About

Halimatou Alaofè is an Associate Professor at the Zuckerman College of Public Health, with expertise in diet, lifestyle, and behavioral interventions, focusing specifically on maternal, child, and adolescent health. Her research involves developing and evaluating community-based interventions, including culturally tailored Medical Nutrition Therapy and programs like the Solar Market Garden, which studies the effects of solar-powered irrigation on food security, nutritional status, and women's empowerment. She has also conducted a four-year trial addressing anemia among boarding adolescent girls in Benin and has developed dietary assessment methodologies for African and indigenous populations. Dr. Alaofè's work has been funded by international organizations, universities, and NIH grants. She has served as a Nutrition Research Advisor for the USAID Health Care Improvement Project, analyzing Zambia's national food consumption survey, and contributed to reports on agriculture's impact on nutrition. Her research interests include diet, lifestyle, and behavioral interventions within the context of global health, with a focus on maternal and child health outcomes.

Research topics

• Medicine
• Nursing
• Internal medicine
• Environmental health
• Psychiatry
• Psychology
• Pediatrics
• Surgery
• Gerontology
• Social psychology
• Endocrinology
• Clinical psychology
• Family medicine
• Emergency medicine

Selected publications

• Translation, Cultural Adaptation, and Psychometric Validation of the McMaster Family Assessment Device’s General Functioning Subscale: A Cross‐Sectional Study Among African Adults With Type 2 Diabetes

  Journal of Diabetes Research · 2026-01-01

  articleOpen access1st authorCorresponding

  BACKGROUND: Family functioning plays a critical role in diabetes self-management and glycemic control, yet validated tools for assessing family dynamics in Francophone African contexts remain limited. This study aimed to translate, culturally adapt, and psychometrically validate the French version of the Family Assessment Device-General Functioning Subscale (FAD-GF12) among adults with type 2 diabetes (T2D) in Benin. METHODS: A cross-sectional psychometric validation study was conducted among 512 adults with T2D recruited from six healthcare centers. Translation and cultural adaptation followed established guidelines, incorporating expert review and participant feedback. The sample was randomly split for exploratory factor analysis (EFA; n = 256) and confirmatory factor analysis (CFA; n = 256). Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients (ICCs). Construct validity was examined using linear regression (continuous hemoglobin A1C-HbA1C) and logistic regression (HbA1c ≤7%) models. RESULTS: The French FAD-GF12 demonstrated good internal consistency (α = 0.85) and satisfactory test-retest reliability (ICC > 0.75). EFA and CFA supported a two-factor structure distinguishing positive and negative family functioning, with good model fit (comparative fit index [CFI] = 0.94, Tucker-Lewis index [TLI] = 0.92, root mean square error of approximation [RMSEA] = 0.06, standardized root mean square residual [SRMR] = 0.04). The two factors were moderately correlated (r = 0.58), indicating related but distinct constructs. Better family functioning was significantly associated with lower HbA1c levels (β = -0.35, p = 0.003) and higher odds of good glycemic control (AOR = 2.04; 95% CI: 1.27-3.27; p = 0.004). CONCLUSIONS: The French FAD-GF12 is a reliable, valid, and culturally appropriate tool for assessing family functioning among adults with T2D in Benin. Its demonstrated association with glycemic control highlights the importance of integrating family-centered approaches into diabetes care in Francophone African settings.

  PublisherDOI

• Comparative Strategies of Medical Nutrition Therapy for Type 2 Diabetes Management in Western and African Contexts: A Scoping Review Protocol

  Open MIND · 2026-01-01

  otherOpen accessSenior author

  This research project is a scoping review that aims to map Medical Nutrition Therapy (MNT) strategies for type 2 diabetes mellitus (T2D) management across Western and African contexts. The review will synthesize evidence on the design, delivery, adaptation, and evaluation of MNT interventions for adults with T2D. The review will follow established scoping review methodology, including the framework proposed by Arksey and O’Malley and subsequent methodological refinements, as well as the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) reporting guideline. Eligibility criteria will be defined using the Population–Concept–Context (PCC) framework. The population includes adults with T2D, the concept focuses on MNT interventions, and the context includes Western and African settings. Literature searches will be conducted in multiple databases, including PubMed, Embase, CINAHL, Scopus, CABI Global Health, and African Journals Online, supplemented by grey literature and citation searching. Studies and program reports published between 2000 and 2025 will be included. Data will be charted using a framework-informed extraction form based on the Consolidated Framework for Implementation Research (CFIR) and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Synthesized findings will be presented using descriptive mapping, thematic analysis, and comparative evidence matrices. The study will map intervention types, compare key characteristics of MNT strategies, summarize methods used to assess dietary adherence, clinical and implementation outcomes, and identify contextual barriers, facilitators, and knowledge gaps to support future research and culturally appropriate MNT program development.

