Community-driven approach to promoting healthy culturally tailored diets and cardiometabolic health among East African immigrants in San Diego: a community case study

The East African immigrant community in San Diego has proactively sought multi-generational, nutrition-focused strategies for the prevention and management of cardiometabolic disease. Existing studies on Somali immigrants in the U.S. Midwest document elevated rates of diabetes (4.5-21.1%), overweight/obesity, and dyslipidemia, while qualitative evidence indicates that dietary acculturation, particularly within the first decade of migration, is associated with decreased consumption of traditional foods and increased exposure to sodium- and sugar-dense processed foods. This community case study describes the long-standing community-academic partnership between United Women of East Africa Support Team (UWEAST) and the University of California, San Diego Herbert Wertheim School of Public Health Anderson Lab, operationalized through the Healthy Eating with Spices and Herbs to Manage Hypertension (HAWAASH) research project series and formative phase of HAWAASH2. Guided by Community Based Participatory Research (CBPR) and community-driven research principles, the partnership prioritized social participation, empowerment, and capacity building through shared governance, community-led recruitment, multilingual engagement strategies, and culturally responsive implementation practices. Using a convenience sampling approach with an iterative mixed-methods formative design, 60 community members and seven key informants contributed to shaping the design of a future culturally tailored nutrition intervention. Activities were conducted at the UWEAST community hub in City Heights, San Diego. Grounded theory-guided thematic analysis identified five themes from community member interviews and four themes from key informant interviews, encompassing cultural food identity, structural barriers to healthy eating, dietary acculturation experiences, community social assets, and readiness for nutrition programming. This case study highlights practical strategies, lessons learned, and contextual constraints relevant to advancing equitable, community-driven nutrition initiatives among underrepresented immigrant populations. Detailed findings on measurement tool acceptability and proof-of-concept intervention plausibility are reported in companion manuscripts.