Culturally tailored steatotic liver disease management: Latino and Asian community partner perspectives and recommendations.

Background: Lifestyle modification is the mainstay of treatment for steatotic liver disease (SLD), and recommendations for behavior change require cultural tailoring to enhance their relevance for minority populations. This study aimed to explore community partner perspectives on barriers and facilitators to lifestyle modification and identify ways to improve cultural sensitivity for SLD management.

Methods: We conducted semi-structured interviews with 20 community partners (public health professionals, community leaders, and health care workers) from Latino (n=9) and Asian (n=11) communities in San Francisco. Interviews explored community knowledge of SLD, perceived barriers and facilitators to lifestyle changes, and feedback on current education materials. Data were analyzed using thematic analysis.

Results: Across 4 levels of influence (societal, community, interpersonal, and individual), 9 shared barriers and 6 shared facilitators emerged. Barriers included poverty, misinformation, social influences, time constraints, and limited nutrition and SLD knowledge, while facilitators included free outdoor spaces, food assistance programs, healthy cultural habits, and family. The Asian community uniquely cited safety concerns for outdoor activities and preference for Eastern medicine, while the Latino community expressed childcare constraints as barriers. We gathered 9 recommendations to improve the cultural sensitivity of lifestyle modification guidance, including working within traditional dietary frameworks, adapting exercise to activities of daily life, and embracing harm reduction for alcohol cessation.

Conclusions: Culturally tailored interventions may improve the relevance and sustainability of SLD lifestyle modification recommendations in Latino and Asian communities. Recommendations for interventions include harnessing community-based support, embracing cultural dietary modifications, and promoting feasible physical activity to enhance engagement in these populations.