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Dela Cruz FA, Yu CHA, Lao BT. Illness perceptions and blood pressure control among hypertensive Filipino Americans: A cross-sectional study. J Am Assoc Nurse Pract 2024:01741002-990000000-00228. [PMID: 38874461 DOI: 10.1097/jxx.0000000000001032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 04/26/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Among Asian Americans, Filipino Americans (FAs)-who constitute the fourth largest US immigrant group and who fill in health care workforce shortages-experience high prevalence but low control rates of high blood pressure (HBP). Research reveals that patients' illness perceptions, their common-sense model (CSM) of the illness, influence treatment behaviors, and management outcomes. However, scarce information exists about FAs' perceptions about HBP. PURPOSE To address this gap, we conducted a cross-sectional study to (a) identify the illness perceptions of hypertensive FAs, (b) classify these perceptions into clusters, and (c) determine the association between illness perceptions and BP control. METHODOLOGY The responses of 248 FAs with HBP to the Brief Illness Perception Questionnaire were analyzed using JMP Pro version 17 to discover their CSMs or illness perceptions. We used iterative K means cluster analysis to classify variations in CSMs and analysis of means chart to determine the association of illness perceptions and BP control. RESULTS Hypertensive FAs expressed threatening (negative) views of HBP through their emotional perceptions of the illness and its chronic time line, whereas their positive views centered on their cognitive beliefs about understanding HBP and its controllability. Based on the biomedical model of HBP, the overall illness perceptions or CSMs encompassed three clusters. Generally, threatening illness perceptions were associated with stage 2 HBP. CONCLUSIONS/IMPLICATIONS The findings underscore the need for nurse practitioners to elicit, listen, discern, and understand the illness perceptions or CSMs of hypertensive FAs to improve BP treatment and control with scientifically and culturally tailored interventions.
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Affiliation(s)
| | - Chong Ho Alex Yu
- Department of Mathematics, College of Natural and Computational Sciences, Hawaii Pacific University, Honolulu, Hawaii
| | - Brigette T Lao
- Student Health Center, University of California Irvine, Irvine, California
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LeCroy MN, Suss R, Russo RG, Sifuentes S, Beasley JM, Barajas-Gonzalez RG, Chebli P, Foster V, Kwon SC, Trinh-Shevrin C, Yi SS. Looking Across and Within: Immigration as a Unifying Structural Factor Impacting Cardiometabolic Health and Diet. Ethn Dis 2023; 33:130-139. [PMID: 38845741 PMCID: PMC11145733 DOI: 10.18865/ed.33.2-3.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Introduction Immigration has been identified as an important social determinant of health (SDH), embodying structures and policies that reinforce positions of poverty, stress, and limited social and economic mobility. In the public health literature with regard to diet, immigration is often characterized as an individual-level process (dietary acculturation) and is largely examined in one racial/ethnic subgroup at a time. For this narrative review, we aim to broaden the research discussion by describing SDH common to the immigrant experience and that may serve as barriers to healthy diets. Methods A narrative review of peer-reviewed quantitative, qualitative, and mixed methods studies on cardiometabolic health disparities, diet, and immigration was conducted. Results Cardiometabolic disease disparities were frequently described by racial/ethnic subgroups instead of country of origin. While cardiovascular disease and obesity risk differed by country of origin, diabetes prevalence was typically higher for immigrant groups vs United States (US)-born individuals. Common barriers to achieving a healthy diet were food insecurity; lack of familiarity with US food procurement practices, food preparation methods, and dietary guidelines; lack of familiarity and distrust of US food processing and storage methods; alternative priorities for food purchasing (eg, freshness, cultural relevance); logistical obstacles (eg, transportation); stress; and ethnic identity maintenance. Conclusions To improve the health of immigrant populations, understanding similarities in cardiometabolic health disparities, diet, and barriers to health across immigrant communities-traversing racial/ethnic subgroups-may serve as a useful framework. This framework can guide research, policy, and public health practices to be more cohesive, generalizable, and meaningfully inclusive.
