Strategies to Reach and Implement the Vision of Health Equity (STRIVE) Project: Qualitative findings about the process of implementing evidence-based strategies in local AANHPI communities

Asian Americans, Native Hawaiians and Pacific Islanders (AANHPIs) are the fastest growing minority population in the US and report low rates of physical activity and healthy eating compared to other groups. Evidence-based (EB) strategies targeting policy, systems and environmental (PSE) change positively affect chronic disease risk factors in the overall population, but may not be meaningful and effective for underserved AANHPIs without cultural tailoring. The STRIVE Project aims to reduce AANHPI health disparities by working with 15 local AANHPI community-based organizations (CBOs) across the US to implement EB strategies tailored to address the unique characteristics of diverse communities. Leaders from 15 AANHPI CBOs were interviewed about their process of implementing EB strategies. Guided by Resnicow’s framework on cultural tailoring, the interview assessed: 1.The process of choosing an EB strategy; 2. Strategy implementation and process of tailoring; and 3. Lessons learned. Transcripts were analyzed for thematic codes using Atlas.ti by two independent coders. All 15 CBOs reported the need to culturally adapt/tailor their strategies to achieve effectiveness. Challenges include lack of relevant data for their local community, logistical issues, and lack of familiarity with EB strategies and PSE change. Facilitating factors of success include relationship building with key stakeholders (e.g. community leaders, health departments) and established community trust.  EB strategies would not be effective if implemented without cultural tailoring. CBOs are able to successfully implement EB strategies at the PSE level due to nuanced understanding and relationships with local AANHPI communities allowing for  appropriately tailored and targeted meaningful approaches.