  PublisherDOI

• Perceptions of Obesity and Weight-Related Behaviors Among Adults With Type 2 Diabetes in Benin

  Journal of Nutrition Education and Behavior · 2026-03-01

  articleOpen access1st authorCorresponding

  OBJECTIVE: To explore body size perceptions, awareness of obesity-related risks, and weight loss willingness among adults with type 2 diabetes (T2D) in Cotonou, Benin. DESIGN: A descriptive qualitative study involving 4 focus group discussions. PARTICIPANTS: Forty-two purposively selected adults with T2D aged 40-65 years. PHENOMENON OF INTEREST: Perception of body size, obesity awareness, and willingness to lose weight. ANALYSIS: Data were thematically analyzed using MAXQDA 2020 and interpreted with the Prototype Willingness Model. RESULTS: Five themes emerged. Participants demonstrated limited awareness of obesity causes and related health risks. Cultural norms linking larger body sizes-especially for women-to health, fertility, respect, and social status shaped preferences and self-perceptions. Many overweight participants underestimated their body size. Men frequently preferred overweight female figures, whereas women favored normal to overweight male figures. Despite recognizing some health consequences, participants described challenges to weight loss, including sociocultural pressures, limited access to exercise opportunities, and insufficient counseling. CONCLUSIONS AND IMPLICATIONS: Findings provide insight into how adults with T2D in Benin perceive overweight and obesity. This work supports the need to develop and test culturally appropriate, weight-neutral community interventions to improve health literacy and promote healthier lifestyle behaviors.

  PublisherOA PDFDOI

• Development of a culturally tailored medical nutrition therapy to improve dietary adherence in type 2 diabetes in Benin: an ORBIT model-based protocol

  Frontiers in Nutrition · 2026-03-06

  articleOpen access1st authorCorresponding

  Background Dietitian-led medical nutrition therapy (MNT) is an effective and cost-efficient strategy for improving dietary adherence and glycemic control in adults with type 2 diabetes (T2D). However, culturally adapted MNT interventions that account for local food systems, food security, and sociocultural eating practices remain scarce in African contexts. This paper describes the development of Objectif Santé Diabète Bénin (OSanDiaBé), a culturally tailored, dietitian-led MNT intervention designed to improve dietary adherence and glycemic control among adults with T2D in Benin, West Africa, using the Obesity-Related Behavioral Intervention Trials (ORBIT) model. Methods To design OSanDiaBé, we use a hybrid framework integrating the ORBIT model with ecological validity and cultural adaptation approaches. In Phase Ia (Define), we developed a theory-driven model to identify key behavioral targets and hypothesized pathways linking a culturally tailored MNT intervention to dietary adherence and glycemic control. Phase Ib (Refine) involved adapting and refining an MNT intervention that combines evidence-based menu plans grounded in the 4A food security framework with individual nutrition counseling and group diabetes education. Intervention refinement was informed by mixed-methods data collected from 512 adults with T2D, including quantitative assessments, focus group discussions, sensory evaluations, and a stakeholder workshop, to enhance feasibility, acceptability, and cultural relevance. Expected outcomes Phase II will evaluate feasibility, acceptability, and preliminary signals of effectiveness, including dietary adherence and glycemic control (HbA1c), prior to planned Phase III efficacy and Phase IV effectiveness trials. Conclusions OSanDiaBé offers a replicable framework for culturally tailoring MNT interventions in low-resource settings. By integrating food security, culturally relevant dietary guidance, and family-centered nutrition support, this approach has the potential to strengthen diabetes nutrition care and reduce inequities in access to effective MNT across African contexts.

