Online Program

Dietary Behaviors of Filipino Adults with Cardiovascular Disease: A mixed methods pilot study using Photovoice

Tuesday, November 3, 2015 : 2:50 p.m. - 3:10 p.m.

Jane Jih, MD, MPH, MAS, Division of General Internal Medicine, UCSF, San Francisco, CA
Patricia Quema, MPA, UCSF, San Francisco, CA
Ofelia Villero, PhD, UCSF, San Francisco, CA
Luisa Antonio, Veterans Equity Center, San Francisco, CA
Mary Roque, Veterans Equity Center, San Francisco, CA
Joseph Domingo, MPH, CHES, Asian American Research Center on Health, San Francisco, CA
Joshua Landicho, Veterans Equity Center, San Francisco, CA
Celia Kaplan, DrPH, Medical Effectiveness Research Center, 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 Asian American Research Center on Health (ARCH), San Francisco, CA
Background: Cardiovascular diseases (CVD) are a significant health disparity for Filipino Americans, and diet is an important modifiable risk factor for CVD.

Objective: To explore the attitudes and beliefs surrounding the dietary behaviors of Filipinos with CVD.

Methods: We recruited Filipinos age 55-84 with a history of CVD. The study included Photovoice which is an empowering process where participants use photos to identify, represent and communicate their community and experiences. Participants a) completed a survey focused on eating habits; b) completed a Photovoice activity which involves taking photos to depict their “food experience” defined as their daily dietary activities such as mealtime experiences, grocery shopping and food preparation; and c) shared several photos during focus group discussions. Four focus group participants were recruited for home visits in which detailed field notes and photos were taken by the research team. Focus group transcripts and home visit field notes were analyzed using an iterative, grounded theory approach by two reviewers using Atlas.ti.

Results: 38 Filipinos enrolled with a mean of 68+9 years old, 53% female and all foreign-born with a mean of 17+12 years living in the US. The prevalence of heart disease was 32%, hypertension was 90%, dyslipidemia was 61%, and diabetes was 24%. An emerging theme was the desire to maintain closeness to the Philippines through eating traditional foods and visiting the local Filipino supermarket. Adaptation of eating habits to foods in the US was prevalent and influenced by housing environment and financial constraints. Assessments of health and “healthy” foods appeared to be more driven by personal experiences than by counseling by health providers. Themes were reflected in participant photos.

Conclusions: Photovoice is feasible among Filipinos and enhances understanding of dietary behaviors. Dietary behaviors among Filipino Americans are heavily influenced by cultural and socio-economic factors outside of the healthcare system.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Diversity and culture
Social and behavioral sciences

Learning Objectives:
Describe prevalence of cardiovascular disease and risk factors among Filipinos Discuss emerging themes of dietary behaviors of older Filipino adults with cardiovascular disease

Keyword(s): Asian Americans, Immigrant Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator and obtained funding support for this pilot study. My research focuses on preventing and managing obesity-related chronic diseases in minority and immigrant populations, particularly Asian Americans. My work aims to address modifiable risk factors, such as dietary habits and physical activity, for obesity-related diseases and to explore how immigration, language, culture and communication impact these behaviors.
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.