catalyst. https:\/\/catalyst.nejm.org\/doi\/full\/10.1056\/CAT.18.0057"},{"key":"bibr6-10901981211052241","doi-asserted-by":"publisher","DOI":"10.1017\/S1463423612000412"},{"key":"bibr7-10901981211052241","doi-asserted-by":"publisher","DOI":"10.1016\/j.nutres.2007.06.010"},{"key":"bibr8-10901981211052241","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1632"},{"key":"bibr9-10901981211052241","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2017.11.021"},{"key":"bibr10-10901981211052241","unstructured":"Centers for Disease Control and Prevention. (2017). National Diabetes Statistics Report, 2017. U.S. Department of Health and Human Services. https:\/\/dev.diabetes.org\/sites\/default\/files\/2019-06\/cdc-statistics-report-2017.pdf"},{"key":"bibr11-10901981211052241","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S94275"},{"key":"bibr12-10901981211052241","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.2.268"},{"key":"bibr13-10901981211052241","unstructured":"Covered California, California Health Benefit Exchange. (2016). Program eligibility by federal poverty level, plan year 2016. https:\/\/www.healthymendocino.org\/content\/sites\/mendocino\/Income_Guidelines_CoveredMendo_15-16.pdf"},{"key":"bibr14-10901981211052241","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2010.09.014"},{"key":"bibr15-10901981211052241","doi-asserted-by":"publisher","DOI":"10.4158\/CS-2017-0153"},{"key":"bibr16-10901981211052241","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.4.556"},{"key":"bibr17-10901981211052241","unstructured":"Kapur K., Kapur A., Ramachandran S., Mohan V., Aravind S. R., Badgandi M., Srishyla M. V. (2008). Barriers to changing dietary behavior. 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