  PublisherOA PDFDOI

• Developing and validating a HEalthCare NAvigation Competency (HECNAC) Scale for refugees in the United States

  PLoS ONE · 2025-01-30 · 2 citations

  articleOpen accessSenior authorCorresponding

  The complex healthcare system in the United States (US) poses significant challenges for people, particularly minorities such as refugees. Refugees often encounter additional layers of challenges to healthcare navigation due to unfamiliarity with the system, limited health literacy, and language barriers. Despite their challenges, it is difficult to identify the gaps as few tools exist to measure navigation competency among this population and many conventional tools assume English proficiency, making them inadequate for refugees and other immigrants. To address this gap, this study developed and validated a HEalthCare NAvigation Competency (HECNAC) Scale tailored to refugees' needs. The scale development process followed three phases: domain identification through a literature review and stakeholder interviews (n = 15), content validation through the Delphi method (2 rounds, n = 12), and face validity assessment via cognitive interviews (2 rounds, n = 4). Based on a literature review and stakeholder interviews, the initial version of the scale was developed, including ten domains and 47 items. An introductory email concerning the scale and the Delphi process was subsequently sent to 21 eligible experts, including staff from refugee resettlement agencies, health care providers serving refugee communities, and refugees. Twelve experts completed the two rounds of the Delphi, resulting in a consensus on 39 items. After conducting cognitive interviews with 4 Afghan refugees, the scale was finalized with ten domains and 35 items. The finalized scale captures multifaceted aspects of healthcare navigation crucial for refugees, organized into domains such as health system knowledge, insurance, making an appointment, transportation, preparing for a visit, in the clinic, interpretation, medicine, medical bills, and preventive care. Overall, the HECNAC Scale represents a significant step towards understanding and assessing refugees' competencies in navigating the US healthcare system. It has the potential to guide tailored interventions and standardized training curricula and ultimately mitigate persistent barriers faced by refugees in accessing healthcare services.

  PublisherDOI

• EE501 Cost-Effectiveness Analysis of Screening for Cervical Lesion and Diagnosis and Treatment of Cervical Cancer In Nigeria

  Value in Health · 2025-07-01 · 1 citations

  article
  PublisherDOI

• Knowledge, attitude, and practice regarding type 2 diabetes and associated factors among rural adolescents in Indonesia: A cross-sectional study

  medRxiv · 2025-09-28

  preprintOpen accessSenior author

  Abstract Background Type 2 diabetes (T2D) is increasingly affecting adolescents globally, yet there is limited evidence on their knowledge, attitudes, and practices (KAP) regarding the disease, which is essential for promoting preventive strategies. This study aims to evaluate KAP levels among adolescents, particularly in rural Indonesia, and identify factors associated with these outcomes. Methods A cross-sectional study was conducted in Kampar Regency, Riau Province, Indonesia, from September 2024 to February 2025. The study involved 1,546 senior high school students, who were selected through multistage cluster sampling. Data were collected using a validated KAP questionnaire. Descriptive statistics were used to summarize the levels of KAP, while multivariable binary logistic regression identified associated factors. Results About 70.6%, 70.3%, and 74.6% of participants showed good knowledge, positive attitudes, and good practices related to T2D. Higher likelihoods of good knowledge were linked to being female (AOR = 1.44; 95% CI: 1.13–1.83), non-Indigenous (AOR = 1.78; 95% CI: 1.40–2.28), studying in peri-urban areas (AOR = 1.43; 95% CI: 1.11–1.84), having longer school hours (AOR = 1.68; 95% CI: 1.07–2.63), being in higher grades (AOR = 1.51; 95% CI: 1.20–1.90), ranking in the top ten (AOR = 1.60; 95% CI: 1.24–2.05), participating in extracurriculars (AOR = 1.49; 95% CI: 1.16–1.92), and having a father with higher education (AOR = 1.32; 95% CI: 1.01–1.72). Positive attitudes and good practices were more common among students from periurban areas (AOR = 1.55; 95% CI: 1.20–2.00), those with longer school hours (AOR = 1.92; 95% CI: 1.22–3.02), higher grades (AOR = 1.33; 95% CI: 1.06–1.68), and top ten rankings (AOR = 1.63; 95% CI: 1.27–2.10). Additionally, adolescents aware of first-degree relatives’ T2D status were more likely to show positive attitudes (AOR = 0.70; 95% CI: 0.53–0.92) and good practices (AOR = 0.72; 95% CI: 0.54–0.96). Conclusion Adolescents in rural Indonesia demonstrated good knowledge, attitude, and practices related to T2D, but notable gaps remain across all domains. Targeted interventions in schools that consider significantly associated factors, along with active parental involvement in promoting healthy habits at home, are crucial for addressing these gaps and preventing future T2M burden in the country.

