Health behavior practice among understudied Chinese and Filipino Americans with cardiometabolic diseases

Q: What are the key findings of this study?

Chinese Americans with cardiometabolic disease were significantly less likely to restrict alcohol intake compared to Filipino Americans with cardiometabolic disease (AOR 0.11, 95% CI 0.01-0.80).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiometabolic diseases (coronary heart disease, heart attack, hypertension, type 2 diabetes mellitus, and high blood cholesterol) (n=374). Intervention: Chinese vs. Filipino ethnicity and cardiometabolic disease (CMD) status vs. No identified disease / Filipino ethnicity. Primary outcome: Low vs. high alcohol consumption among Chinese Americans with CMD compared to Filipino Americans with CMD (OR 0.11, 95% CI 0.01-0.80, p=<0.05).

Q: What does this research mean for the field?

Chinese Americans with cardiometabolic disease are significantly less likely to restrict alcohol intake than Filipino Americans with cardiometabolic disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Q: What question did this study set out to answer?

To investigate and compare health behavior practices—including physical activity, alcohol consumption, smoking, and dietary intake—among Chinese and Filipino Americans with and without cardiometabolic diseases.

Minsun Lee; Danielle Y. Hu; Gabrielle Bunney; Crystal A. Gadegbeku; Daniel Edmundowicz; S. R. Houser; Hong Wang; X. Grace

doi:10.1016/j.pmedr.2018.06.004

June 2, 2018Preventive Medicine ReportsOpen Access

Health behavior practice among understudied Chinese and Filipino Americans with cardiometabolic diseases

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Key result

Chinese Americans with cardiometabolic disease show ~89% lower odds of restricting alcohol intake versus Filipino Americans.

OR 0.11
95% CI 0.01-0.80
P<0.05
n=374

Why the study?

Do health behavior practices and adherence to lifestyle modification guidelines differ by disease status and sub-ethnicity among Chinese and Filipino Americans with cardiometabolic diseases?

Key Points

To investigate and compare health behavior practices—including physical activity, alcohol consumption, smoking, and dietary intake—among Chinese and Filipino Americans with and without cardiometabolic diseases.
Surveyed 374 Asian Americans (211 Chinese and 163 Filipino) residing in the greater Philadelphia region, including 241 participants with cardiometabolic disease and 133 with no identified disease.
Collected self-reported data on smoking, alcohol intake, physical activity, salt addition, and sweets consumption alongside demographic and acculturation characteristics.
Performed multivariate logistic regression analyses controlling for demographic and acculturation covariates to assess subethnic and disease-associated differences.
Compared to those with no disease, Chinese participants with cardiometabolic disease were significantly more likely to never add salt to food (AOR 4.42, 95% CI 1.28–15.25).
Filipino participants with cardiometabolic disease were significantly less likely to never consume sweets compared to those with no disease (AOR 0.12, 95% CI 0.02–0.90).
Among individuals with cardiometabolic disease, Chinese participants were significantly less likely to report low levels of alcohol consumption compared to Filipino participants (AOR 0.11, 95% CI 0.01–0.80).

Study Design

Type

Cross-Sectional (n=374)

Multicenter

Yes

Structured PICO

Do health behavior practices and adherence to lifestyle modification guidelines differ by disease status and sub-ethnicity among Chinese and Filipino Americans with cardiometabolic diseases?

P

Population

374 first-generation Chinese (n=211) and Filipino (n=163) American adults (55.3% female) residing in the greater Philadelphia region with either cardiometabolic disease (64.4%) or no identified chronic disease (35.6%).