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Affiliation(s)
- Madison N. LeCroy
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Rachel Suss
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Rienna G. Russo
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Sonia Sifuentes
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Jeannette M. Beasley
- Department of Nutrition and Food Studies, NYU Steinhardt School of Culture, Education, and Health, New York, NY
- Department of Medicine, NYU Grossman School of Medicine, New York, NY
| | - R. Gabriela Barajas-Gonzalez
- Department of Population Health, Center for Early Childhood Health and Development, NYU Grossman School of Medicine, New York, NY
| | - Perla Chebli
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Victoria Foster
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Simona C. Kwon
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Chau Trinh-Shevrin
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Stella S. Yi
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
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Provido SMP, Abris GP, Lee H, Okekunle AP, Gironella GM, Capanzana MV, Chung GH, Hong S, Yu SH, Lee CB, Lee JE. Comparison of cardiovascular disease risk factors among FiLWHEL (2014-2016), NNS (2013) and KNHANES (2013-2015) women. BMC Womens Health 2023; 23:149. [PMID: 36997917 PMCID: PMC10064574 DOI: 10.1186/s12905-023-02218-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 02/08/2023] [Indexed: 04/01/2023] Open
Abstract
OBJECTIVES This study assessed the CVD risk factors among Filipino women (FW) in Korea and compared them with FW in the Philippines and women in Korea (KW). METHODS A cohort of 504 women from the Filipino Women's Health and Diet Study (FiLWHEL) aged 20-57 years old were age-matched (1:1 ratio) with women from the 2013 National Nutrition Survey in the Philippines and the 2013-2015 Korean National Health and Nutrition Examination Survey. Anthropometric data, blood pressure (BP), lipid and glucose levels were compared across the four populations by calculating the odds ratio (OR)s and 95% confidence interval (CI)s using conditional logistic regression models. RESULTS Compared to KW, FW in Korea and FW in the Philippines were more than 2 and 3 times higher odds of having obesity for BMI ≥ 30 kg/m2 and waist circumference ≥ 88 cm, respectively. However, FW in Korea had the highest odds (OR 5.51, 95% CI 3.18-9.56) of having hypertension compared to KW. FW in the Philippines had the highest odds of having dyslipidemia (compared to KW, total cholesterol ≥ 200 mg/dL: OR 8.83, 95% CI 5.30-14.71; LDL-C ≥ 130 mg/dL: OR 3.25, 95% CI 2.13-4.98; and triglyceride ≥ 150 mg/dL: OR 2.59, 95% CI 1.59-4.22), but FW in Korea and KW had similar prevalence of dyslipidemia. CONCLUSIONS FW in Korea had higher prevalence of obesity and hypertension, with similar prevalence of dyslipidemia compared to KW in this sample. FW in the Philippines had higher prevalence of dyslipidemia compared to FW in Korea. Further prospective studies are warranted to examine the CVD risk factors among continental and native-born Filipino women.
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Affiliation(s)
- Sherlyn Mae P Provido
- Research Institute of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Grace P Abris
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Heejin Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
| | - Akinkunmi Paul Okekunle
- Research Institute of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Glen Melvin Gironella
- Department of Science and Technology-Food and Nutrition Research Institute, DOST Compound, Gen. Santos Avenue, Bicutan, Taguig, Metro Manila, Philippines
| | - Mario V Capanzana
- Department of Science and Technology-Food and Nutrition Research Institute, DOST Compound, Gen. Santos Avenue, Bicutan, Taguig, Metro Manila, Philippines
| | - Grace H Chung
- Research Institute of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
- Department of Child Development and Family Studies, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Sangmo Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, South Korea
| | - Sung Hoon Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, South Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, South Korea
| | - Jung Eun Lee
- Research Institute of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea.
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea.
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Nagtalon-Ramos J, Ayres C, Faught B. Sexual and Reproductive Health Knowledge, Attitudes, and Self-Efficacy Among Young Adult Filipino American Women. J Transcult Nurs 2022; 33:576-584. [PMID: 35822669 PMCID: PMC9449433 DOI: 10.1177/10436596221107600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Little is known about Filipino American women's (FAW) sexual and reproductive health (SRH). The purpose of this study was to examine the SRH knowledge, attitudes, and self-efficacy among young adult FAW. METHOD This was a qualitative, descriptive interpretive design. Four focus group interviews and one individual interview were conducted. Purposive sampling was used for this study. Inclusion criteria were female, Filipino American, between the ages 18 and 24 years old, and be able to understand and speak English. RESULTS Twelve participants (n = 12) were recruited. Three themes emerged from this study: (a) sources of SRH information; (b) influence of cultural values, religion, and intergenerational factors; and (c) facilitators of and barriers to women's health services. DISCUSSION Themes emerged from the content analysis identifying SRH disparities within the Filipino American community, which may inform future interventions and research on this topic.
