Health is Wealth: Methods to Improve Attendance in a Lifestyle Intervention for a Largely Immigrant Filipino-American Sample

Abstract

Diabetes prevention requires lifestyle changes, and traditional educational programs for lifestyle changes have had low attendance rates in ethnic populations. This article describes the development and implementation of an educational program, emphasizing retention strategies, cultural tailoring and community participation. Community-based participatory research approaches were used to adapt and test the feasibility of a culturally tailored lifestyle intervention (named Health is Wealth) for Filipino-American adults at risk for diabetes (n = 40) in order to increase program attendance. A unique feature of this program was the flexibility of scheduling the eight classes, and inclusion of activities, foods and proverbs consistent with Filipino culture. We found that with this approach, overall program attendance for the experimental and wait-listed control groups was 88% and participant satisfaction was high with 93% very satisfied. Flexible scheduling, a bilingual facilitator for the classes, and the community-academic partnership contributed to the high attendance for this lifestyle intervention.

Immigration as a Social Determinant of Health

“…The primary topics addressed by the behavioral approach to immigration and health include health service utilization (44,64), cancer risk behaviors and screening (18,83,146), chronic disease (30,60,70), and mental health (10,64). Most articles conduct analyses of immigrants' health practices rather than of the social or economic contexts of these practices.…”

Cardiovascular Health of Filipinos in the United States

“…This diabetes education program consisted of eight educational classes. The class times were taught by bilingual facilitators with flexible class times and incorporated culturally appropriate activities, food, and values (Leake et al, 2012). …”

Lifestyle Intervention for Filipino Americans at Risk for Diabetes

“…This goal is not only important for reducing the burden of T2D and its complications for FAs, but to determine if the culturally appropriate procedures developed can also be applied to other ethnic minority and underserved immigrant populations. By meeting the objectives of the project, new knowledge Lack of time is often a barrier to participation in lifestyle interventions and maintaining behavior change (Leake et al, 2012). Health is Wealth (Kalusugan ay Kayamanan) was a pilot study (n = 40) testing flexible scheduling for eight stand-alone classes for community dwelling FAs at high risk for diabetes.…”

“…The intervention was held in a park on Sunday afternoons, with most participants recruited from two large Catholic churches not far from the study site, frequently visited by Filipino families (Leake et al, 2012). Participants were counted if they attended at least 75% of the intervention sessions, such as at least six of eight units in the curriculum.…”

“…Health is Wealth was a cultural belief of the sakadas (original Filipino immigrants who came to Hawaii beginning in 1886 as plantation workers; Leake et al, 2012). The Philippine Nurses Association (PNA) of Hawaii, the community partner for this study, chose this name to bridge the cultural values of the importance of good health, the value of working hard, and the dreams that the sakadas followed to America for a better life for their families.…”