  PublisherOA PDFDOI

• Understanding the role of family functioning, dietary adherence, and culture on glycemic control among adults with type 2 diabetes: A mediation and moderation analysis

  PLoS ONE · 2025-04-01 · 2 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Families and cultural contexts can impact dietary adherence and glycemic control of type 2 diabetes (T2D). Yet little is known about these relationships in Africa, where poor dietary adherence and glycemic control are prevalent. To address this gap, this study investigated whether dietary adherence mediates family functioning and glycemic control among T2D adults in Benin, West Africa. We also explored whether cultural identity affected the association between family functioning and dietary adherence. METHODS: A cross-sectional study of 512 T2D patients from six health centers was conducted to assess: 1) family functioning with the 12-item McMaster Family Assessment Device-General Functioning Subscale (FAD-GF); 2) dietary adherence via the Perceived Dietary Adherence Questionnaire (PDAQ); and 3) cultural identity with the 12-item Multigroup Ethnic Identity Measure (MEIM). The three-month glycemic control was determined with Glycated Hemoglobin - HbA1c. Mediation and moderation analyses were conducted using Stata's structural equation model (SEM). RESULTS: Healthy family functioning, good dietary adherence and good glycemic control rates were 56.8%, 33%, and 30.5% respectively. Path analysis showed that healthy family functioning was significantly associated with lower HbA1c levels (-0.34, 95% CI: [-0.72, -0.03]), and there was a significant indirect effect via greater dietary adherence (-0.12, 95% CI: [-0.22, -0.01]). However, cultural identity did not significantly impact the relationship between family functioning and dietary adherence. CONCLUSIONS: Our study revealed that family functioning, adherence to dietary recommendations, and glycemic control are interconnected in adults with T2D. Interventions should target modifiable factors like dietary adherence and address relevant risk and resilience sources to improve glycemic control in urban African families.

  PublisherOA PDFDOI

• Women-led sustainable irrigation improved indicators of nutritional status in children from Northern Benin

  Journal of Health Population and Nutrition · 2025-12-08

  articleOpen access

  BACKGROUND: Climate change threatens food security and child nutrition in Africa. This study assessed the impact of community-based, solar-powered drip irrigation gardens (SMGs) on the nutritional status of children in households reliant on local food production. METHODS: Women's groups (WGs) from 16 matched villages in Northern Benin were randomly assigned to receive SMGs (WG_SMG) or continue traditional irrigation (WG_C). Additional households without women's groups (NWG_SMG and NWG_C) were recruited from intervention and comparison villages. Children aged 1-5 years participated in baseline and one-year follow-up surveys. Outcomes included dietary diversity, anthropometry, anemia, and micronutrient status. Dietary diversity was assessed using the WHO minimum dietary diversity indicator, based on consumption from at least five of eight food groups in the previous 24 h. Anemia was defined as hemoglobin < 10.5 g/dL or < 11 g/dL, age dependent. Difference-in-differences analysis estimated treatment effects (TEs). RESULTS: WG_SMG participation increased the percentage of children meeting minimum dietary diversity compared with all groups (TE: 0.64; p < 0.001). Hemoglobin concentrations increased in WG_SMG children versus all groups (TE: 0.53; p < 0.05), with reductions in anemia compared with WG_C (TE: - 0.15; p < 0.05). WG_SMG membership also improved weight-for-age z-scores (TE: 0.35; p < 0.05) and reduced wasting (TE: - 0.04; p < 0.01). Effects remained statistically significant when clustering at child or village levels. CONCLUSIONS: Children from women-owned SMGs had improved dietary diversity, hemoglobin status, and growth outcomes while reducing anemia and wasting compared to controls. Expanding this technology may enhance food security and child nutrition in climate-vulnerable regions.

  PublisherDOI

• Linear goal programming to improve the diets of patients with type 2 diabetes in Benin

  Diabetes Research and Clinical Practice · 2025-12-01

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

Frequent coauthors

• John E. Ehiri

  University of Arizona

  24 shared

• Waliou Amoussa Hounkpatin

  15 shared

• Sarah Yeo

  14 shared

• Huguette Turgeon O’Brien

  Ministry of Agriculture, Fisheries and Food

  14 shared

• J.A. Zee

  Université Laval

  14 shared

• Abidemi Okechukwu

  University of Arizona

  11 shared

• Jennifer Burney

  Scripps Institution of Oceanography

  10 shared

• Priscilla Magrath

  University of Arizona

  9 shared