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Affiliation(s)
| | | | - Brooke Faught
- Women's Institute of Sexual Health, Nashville, TN, USA
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Sauter A, Kikhia S, von Sommoggy J, Loss J. Factors influencing the nutritional behavior of Syrian migrants in Germany - results of a qualitative study. BMC Public Health 2021; 21:1334. [PMID: 34229649 PMCID: PMC8262055 DOI: 10.1186/s12889-021-11268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Syrian migrants represent the third-largest group of foreigners in Germany and are therefore potential users of health promotion initiatives, including nutrition programs. It is little known how (healthy) nutrition is understood and implemented by this group and which factors influence their experiences related to food and eating in the host country. Thus, this study aimed to explore the importance of (healthy) nutrition, facilitators, and barriers of a preferred diet; nutritional changes in relation to the country of origin; and how nutrition may change with increasing length of stay. Methods Thirty semi-structured qualitative interviews with Syrian migrants (male = 16, female = 14, 18–35 years, length of stay 10–68 months) were conducted in 2018. Seventeen migrants could be followed-up after 12 months and were interviewed in 2019 again and were asked for changes in their nutritional behavior. Interviews were conducted in German, English, or Arabic, transcribed and translated into English if necessary. For analysis, an abbreviated version of the Grounded Theory was used. Results We identified six overarching themes that described influencing factors on a favored diet in Germany over the course of stay: (1) managing everyday life; (2) intercultural contact with local residents; (3) social context of cooking and eating; (4) ambiguity toward Arabic food; (5) mistrust toward certain types of food; and (6) influence of postmigration stressors. In general, the importance of nutrition is high among Syrian migrants. However, daily stressors, the lack of practical knowledge of how to cook favored dishes, and food insecurity in the new food environment make it difficult to obtain a preferred diet. With increasing stay, many developed a higher awareness of healthy eating, mainly due to a new independence or influences from the social environment in Germany. Conclusion Results highlight the need for health promotion interventions to be more responsive to the specific needs of Syrian migrants, including nutrition. Syrian migrants differ in their capabilities, needs, and aims, and they should be addressed differently by health professionals, social services or migrant specific services. Future research should continue to focus on the living conditions of Syrian migrants and its influence on nutrition.
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Affiliation(s)
- Alexandra Sauter
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany.
| | - Salma Kikhia
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Julia von Sommoggy
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Julika Loss
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
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Colorectal Cancer-Related Knowledge, Acculturation, and Healthy Lifestyle Behaviors Among Low-Income Vietnamese Americans in the Greater Philadelphia Metropolitan Area. J Community Health 2020; 45:1178-1186. [PMID: 33026553 DOI: 10.1007/s10900-020-00931-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
Colorectal cancer (CRC) is the second and fourth most common cancer in Vietnamese American women and men, respectively. Recent research has highlighted the importance of modifiable lifestyle behaviors such as smoking, alcohol use, dietary behaviors, and physical activities in CRC prevention for the general population. However, it is not well understood how well Vietnamese Americans knew about CRC prevention and risk factors, and whether there were any disparities in knowledge within this vulnerable population. This study examined whether comprehensive measures of acculturation and knowledge of CRC risk are associated with different health behaviors, specifically physical activity, protective dietary behaviors, and risky dietary behaviors in Vietnamese Americans. We recruited 374 Vietnamese Americans aged 50 or above from community-based organizations in the Vietnamese American communities in the greater Philadelphia metropolitan area. Through a cross-sectional survey, we collected data on their knowledge of CRC prevention and risk factors, acculturation-related factors, and sociodemographic characteristics. We found limited knowledge of CRC prevention and risk factors, and suboptimal physical activity and healthy dietary behaviors in the Vietnamese Americans. We also found that higher levels of knowledge about CRC and risk factors were associated with less unhealthy diets but not with more protective diets or physical activity. Acculturation was not significantly associated with overall dietary behaviors in our study. Our findings addressed gaps in current literature concerning the impact of knowledge about CRC risk factors and acculturation on different dimensions of dietary behaviors as well as physical activity. Research and practical implications were discussed.
