Co-designing roadmaps for promoting culturally relevant food in long-term care homes for the African, Caribbean and Black populations in Canada: a multi-method, participatory action research study protocol

BACKGROUND: Access to culturally relevant foods is essential to aging well, particularly for Canadians from ethno-cultural minority groups, including African, Caribbean, and Black communities. Food insecurity is defined as inadequate or unreliable access to affordable, safe, and nutritious food that meets one's needs and preferences. While food insecurity is often framed primarily in economic terms, with limited attention to culturally appropriate food access, it is also closely linked to systemic inequities shaped by policy-making and institutional barriers that ultimately affect dietary intake, mealtime experiences, and overall health among ethnocultural minority groups. In the Canadian long-term care sector, food insecurity is exacerbated among African, Caribbean, and Black residents due to limited access to culturally congruent food options within care environments designed to accommodate the ethnic majority. This project will develop roadmaps to promote healthy aging among African, Caribbean, and Black residents in long-term care homes through culturally relevant food provision as part of resident-centered care. METHODS: We will use a community-based research approach guided by an intersectionality framework and a Community Advisory Council. The study includes a policy analysis of legislation, policies, and regulations shaping food provision in long-term care homes, supplemented by interviews with policy and decision-makers. Focus groups with key informants in food, aging, or long-term care will identify opportunities for change at organizational and governance levels. Ethnographic site visits to community-based food programs in three Canadian provinces-Alberta, Ontario, and Quebec-will explore how social and cultural factors influence food sourcing, preparation, and provision. Interviews with long-term care stakeholders will examine how promising community practices may be adapted to institutional settings. Finally, we will co-create and share roadmaps to support culturally safe food services and programming for African, Caribbean, and Black residents in long-term care. DISCUSSION: This equity-focused project aims to increase access to culturally relevant foods in long-term care as part of resident-centered care for African, Caribbean, and Black communities, and contributes to broader efforts to decolonize long-term care through culturally safer and more responsive care for people living in institutional settings.