A Randomized-Controlled, Pilot Intervention on Diabetes Prevention and Healthy Lifestyles in the New York City Korean Community
Asian Americans experience diabetes at a higher rate than non-Hispanic whites. Diabetes prevention programs using lifestyle interventions have been shown to produce beneficial results, yet there have been no culturally-tailored programs for diabetes prevention in the Korean community. We explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve health behaviors and promote diabetes prevention among Korean Americans using a randomized controlled trial. Between 2011 and 2012, a total of 48 Korean Americans at risk for diabetes living in New York City (NYC) participated in the intervention. Participants were allocated to treatment or control groups. A community-based participatory research approach guided development of the intervention, which consisted of 6 workshops held by CHWs on diabetes prevention, nutrition, physical activity, diabetes complications, stress and family support, and access to health care. Changes over 6 months were examined for clinical measurements (weight, BMI, waist circumference, blood pressure, glucose, and cholesterol); health behaviors (physical activity, nutrition, food behaviors, diabetes knowledge, self-efficacy, and mental health); and health access (insurance and self-reported health). In this small pilot study, changes were seen in weight, waist circumference, diastolic blood pressure, physical activity nutrition, diabetes knowledge, and mental health. Qualitative findings provide additional contextual information that inform ways in which CHWs may influence health outcomes. These findings demonstrate that a diabetes prevention program can be successful among a Korean American population in NYC, and important insight is provided for ways that programs can be tailored to meet the needs of vulnerable populations.
KeywordsAsian Americans Korean Americans Community health workers Community-based participatory research Diabetes prevention
This study was supported by Grant 1U48DP001904-01 from the Centers for Disease Control and Prevention, Grants P60MD000538 and MD001786 from the National Institutes of Health, Grant R24MD001786 from the National Insitutes of Health National Institute on Minority Health and Health Disparities, and Grant UL1 TR000038 from the National Center for Advancing Translational Sciences, National Institutes of Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding organizations. The authors would also like to thank the following individuals for their guidance and support on the project: Mariano J. Rey at the New York University School of Medicine, Sunhi Shin at the New York University Langone Medical Center, Miyong Kim and Hae-Ra Han at Johns Hopkins University School of Nursing, Kim B. Kim at Korean Resource Center, Ashwini Rao at Columbia University Medical Center, Darius Tandon at Johns Hopkins University School of Medicine, Tazuko Shibusawa at the New York University Silver School of Social Work, the Project RICE community health workers Christina Choi and Hyunjae Yim, and the staff at Korean Community Services for their service and dedication in implementing this project.
- 1.Centers for Disease Control and Prevention. (2011). National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Available from: http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
- 3.Barnes, P. M., Adams, P. F., & Powell-Griner, E. (2008). Health characteristics of the Asian adult population: United States, 2004–2006. Adv Data (394), 1–22.Google Scholar
- 8.Ramachandran, A., & Snehalatha, C. (2011). Diabetes prevention programs. Med Clin North Am, 95(2), 353–372, viii.Google Scholar
- 10.American Diabetes Association. American Diabetes Association unveils new diabetes risk test. 2012 March, 2013. Available from: http://www.diabetes.org/for-media/2012/american-diabetes-association-new-risk-test.html.
- 11.National Heart, L., & Blood Institute. Healthy heart, healthy family: A community health worker’s manual for the filipino community. 1999 March, 2013. Available from: http://www.nhlbi.nih.gov/health/prof/heart/other/chdfilipino/intro.htm.
- 13.National Diabetes Education Program. The road to health toolkit resource guide. Available from: http://www.ndep.nih.gov/media/road-to-health-toolkit-resources-guide.pdf.
- 14.National Diabetes Education Program. Power to prevent: A family lifestyle approach to diabetes prevention. Available from: http://ndep.nih.gov/media/power-to-prevent-508.pdf.
- 17.United States Census: American community survey. 2011. Available from: http://www.census.gov/acs/www/methodology/questionnaire_archive/.
- 18.CDC: Behavioral risk factor surveillance system. 2011. Available from: http://www.cdc.gov/brfss/questionnaires/english.htm.
- 19.Bandura, A. (2006). Guide for constructing self-efficacy scales. In Self-efficacy beliefs of adolescents. Information Age Publishing.Google Scholar
- 21.American Diabetes Association. Diabetes basics: Your risk. 2013 1/9/2013. Available from: http://www.diabetes.org/diabetes-basics/prevention/risk-factors/.
- 26.Islam, N., Wyatt, L., Patel, S., et al. Evaluation of a community health worker pilot intervention to improve diabetes management in Bangladeshi immigrants with type 2 diabetes in New York City. Diabetes Educ (in press).Google Scholar