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Abstract
Objective: To summarise the existing evidence of development, validation and current status of utilisation of dish-based dietary assessment tools. Design: Scoping review. Setting: Systematic search using PubMed and Web of Science. Results: We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26–83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet–disease relationships in target populations. Conclusions: Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.
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Kirshner L, Yi SS, Wylie-Rosett J, Matthan NR, Beasley JM. Acculturation and Diet Among Chinese American Immigrants in New York City. Curr Dev Nutr 2020; 4:nzz124. [PMID: 32270131 PMCID: PMC7121198 DOI: 10.1093/cdn/nzz124] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/25/2019] [Accepted: 11/04/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND There are limited data on the social and cultural determinants of dietary intake in Chinese Americans. Over 560,000 New York City residents are Chinese American, and there has been a growing trend over the past 30 y of permanent migration from China to the USA. OBJECTIVES The purpose of this secondary data analysis is to describe associations between diet, measured by self-report, and diet quality, with level of acculturation in a cross-sectional sample of urban-dwelling Chinese American immigrants. METHODS This was a cross-sectional study involving 2071 foreign-born Chinese American adults. Acculturation was assessed using the Stephenson Multigroup Acculturation Scale, diet using a Chinese-adapted FFQ, and diet quality using the Alternative Healthy Eating Index (AHEI). Multivariable regression was used to assess associations between ethnic (ESI; Chinese) and dominant (DSI; American) society immersion scores with self-reported dietary measures. RESULTS No significant associations were found between acculturation and overall AHEI score. Higher ESI and DSI scores were associated with higher vegetable, fruit, and nut/legume scores; a higher DSI score only was associated with higher whole grain and PUFA scores. A 1-unit increase in the ESI score was associated with a 0.005 (P = 0.009) lower red and processed meat component score, whereas a 1-unit increase in DSI score was associated with a 0.01 (P = 0.025) higher red and processed meat component score. CONCLUSIONS Assessment of acculturation level may help to tailor dietary strategies that are appropriate to what Chinese American immigrant communities are consuming to more effectively decrease the risk of chronic disease.
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Affiliation(s)
| | - Stella S Yi
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nirupa R Matthan
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Vargas P. Dietary Intake and Obesity among Filipino Americans in New Jersey. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:6719861. [PMID: 30305824 PMCID: PMC6165614 DOI: 10.1155/2018/6719861] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/29/2018] [Accepted: 07/13/2018] [Indexed: 11/18/2022]
Abstract
The prevalence of obesity is a public concern and is linked to chronic diseases. Filipino Americans have a high prevalence rate of hypertension and diabetes. This study investigated the dietary intake of first-generation Filipino Americans (n=210). In addition, it provides a comparison of the obesity rates using the International guideline and the WHO Asian recommendation. The dietary intake included caloric, carbohydrate, and fat intake and was determined using the Block Brief Food Frequency Questionnaire. The anthropometric measurements included actual height, weight, and waist measurements. The body mass index (BMI) and waist circumference were categorized using the International guideline and the WHO Asian recommendation to determine obesity. The caloric and carbohydrate intake were normal; however, fat intake was increased. The BMI and waist circumference showed substantial difference when using the International and Asian guidelines to determine obesity. The results highlight the increased health risks of Filipino American immigrants including a high dietary fat intake and an increased obesity rate.
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dela Cruz FA, Yu CH, Vindua KI. The factor structure of a short acculturation scale for Filipino Americans in an adult U.S.-born sample. JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 46:535-550. [PMID: 31682290 PMCID: PMC6190797 DOI: 10.1002/jcop.21955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 11/28/2017] [Accepted: 12/20/2017] [Indexed: 06/10/2023]
Abstract
The influx of non-European immigrants since 1965 ushered the development and use of acculturation measures in immigrant health studies. A Short Acculturation Scale for Filipino Americans (ASASFA) represents a validated, unidirectional ethnic-specific measure used with first-generation FAs. ASASFA's psychometric properties with adult U.S.-born children-the second generation-remain unexplored. This study determined (a) the factor structure of ASASFA with adult U.S.-born FAs and (b) the predictors of their acculturation scores. A secondary analysis was conducted on ASASFA data from a mental health survey of 116 U.S.-born FAs. Exploratory factor and parallel analyses showed a two-factor solution: language use and preference (Factor 1) and ethnic social relations (Factor 2). Ordinary least squares regression indicated gender and ethnic self-identification predict Factor 1 scores; self-identification solely predicts Factor 2 scores. Results demonstrate ASASFA's validity and parsimony, supporting its use in FA health studies when lengthy bidirectional acculturation measures become impractical.
