Cultural Adaptation of the Group Lifestyle Balance Program for Chinese Americans

Chesla, Catherine A.; Chun, Kevin M.; Kwong, Yulanda; Lin, Han Chieh; Gu, Yunzi; Hernandez, Lenore; Huang, Peggy; Strycker, Lisa A.; Ma, Jun

doi:10.1177/0145721716666679

Cited by 21 publications

(22 citation statements)

References 41 publications

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“…The results of this study demonstrated high feasibility and acceptability of this intervention. The retention rate was comparable to or better than that previously reported in in-person diabetes interventions in Chinese immigrants [ 8 , 9 , 38 ]. The video watch rate was high over the 12-week intervention, with an adherence rate higher than most in-person DSME interventions in Chinese immigrants [ 6 , 8 , 9 , 38 ].…”

Section: Discussionsupporting

confidence: 77%

A Social Media–Based Diabetes Intervention for Low-Income Mandarin-Speaking Chinese Immigrants in the United States: Feasibility Study

Hu¹,

Islam²,

Trinh‐Shevrin³

et al. 2022

JMIR Form Res

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Background Chinese immigrants bear a high diabetes burden and face significant barriers to accessing diabetes self-management education (DSME) and counseling programs. Objective The goal of this study was to examine the feasibility and acceptability and to pilot test the potential efficacy of a social media–based DSME intervention among low-income Chinese immigrants with type 2 diabetes (T2D) in New York City. Methods This was a single group pretest and posttest study in 30 Chinese immigrants with T2D. The intervention included 24 culturally and linguistically tailored DSME videos, focusing on diabetes education and behavioral counseling techniques. Over 12 weeks, participants received 2 brief videos each week via WeChat, a free social media app popular among Chinese immigrants. Primary outcomes included the feasibility and acceptability of the intervention. Feasibility was evaluated by recruitment processes, retention rates, and the video watch rate. Acceptability was assessed via a satisfaction survey at 3 months. Secondary outcomes, that is, hemoglobin A1c (HbA1c), self-efficacy, dietary intake, and physical activity, were measured at baseline, 3 months, and 6 months. Descriptive statistics and paired 2-sided t tests were used to summarize the baseline characteristics and changes before and after the intervention. Results The sample population (N=30) consisted of mostly females (21/30, 70%) who were married (19/30, 63%), with limited English proficiency (30/30, 100%), and the mean age was 61 (SD 7) years. Most reported an annual household income of <US $25,000 (24/30, 80%) and a high school education or less (19/30, 63%). Thirty participants were recruited within 2 months (January and February 2020), and 97% (29/30) of the participants were retained at 6 months. A video watch rate of 92% (28/30) was achieved. The mean baseline HbA1c level was 7.3% (SD 1.3%), and this level declined by 0.5% (95% CI –0.8% to –0.2%; P=.003) at 6 months. The mean satisfaction score was 9.9 (SD 0.6) out of 10, indicating a high level of satisfaction with the program. All strongly agreed or agreed that they preferred this video-based DSME over face-to-face visits. Compared to baseline, there were significant improvements in self-efficacy, dietary, and physical activity behaviors at 6 months. Conclusions This pilot study demonstrated that a social media–based DSME intervention is feasible, acceptable, and potentially efficacious in a low-income Chinese immigrant population with T2D. Future studies need to examine the efficacy in an adequately powered clinical trial.

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Section: Discussionsupporting

confidence: 77%

A Social Media–Based Diabetes Intervention for Low-Income Mandarin-Speaking Chinese Immigrants in the United States: Feasibility Study

Hu¹,

Islam²,

Trinh‐Shevrin³

et al. 2022

JMIR Form Res

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“…Funded sites frequently implemented cultural adaptations to address participants’ needs or preferences, which were positively associated with participants’ overall attendance, attendance in months 7–12, and duration of participation. This finding is consistent with Chesla et al, who adapted the CDC-approved Group Lifestyle Balance curriculum for Chinese Americans with prediabetes, resulting in greater achievement of the 5% weight loss goal when compared to Chinese Americans receiving a non-adapted curriculum [42]. We did not, however, find improved results among sites that used language adaptations.…”

Section: Discussionsupporting

confidence: 91%

Using a RE-AIM framework to identify promising practices in National Diabetes Prevention Program implementation

