Journal of Asian Health

Association of American Identity with Cardiovascular Health in South Asian Americans: The MASALA Study

Ashwin Sunderraj — 2023-03-28

Background: Ethnic and national identity may influence cardiovascular health (CVH)-related behaviors, such as dietary preference. To better understand how acculturation is related to CVH among South Asian American adults, we evaluated the association of self-rated American identity with CVH factors among participants of the MASALA (Mediators of Atherosclerosis in South Asians Living in America) Study.

Methods: Multivariable linear regression quantified the associations of self-rated American identity (1 [low American identity] to 10 [high American identity]) with CVH factors, including measures of cholesterol, blood pressure, and blood glucose. The role of diet quality, physical activity, and social support in mediating these associations was evaluated.

Results: Participants (n=771) lived in the US for an average 27 (SD 11) years. Mean self-rated American identity score was 5.5 (2.4). After adjustment, a 5-point higher American identity score was associated with 6.5 mg/dL higher low density lipoprotein cholesterol, 6.6 mg/dL higher total cholesterol, 2.9 mmHg higher systolic blood pressure, and 1.4 mmHg higher diastolic blood pressure. Accounting for diet quality, physical activity, or social support did not alter these associations.

Conclusions: Higher self-rated American identity is associated with worse CVH factors among South Asian American adults.

Evaluating a Culturally Tailored Public Health Forum in Improving the Knowledge and Understanding of Chronic Disease Management in the Chinese Population: A Mixed-methods Study

Jayneel Limbachia — 2023-03-28

Background:

Chronic disease management is fraught with many challenges for ethnic minorities. Studies conducted in non-multicultural populations suggest that patient and community engaging initiatives can improve chronic disease management practices. However, literature on culturally specific community engaging programs is relatively sparse. The interCultural Online Health Network (iCON) is a culturally tailored, patient and community engaging health promotion program, which provides culturally specific health education to BC’s multicultural communities. We aimed to assess if the iCON 2020 Chinese Health Forum can improve the knowledge and understanding of chronic disease self-management in the Chinese community of Vancouver, BC.

Methods:

We conducted a sequential mixed-methods study by administering pre- and post- validated questionnaires, followed by semi-structured interviews conducted one-two months after the forum. We assessed our primary outcome of difference in self-efficacy scores post-forum using paired t-tests and further illuminated our research question through a thematic analysis of the semi-structured interviews.

Results:

From the 381 participants that attended the Health Forum, 131 consented to completing the pre- and/or post- surveys, and seven provided consent to participate in the follow-up interview. There was a statistically significant difference in self-efficacy scores pre- and post- forum participation (Mean difference = 0.58, S.D. = 1.42; [95% CI: 0.26 – 0.90], t(77) = 3.60; P = 0.001, d = 0.41). Participants attributed the effectiveness of the Health Forum to its accessible yet engaging programming and focus on culturally tailored health education.

Conclusion:

A culturally tailored, patient engagement and community outreach program effectively improved Chinese community members self-efficacy in managing their chronic diseases and was well received by participants. iCON’s 2020 Chinese Health Forum presents a model with associated principles of approach for similar culturally specific health education and community engagement programs that need to be developed to reduce the burden of chronic diseases in multicultural populations.

A review of the role of cultural practices, values, and norms in type II diabetes treatment for Chinese immigrants

Cameron Ormiston — 2023-03-28

Although Type II diabetes (T2D) prevalence in US Chinese immigrants continues to rise, gaps in research and clinical care persist. These gaps are largely due to generalizations of the Asian immigrant population, barriers within biomedical culture, and a lack of culturally sensitive treatment plans. Little attention is paid to the unique sociocultural factors and contexts within each subpopulation, such as family influences or traditional medicine approaches. After an analysis of available literature, folk interpretations of disease, the family unit, and cultural food practices were found to be significant influences on T2D treatment. As they navigate their treatment, Chinese immigrants grapple with issues such as the stigmatization of insulin, the importance of providing food as care, and family well-being and harmony. Understanding how and why these elements of PVN affect T2D treatment is crucial to tailoring medical care to the needs of Chinese immigrant communities.