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Bhimla A, Yap L, Lee M, Seals B, Aczon H, Ma GX. Addressing the Health Needs of High-Risk Filipino Americans in the Greater Philadelphia Region. J Community Health 2018; 42:269-277. [PMID: 27639868 DOI: 10.1007/s10900-016-0252-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Filipino Americans represent one of the largest and most diverse immigrant populations in the United States. It has been established that chronic diseases are a significant public health issue affecting this population. We conducted a health needs assessment of 200 Filipino Americans aged 18 years or older residing in the greater Philadelphia region. Study participants were recruited from eight Filipino community-based organizations in the region. Information about demographic and acculturative characteristics, health behaviors, self-reported chronic health conditions, and chronic disease perception were collected. Participants were older and highly acculturated. With regards to health behaviors, several did not meet dietary fruit and vegetables intake and physical activity guidelines. The top five health conditions were high blood pressure (67.5 %), high blood cholesterol (57.1 %), arthritis (28.9 %), diabetes (21.8 %), and cancer (14.7 %). Majority of participants perceived high blood pressure, high blood cholesterol, and diabetes to be a concern in their community, and had high awareness of the risk factors associated with these diseases. Reported rates of hypertension, high cholesterol, and diabetes suggest that lifestyle interventions targeting diet and physical activity, in addition to health education, are needed in this population.
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Affiliation(s)
- Aisha Bhimla
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19122-0843, USA
| | - Lauren Yap
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19122-0843, USA
| | - Minsun Lee
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19122-0843, USA
| | - Brenda Seals
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19122-0843, USA
| | - Hermie Aczon
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19122-0843, USA.,Filipino American Society of South Jersey, Inc., Sicklerville, NJ, USA.,Filipino Executive Council of Greater Philadelphia, Inc., Mount Laurel, NJ, USA
| | - Grace X Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19122-0843, USA.
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Jih J, La Chica T, Antonio LM, Villero OO, Roque MN, Domingo JR, Landicho JF, Napoles AM, Kaplan CP, Nguyen TT. Application of Photovoice with Focus Groups to Explore Dietary Behaviors of Older Filipino Adults with Cardiovascular Disease. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2018; 11:133-149. [PMID: 31745445 PMCID: PMC6863513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Filipino Americans have high rates of cardiovascular diseases (CVD). This study explored the dietary behaviors, a modifiable risk factor, of Filipinos with CVD. Filipinos with CVD were recruited and trained to do Photovoice. Participants took photos to depict their "food experience," defined as their daily dietary activities. Participants then shared their photos during focus groups. Focus group transcripts were analyzed using an iterative, grounded theory approach. Among 38 Filipino participants, the mean age was 70 years old and all were foreign-born. Major themes included efforts to retain connection to Filipino culture through food, and dietary habits shaped by cultural health beliefs. Many believed that traditional dietary practices increased CVD risk. Receiving a CVD diagnosis and clinician advice changed their dietary behaviors. Household members, the physical environment, and economic constraints also influenced dietary behaviors. Photovoice is feasible among older Filipinos and may enhance understanding of drivers of dietary behaviors.