E

Exposure

Cardiometabolic disease (CMD) diagnosis and sub-ethnic group membership (Chinese American vs. Filipino American)

C

Comparator

Individuals with no identified chronic disease (n=133; 121 Chinese, 12 Filipino) and cross-ethnic comparison between Chinese with CMD (n=90) and Filipinos with CMD (n=151)

O

Outcome

Self-reported adherence to health behavior and lifestyle guidelines (alcohol consumption, smoking status, physical activity, salt added to food, sweets consumption, and fruit/vegetable intake) assessed via adapted CDC Behavioral Risk Factor Surveillance System (BRFSS) questionnairespatient reported

Main Result

Odds Ratio: 0.11 (95% CI 0.01–0.8)

Absolute Event Rate: 47.8% vs 84.8%

p-value: p=<0.05

A majority of Chinese and Filipino Americans with cardiometabolic diseases fail to meet secondary prevention lifestyle guidelines, with distinct sub-ethnic behavioral patterns (higher alcohol/smoking in Chinese vs. higher sweets intake and inactivity in Filipinos) highlighting the need for culturally tailored interventions.

Limitations

Cross-sectional design precludes determining whether health behaviors preceded CMD diagnosis or changed afterward
Self-reported health behavior measurements adapted from BRFSS lacking clinical and laboratory validation
Relatively small sample size restricted to the greater Philadelphia region, limiting generalizability
Cross-sectional study design preventing determination of temporality between health behaviors and CMD development or diagnosis
Self-administered questionnaire measures adapted from CDC BRFSS without objective clinical or laboratory validation
Relatively small sample size limited to the greater Philadelphia region, restricting generalizability

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Implication

Sub-ethnic differences in alcohol restriction warrant consideration in counseling Asian Americans with cardiometabolic disease; leaves open whether targeted interventions improve adherence.

Abstract

Lifestyle modification and health behavior practice among the individuals with cardiometabolic diseases (CMD) are important for secondary prevention and disease control. This study was designed to investigate and compare health behavior practices among Chinese and Filipino Americans with CMD. Three hundred seventy-four Asian Americans (211 Chinese and 163 Filipino) who reside in the greater Philadelphia region and had either CMD or no identified disease were included in the study. Information on smoking, alcohol intake, physical activity, and salt and sweets consumption was collected, as well as demographic and acculturative characteristics. Of the 374 participants, 241 (64.4%) had CMD and 133 (35.6%) had no identified disease. The majority of Chinese and Filipino Americans with CMD failed to meet the dietary and physical activity guidelines, and only a small percentage of them restricted their amount of salt added to food and amount of sweets consumption. Compared to participants with no disease, Chinese participants with CMD were more likely to “never” add salt to food (AOR 4.42 compared to “frequently”). Filipino Americans with CMD were less likely to be those who “never” consume sweets than those who frequently consume sweets (AOR = 0.12). Among the participants with CMD, Chinese participants with CMD were less likely to restrict drinking (AOR 0.11) than Filipinos with CMD. The findings suggest that tailored interventions for Chinese and Filipino Americans with CMD should be developed to enhance their compliance to behavioral guidelines to prevent further disease progression and complications. • Many Chinese and Filipino Americans with CMD failed to meet the behavior guidelines. • Chinese with CMD were also less likely to add salt to food than those with no disease. • Filipinos with CMD were more likely to consume sweets than those with no disease. • Among those with CMD, Chinese were more likely to be heavy drinkers than Filipinos.

Discussion

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Cite This Study

Lee et al. (2018) conducted a cross-sectional in Cardiometabolic diseases (coronary heart disease, heart attack, hypertension, type 2 diabetes mellitus, and high blood cholesterol) (n=374). Chinese vs. Filipino ethnicity and cardiometabolic disease (CMD) status vs. No identified disease / Filipino ethnicity was evaluated on Low vs. high alcohol consumption among Chinese Americans with CMD compared to Filipino Americans with CMD (OR 0.11, 95% CI 0.01-0.80, p=<0.05). Chinese Americans with cardiometabolic disease were significantly less likely to restrict alcohol intake compared to Filipino Americans with cardiometabolic disease (AOR 0.11, 95% CI 0.01-0.80).

synapsesocial.com/papers/6a8196fbcb8186709ca1e5c0 https://doi.org/10.1016/j.pmedr.2018.06.004

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Health behavior practice among understudied Chinese and Filipino Americans with cardiometabolic diseases

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Health behavior practice among understudied Chinese and Filipino Americans with cardiometabolic diseases

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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