YEARS

2012-2014

AUTHORS

Namratha R Kandula

TITLE

Translating a Heart Disease Lifestyle Intervention into the Community

ABSTRACT

DESCRIPTION (provided by applicant): Asian Indians and Pakistanis (South Asians) have a disproportionate risk of coronary heart disease (CHD) and are at greater risk for death from CHD compared to all other racial/ethnic groups. There are almost 3 million South Asians Americans; over the past decade they have been the second fastest growing U.S. ethnic group after Hispanics. Relative to Whites, Blacks, Latinos, Japanese, and Chinese in California, South Asians have the highest CHD mortality rates. Behavioral factors contribute significantly to the increased CHD risk observed in South Asians; among all U.S. Asians, South Asians have the highest rates of overweight/obesity and report the least physical activity. Published data strongly support the benefits of healthy lifestyle interventions as a means to decrease CHD risk factors. Facilitating and promoting lifestyle interventions for this growing population could lead to a substantial impact on South Asians' CHD risk; yet knowledge is limited on how best to deliver lifestyle interventions in medically underserved communities and to South Asians, specifically. While clinic-based screening, lifestyle advice, and medication are key to reducing CHD risk factors in individual patients, traditional health care system approaches are unlikely to reach underserved South Asians. Our prior research, conducted in a South Asian community with low socioeconomic status and limited English proficiency, identified several social, cultural, and environmental factors that could limit the impact of clinic- based interventions in this group. Given the limits of clinic-based CHD prevention to address these factors, a culturally-salient lifestyle intervention delivered in the patient's community can enhance the impact of clinical care by: [1] Extending the practical applications of behavioral interventions into underserved neighborhoods; and [2] Filling gaps in clinic-based CHD risk factor management, such as lack of time to engage in lifestyle counseling, limited knowledge about different cultural groups, limited awareness of neighborhood resources, and lack of between-visit support. In partnership with the community, the research team used formative data and health behavior and learning theory to develop the South Asian Heart Lifestyle Intervention (SAHELI), a culturally targeted, group-based, CHD prevention lifestyle intervention for medically underserved South Asians. The intervention incorporates the deep structures of South Asian culture (e.g., explanatory models of CHD) as the mechanism to engage South Asians in CHD prevention and a healthy lifestyle. The goal of this study is to pilot-test SAHELI, via a randomized design, and examine its feasibility and initially efficacy to change physical activity and diet behaviors among medically underserved South Asians in a community-based setting. We will also conduct a process evaluation to understand participants' perceptions of the intervention. This study will provide essential data for the planning of a future large-scale comparative effectiveness trial of differen approaches to enhance CHD prevention in hard to reach South Asian American populations.

FUNDED PUBLICATIONS

  • Translating a heart disease lifestyle intervention into the community: the South Asian Heart Lifestyle Intervention (SAHELI) study; a randomized control trial.
  • The South Asian Heart Lifestyle Intervention (SAHELI) study to improve cardiovascular risk factors in a community setting: design and methods.
  • Translating a heart disease lifestyle intervention into the community: the South Asian Heart Lifestyle Intervention (SAHELI) study; a randomized control trial
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    20 TRIPLES      17 PREDICATES      21 URIs      9 LITERALS

    Subject Predicate Object
    1 grants:6487aabffc11445fd58e2e84fe0dbbdb sg:abstract DESCRIPTION (provided by applicant): Asian Indians and Pakistanis (South Asians) have a disproportionate risk of coronary heart disease (CHD) and are at greater risk for death from CHD compared to all other racial/ethnic groups. There are almost 3 million South Asians Americans; over the past decade they have been the second fastest growing U.S. ethnic group after Hispanics. Relative to Whites, Blacks, Latinos, Japanese, and Chinese in California, South Asians have the highest CHD mortality rates. Behavioral factors contribute significantly to the increased CHD risk observed in South Asians; among all U.S. Asians, South Asians have the highest rates of overweight/obesity and report the least physical activity. Published data strongly support the benefits of healthy lifestyle interventions as a means to decrease CHD risk factors. Facilitating and promoting lifestyle interventions for this growing population could lead to a substantial impact on South Asians' CHD risk; yet knowledge is limited on how best to deliver lifestyle interventions in medically underserved communities and to South Asians, specifically. While clinic-based screening, lifestyle advice, and medication are key to reducing CHD risk factors in individual patients, traditional health care system approaches are unlikely to reach underserved South Asians. Our prior research, conducted in a South Asian community with low socioeconomic status and limited English proficiency, identified several social, cultural, and environmental factors that could limit the impact of clinic- based interventions in this group. Given the limits of clinic-based CHD prevention to address these factors, a culturally-salient lifestyle intervention delivered in the patient's community can enhance the impact of clinical care by: [1] Extending the practical applications of behavioral interventions into underserved neighborhoods; and [2] Filling gaps in clinic-based CHD risk factor management, such as lack of time to engage in lifestyle counseling, limited knowledge about different cultural groups, limited awareness of neighborhood resources, and lack of between-visit support. In partnership with the community, the research team used formative data and health behavior and learning theory to develop the South Asian Heart Lifestyle Intervention (SAHELI), a culturally targeted, group-based, CHD prevention lifestyle intervention for medically underserved South Asians. The intervention incorporates the deep structures of South Asian culture (e.g., explanatory models of CHD) as the mechanism to engage South Asians in CHD prevention and a healthy lifestyle. The goal of this study is to pilot-test SAHELI, via a randomized design, and examine its feasibility and initially efficacy to change physical activity and diet behaviors among medically underserved South Asians in a community-based setting. We will also conduct a process evaluation to understand participants' perceptions of the intervention. This study will provide essential data for the planning of a future large-scale comparative effectiveness trial of differen approaches to enhance CHD prevention in hard to reach South Asian American populations.
    2 sg:endYear 2014
    3 sg:fundingAmount 401555.0
    4 sg:fundingCurrency USD
    5 sg:hasContribution contributions:d763e4544ecc84efe9c39afec3346fbb
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    8 sg:hasFundedPublication articles:32d264553ad57be7a9e959f116dd4bee
    9 articles:d92317276f88f51a738aebec664af6c2
    10 articles:def5a0f8dae62dd27d32a6d29bd53617
    11 sg:hasFundingOrganization grid-institutes:grid.279885.9
    12 sg:hasRecipientOrganization grid-institutes:grid.16753.36
    13 sg:language English
    14 sg:license http://scigraph.springernature.com/explorer/license/
    15 sg:scigraphId 6487aabffc11445fd58e2e84fe0dbbdb
    16 sg:startYear 2012
    17 sg:title Translating a Heart Disease Lifestyle Intervention into the Community
    18 sg:webpage http://projectreporter.nih.gov/project_info_description.cfm?aid=8442836
    19 rdf:type sg:Grant
    20 rdfs:label Grant: Translating a Heart Disease Lifestyle Intervention into the Community
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