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Affiliation(s)
- Jane Jih
- University of California San Francisco
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Bender MS, Cooper BA, Park LG, Padash S, Arai S. A Feasible and Efficacious Mobile-Phone Based Lifestyle Intervention for Filipino Americans with Type 2 Diabetes: Randomized Controlled Trial. JMIR Diabetes 2017; 2:e30. [PMID: 30291068 PMCID: PMC6238885 DOI: 10.2196/diabetes.8156] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 10/02/2017] [Accepted: 10/29/2017] [Indexed: 01/05/2023] Open
Abstract
Background Filipino Americans have a high prevalence of obesity, type 2 diabetes (T2D), and cardiovascular disease compared with other Asian American subgroups and non-Hispanic whites. Mobile health (mHealth) weight loss interventions can reduce chronic disease risks, but these are untested in Filipino Americans with T2D. Objective The objective of this study was to assess feasibility and potential efficacy of a pilot, randomized controlled trial (RCT) of a culturally adapted mHealth weight loss lifestyle intervention (Pilipino Americans Go4Health [PilAm Go4Health]) for overweight Filipino Americans with T2D. Methods This was a 2-arm pilot RCT of the 3-month PilAm Go4Health intervention (phase 1) with an active waitlist control and 3-month follow-up (phase 2). The waitlist control received the PilAm Go4Health in phase 2, whereas the intervention group transitioned to the 3-month follow-up. PilAm Go4Health incorporated a Fitbit accelerometer, mobile app with diary for health behavior tracking (steps, food/calories, and weight), and social media (Facebook) for virtual social support, including 7 in-person monthly meetings. Filipino American adults ≥18 years with T2D were recruited from Northern California. Feasibility was measured by rates of recruitment, engagement, and retention. Multilevel regression analyses assessed within and between group differences for the secondary outcome of percent weight change and other outcomes of weight (kg), body mass index (BMI), waist circumference, fasting plasma glucose, HbA1c, and steps. Results A total of 45 Filipino American adults were enrolled and randomized. Mean age was 58 (SD 10) years, 62% (28/45) were women, and mean BMI was 30.1 (SD 4.6). Participant retention and study completion were 100%, with both the intervention and waitlist group achieving near-perfect attendance at all 7 intervention office visits. Groups receiving the PilAm Go4Health in phase 1 (intervention group) and phase 2 (waitlist group) had significantly greater weight loss, −2.6% (−3.9 to −1.4) and −3.3% (−1.8 to −4.8), respectively, compared with the nonintervention group, resulting in a moderate to small effect sizes (d=0.53 and 0.37, respectively). In phase 1, 18% (4/22) of the intervention group achieved a 5% weight loss, whereas 82% (18/22) maintained or lost 2% to 5% of their weight and continued to maintain this weight loss in the 3-month follow-up. Other health outcomes, including waist circumference, BMI, and step counts, improved when each arm received the PilAm Go4Health, but the fasting glucose and HbA1c outcomes were mixed. Conclusions The PilAm Go4Health was feasible and demonstrated potential efficacy in reducing diabetes risks in overweight Filipino Americans with T2D. This study supports the use of mHealth and other promising intervention strategies to reduce obesity and diabetes risks in Filipino Americans. Further testing in a full-scale RCT is warranted. These findings may support intervention translation to reduce diabetes risks in other at-risk diverse populations. Trial Registration Clinicaltrials.gov NCT02290184; https://clinicaltrials.gov/ct2/show/NCT02290184 (Archived by WebCite at http://www.webcitation.org/6vDfrvIPp)
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Affiliation(s)
- Melinda S Bender
- Family Health Care Nursing Department, School of Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Bruce A Cooper
- Office of the Dean and Administration, School of Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Linda G Park
- Community Health Services, School of Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Sara Padash
- School of Nursing, University of San Francisco, San Francisco, CA, United States
| | - Shoshana Arai
- Family Health Care Nursing Department, School of Nursing, University of California San Francisco, San Francisco, CA, United States
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Bayog MLG, Waters CM. Nativity, Chronic Health Conditions, and Health Behaviors in Filipino Americans. J Transcult Nurs 2017; 29:249-257. [PMID: 28826340 DOI: 10.1177/1043659617703164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Nearly half of Americans have a chronic health condition related to unhealthful behavior. One in four Americans is an immigrant; yet immigrants' health has been studied little, particularly among Asian American subpopulations. METHODOLOGY Years lived in United States, hypertension, diabetes, smoking, walking, adiposity, and fruit/vegetable variables in the 2011-2012 California Health Interview Survey were analyzed to examine the influence of nativity on chronic health conditions and health behaviors in 555 adult Filipinos, the second largest Asian American immigrant subpopulation. RESULTS Recent and long-term immigrant Filipinos had higher odds of having hypertension and diabetes, but lower odds of smoking and overweight/obesity compared with second-generation Filipinos. DISCUSSION Being born in the United States may be protective against chronic health conditions, but not for healthful behaviors among Filipinos. Chronic disease prevention and health promotion strategies should consider nativity/length of residence, which may be a more consequential health determinant than other immigration and acculturation characteristics.