et al. 2019

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Background The National Diabetes Prevention Program (National DPP) is rapidly expanding in an effort to help those at high risk of type 2 diabetes prevent or delay the disease. In 2012, the Centers for Disease Control and Prevention funded six national organizations to scale and sustain multistate delivery of the National DPP lifestyle change intervention (LCI). This study aims to describe reach, adoption, and maintenance during the 4-year funding period and to assess associations between site-level factors and program effectiveness regarding participant attendance and participation duration. Methods The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation from October 2012 to September 2016. Multilevel linear regressions were used to examine associations between participant-level demographics and site-level strategies and number of sessions attended, attendance in months 7–12, and duration of participation. Results The six funded national organizations increased the number of participating sites from 68 in 2012 to 164 by 2016 across 38 states and enrolled 14,876 eligible participants. By September 2016, coverage for the National DPP LCI was secured for 42 private insurers and 7 public payers. Nearly 200 employers were recruited to offer the LCI on site to their employees. Site-level strategies significantly associated with higher overall attendance, attendance in months 7–12, and longer participation duration included using self-referral or word of mouth as a recruitment strategy, providing non-monetary incentives for participation, and using cultural adaptations to address participants’ needs. Sites receiving referrals from healthcare providers or health systems also had higher attendance in months 7–12 and longer participation duration. At the participant level, better outcomes were achieved among those aged 65+ (vs. 18–44 or 45–64), those who were overweight (vs. obesity), those who were non-Hispanic white (vs. non-Hispanic black or multiracial/other races), and those eligible based on a blood test or history of gestational diabetes mellitus (vs. screening positive on a risk test). Conclusions In a time of rapid dissemination of the National DPP LCI the findings of this evaluation can be used to enhance program implementation and translate lessons learned to similar organizations and settings. Electronic supplementary material The online version of this article (10.1186/s13012-019-0928-9) contains supplementary material, which is available to authorized users.

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“…All eight studies conducted among children/adolescents were conducted in San Francisco, CA, USA [26][27][28][29][30][34][35][36], and all but one [26] were led by the same principal investigator (Chen) ( Table 1). Among adults, one study was set in Australia [37], one in Canada [33], and one in South Korea [38], while all others were conducted in the United States [31,32,[39][40][41][42][43][44][45][46][47] (Table 2). The average sample size was 60 and 63 among studies conducted in children/adolescents and adults, respectively (Tables 1 and 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Among adults, three studies were randomized controlled trials, nine studies were pre-post single-arm interventions, and two studies were two-group repeated measures quasi-experimental design (Table 4). Interventions included adaptations of the Diabetes Prevention Program [32,37,39,45] DASH diet [33], a cancer survival program [41], diabetes management programs [43,46,47], walking programs [38,40], community-based programs [42], tai chi [44], and an intervention to incorporate more brown rice in the diet [31]. Theoretical models included Transtheoretical Model, Culture Care Theory, Chronic Care model, Theory of reasoned action, Orem's theory of self care, Empowerment model, RE-AIM, Social Cognitive Theory, and traditional Chinese Medicine principles (Table 4).…”

Section: Intervention Characteristicsmentioning

confidence: 99%

Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review

et al. 2020

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Background: This review examines the effectiveness of diet and physical activity interventions to reduce cardiometabolic risk among Chinese immigrants and their descendants living in high income countries. The objective of this review is to provide information to help build future interventions aimed at improving diet and increasing physical activity levels among Chinese immigrants. Methods: Outcomes included BMI, weight, waist circumference (WC), waist-hip ratio (WHR), cholesterol (LDL, HDL), systolic and diastolic blood pressure (SBP, DBP), hemoglobin A1c (HgbA1c), fasting blood glucose (FBG), and HOMA-IR. Six databases were systematically searched from database inception to date of search (February 2020). Meta-analyses used random effect models to estimate pooled effects of outcomes with 95% confidence intervals. The outcomes assessed were changes in mean outcomes (post-intervention versus baseline) among the intervention group versus control groups. Results: Twenty-one articles were included for synthesis, and eight of these were included in the meta-analysis. Among children/adolescents, there were no significant effects of intervention for any of the outcomes having sufficient data for meta-analysis (BMI, WHR, SBP, and DBP). Among adults, the pooled effect including three studies showed significant changes in BMI (effect size = − 1.14 kg/m 2 ; (95% CI: − 2.06, − 0.21), I 2 = 31%). There were also significant effects of intervention among adults in terms of changes in SBP and DBP, as the pooled effect across three studies was − 6.08 mmHg (95% CI − 9.42, − 2.73), I 2 = 0% and − 3.81 mmHg (95% CI: − 6.34, − 1.28), I 2 = 0%, respectively. Among adults there were no other significant effects among the meta-analyses conducted (weight, WC, LDL, HgbA1c, and FBG).

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Cultural Adaptation of the Group Lifestyle Balance Program for Chinese Americans

Abstract: Results suggest that the culturally adapted Group Lifestyle Balance program for Chinese Americans was both acceptable and effective. The culturally adapted program warrants further examination using scientific approaches for dissemination and implementation.

Cited by 21 publications

References 41 publications

A Social Media–Based Diabetes Intervention for Low-Income Mandarin-Speaking Chinese Immigrants in the United States: Feasibility Study

A Social Media–Based Diabetes Intervention for Low-Income Mandarin-Speaking Chinese Immigrants in the United States: Feasibility Study

Using a RE-AIM framework to identify promising practices in National Diabetes Prevention Program implementation

Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review

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