142nd APHA Annual Meeting and Exposition

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Increased Healthy Nutrition and Physical Activity in a Health Educator-Led Intervention among Older Chinese American Immigrants

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 3:30 PM - 3:50 PM

Jane Jih, MD, MPH, MAS , Division of General Internal Medicine, UCSF, San Francisco, CA
Gem Le, PhD , Department of Medicine, UCSF, and Asian American Research Center on Health (ARCH), San Francisco, CA
Ginny Gildengorin, PhD , Department of Medicine, University of California, San Francisco, San Francisco, CA
Susan Stewart, PhD , Division of Biostatistics, University of California-Davis, Davis, CA
Janice Tsoh, PhD , Department of Psychiatry, UCSF, San Francisco, CA
Ching Wong, BS , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Adam Burke, PhD, MPH, LAc , Health Education/Holistic Health Studies, San Francisco State University, San Francisco, CA
Kent Woo, MSW , NICOS Chinese Health Coalition, San Francisco, CA
Elaine Chow, BA , NICOS Chinese Health Coalition, San Francisco, CA
Jun Wang, PhD , Health Education, San Francisco State University, San Francisco, CA
Lei-Chun Fung, MPH, MSW , Health Education Department, Chinatown Public Health Center, San Francisco, CA
Stephen McPhee, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Tung T. Nguyen, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, and and Asian American Research Center on Health (ARCH), San Francisco, CA
Audio (mp3) recording Recorded Presentation (mp4)
Background/Significance:
Chinese Americans have low levels of knowledge and adherence with recommendations for healthy nutrition and physical activity (NPA).

Objective:
To evaluate a health educator intervention to teach NPA in a randomized controlled trial.

Methods:
Chinese Americans aged 50-75 in San Francisco were recruited by lay health workers (LHW) and randomized. A health educator delivered two NPA lectures in English, Cantonese or Mandarin to the intervention group, who also received lecture handouts and a brochure. The comparison group received the handouts and the brochure. NPA knowledge and self-reported behaviors were assessed by pre- and post- intervention surveys 6 months apart. T-tests for continuous measures and chi-square tests for categorical measures were used to calculate statistical significance for pre-post changes within each group.

Results:
Out of 541 participants, 82% were female, 99% foreign-born, 96% limited English speakers, and 58.4% were overweight or obese using the Asian body mass index cut-off of > 23 kg/m2. At 6 months, participant retention rate was 98.7%. Knowledge of the vegetable intake recommendation (5+ servings daily) increased from 2.6% to 34.8% (p<0.0001) among intervention participants (N=268) and from 5.2% to 9.5% (p=0.02) among comparison participants (N=273). Knowledge of the physical activity recommendation (150+ minutes weekly) increased from 1.5% to 19.6% (p<0.001) in the intervention group and 0.0% to 2.3% in the comparison group. Consumption of 5+ vegetables daily increased significantly in the intervention group (from 1.8% to 13.2%, p<0.0001) but not in the comparison group (4.1% to 4.9%, p=0.65). Participants reporting 150+ minutes weekly of physical activity increased from 53.1% to 68.9% (p<0.0001) in the intervention group and from 58.2% to 65.5% (p=0.06) in the comparison group.

Conclusions:
Rates of knowledge and self-reported adherence to NPA guidelines were low among Chinese Americans. An intervention with health educator presentations may lead to improvements in knowledge and behaviors.

Learning Areas:

Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the extent of knowledge about healthy nutrition and physical activity (NPA) among Chinese Americans aged 50-75. Describe the adherence to NPA recommendations among Chinese Americans aged 50-75. Describe the impact of a health educator-led intervention to increase NPA knowledge and adherence in this population. Discuss opportunities for application and sustainability of such health educator-led NPA education in other community-based settings.

Keyword(s): Health Promotion and Education, Asian Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator on several studies examining modifiable health behaviors such diet and exercise in immigrant populations particularly Asian Americans.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3336.0: Global perspectives and approaches to Asian and Pacific Islander health