Exposure to Starvation: Associations with HbA1c, Anthropometrics, and Trauma Symptoms Four Decades Later Among Cambodians Resettled in the USA

Wagner, Julie; Bermúdez‐Millán, Angela; Berthold, S. Megan; Buckley, Thomas; Buxton, Orfeu M.; Feinn, Richard; Kong, Sengly; Kuoch, Theanvy; Scully, Mary; Seng, Kagnica

doi:10.1007/s12529-022-10108-3

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…We also asked survey questions about Khmer culture-bound symptoms including baksbat , which uses folk idioms to describe a condition similar to post-traumatic stress disorder and kmoach sanghkat , a sleep disturbance related to trauma that describes sleep paralysis. LHR also assessed food insecurity [25], the discussion of which can be distressing to participants, particularly those with a history of starvation [26].…”

Section: Study #2 Methods – Dreammentioning

confidence: 99%

Lay health worker research personnel for home-based data collection in clinical and translational research: Qualitative and quantitative findings from two trials in hard-to-reach populations

Wagner,

Barth,

Bermúdez-Millán

et al. 2023

J. Clin. Trans. Sci.

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Aims: The role of lay health workers in data collection for clinical and translational research studies is not well described. We explored lay health workers as data collectors in clinical and translational research studies. We also present several methods for examining their work, i.e., qualitative interviews, fidelity checklists, and rates of unusable/missing data. Methods: We conducted 2 randomized, controlled trials that employed lay health research personnel (LHR) who were employed by community-based organizations. In one study, n = 3 Latina LHRs worked with n = 107 Latino diabetic participants. In another study, n = 6 LHR worked with n = 188 Cambodian American refugees with depression. We investigated proficiency in biological, behavioral, and psychosocial home-based data collection conducted by LHR. We also conducted in-depth interviews with lay LHR to explore their experience in this research role. Finally, we described the training, supervision, and collaboration for LHR to be successful in their research role. Results: Independent observers reported a very high degree of fidelity to technical data collection protocols (>95%) and low rates of missing/unusable data (1.5%–11%). Qualitative results show that trust, training, communication, and supervision are key and that LHR report feeling empowered by their role. LHR training included various content areas over several weeks with special attention to LHR and participant safety. Training and supervision from both the academic researchers and the staff at the community-based organizations were necessary and had to be well-coordinated. Conclusions: Carefully selected, trained, and supervised LHRs can collect sophisticated data for community-based clinical and translational research.

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Section: Study #2 Methods – Dreammentioning

confidence: 99%

Lay health worker research personnel for home-based data collection in clinical and translational research: Qualitative and quantitative findings from two trials in hard-to-reach populations

Wagner,

Barth,

Bermúdez-Millán

et al. 2023

J. Clin. Trans. Sci.

View full text Add to dashboard Cite

show abstract

“…Participants were paid $10 USD in gift cards to a local pharmacy for completing the surveys. CHWs obtained anthropometrics and blood pressures according to standard practice as previously described [ 21 , 27 ]. Participants were asked to wear accelerometers on their non-dominant wrist (for sleep measurement) and hip (for physical activity measurement) for seven consecutive days.…”

Section: Methodsmentioning

confidence: 99%

Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep

Wagner,

Bermúdez-Millán,

Buckley

et al. 2023

Int J Behav Nutr Phys Act

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Background Refugees have high levels of psychological distress that hamper lifestyle change efforts. We previously reported that community health educator (CHE) diabetes prevention interventions decreased HbA1c and depressive symptoms among Cambodian-American refugees with depression; this paper reports health behavior outcomes of those interventions. Methods Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either a) antidepressant medication and/or b) prolonged elevated depressive symptoms. Participants were randomized to one of three CHE interventions: 1) lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus medication therapy management with a pharmacist/CHE team (EWS + MTM), or, 3) social services (SS; control). Physical activity and sleep were measured with 7 days of actigraphy. Nutrition was measured as carbohydrates as reported in a culturally tailored food frequency questionnaire. Assessments were at baseline, end point (12 months), and follow-up (15 months). Results The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal education was 7.0 years. Individuals in the two treatment groups that received the EWS intervention significantly increased their brown rice consumption (p < .001, Cohen’s d = 0.76) and their moderate-to-vigorous activity (p = .039, d = 0.32). No intervention changed sleep duration, timing, efficiency or wake after sleep onset. Across groups, individuals who increased brown rice consumption, increased vigorous activity and decreased total sleep time variability showed decreased HbA1c, with small effect sizes. Conclusions CHEs may improve nutrition and physical activity in refugees with depression but more intensive interventions may be required to impact sleep. Improvements in all three behaviors appear to be associated with HbA1c lowering Trial registration ClinicalTrials.gov identifier NCT02502929.

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Exposure to Starvation: Associations with HbA1c, Anthropometrics, and Trauma Symptoms Four Decades Later Among Cambodians Resettled in the USA

Cited by 2 publications

References 19 publications

Lay health worker research personnel for home-based data collection in clinical and translational research: Qualitative and quantitative findings from two trials in hard-to-reach populations

Lay health worker research personnel for home-based data collection in clinical and translational research: Qualitative and quantitative findings from two trials in hard-to-reach populations

Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep

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