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15
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Bayog ML, Waters CM. Cardiometabolic risks, lifestyle health behaviors and heart disease in Filipino Americans. Eur J Cardiovasc Nurs 2017; 16:522-529. [PMID: 28756695 DOI: 10.1177/1474515117697886] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cardiovascular disease is the leading cause of death among all racial and ethnic populations in the USA. Cardiovascular risks and cardioprotective factors have been disparately estimated among Asian American subpopulations. AIMS The study's purpose was to describe the cardiometabolic risks and lifestyle health behaviors associated with cardiovascular disease, considering age and gender, in Filipinos, the second largest Asian American population. METHODS Secondary analysis was conducted of behavioral (smoking, walking, body mass index and soda, fast food and fruit/vegetable consumption), cardiometabolic (hypertension and diabetes) and heart disease variables in the 2011-2012 California Health Interview Survey. The metropolitan sample of Filipino American adults included 57.3% women and had a mean age of 47.9 ± 18.3 years ( n = 555). RESULTS Among the sample, 7.4% had heart disease, 38.9% had hypertension, 16.6% had diabetes, 12.4% smoked cigarettes, 83.2% were insufficiently active, 54.2% were overweight/obese, 21.8% routinely ate fast food, 13.2% routinely drank soda and 90.3% did not meet the fruit/vegetable consumption recommendation. Age (unadjusted odds ratio [OR] = 1.0, p < 0.0001), hypertension (unadjusted OR = 4.8, p < 0.0001) and diabetes (unadjusted OR = 3.3, p = 0.001) were associated with heart disease. Hypertension was the single greatest heart disease risk, controlling for diabetes, age and gender (adjusted OR = 3.1, p = 0.006). CONCLUSIONS Primary and secondary prevention and treatment of hypertension should be paramount, along with promotion of glucose control, regular moderate-intensity physical activity, weight management and increased fruit and vegetable consumption in the Filipino American population. A multidisciplinary, chronic care model that is population-specific, emphasizes integrated, comprehensive care and provides linkages between primary healthcare and community resources is recommended for practice.
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Affiliation(s)
- Maria Lg Bayog
- University of California, San Francisco School of Nursing, Department of Community Health Systems, San Francisco, CA, USA
| | - Catherine M Waters
- University of California, San Francisco School of Nursing, Department of Community Health Systems, San Francisco, CA, USA
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Dietary Acculturation among Filipino Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010016. [PMID: 26703646 PMCID: PMC4730407 DOI: 10.3390/ijerph13010016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/06/2015] [Accepted: 10/12/2015] [Indexed: 01/20/2023]
Abstract
Acculturation, the subsequent changes that occur in one culture after continuous first hand contact with another culture, impacts the dietary habits and health risks of individuals. This study examines the acculturation, dietary habits and anthropometric measurements in a sample of 210 first generation Filipino American immigrants in New Jersey (NJ). Acculturation was measured using the Short Acculturation Scale for Filipino Americans (ASASFA). Dietary acculturation was measured using the Dietary Acculturation Questionnaire for Filipino Americans (DAQFA) and dietary intake was determined using the Block's Brief Food Frequency Questionnaire (BFFQ). Anthropometric measurements were obtained including weight, height and waist circumference. Acculturation had a significant negative relationship with Filipino Dietary acculturation. Western dietary acculturation was significantly correlated with caloric intake (r(208) = 0.193, p < 0.01), percentage fat intake (r(208) = 0.154, p < 0.05), percentage carbohydrate intake (r(208) = -0.172, p < 0.05), Body Mass Index (BMI) (r(208) = 0.216, p < 0.01) and waist circumference (r(208) = 0.161, p < 0.01). There was no significant correlation between Filipino dietary acculturation, dietary intake and anthropometric measurements. The results showed that Filipino American immigrants have increased risks including increased BMI, waist circumference and increased fat intake. Over all, this research highlighted some dietary changes and their effects on dietary intake and health status.
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Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion. BIOMED RESEARCH INTERNATIONAL 2015; 2015:506269. [PMID: 26380277 PMCID: PMC4561863 DOI: 10.1155/2015/506269] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/22/2014] [Accepted: 01/22/2015] [Indexed: 12/29/2022]
Abstract
Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants' perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle.
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