Shilpa Patel

Evaluation of a Community Health Worker Pilot Intervention to Improve Diabetes Management in Bangladeshi Immigrants with Type 2 Diabetes in New York City

Purpose The purpose of this study is to explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve diabetes management among Bangladeshi-American individuals with type 2 diabetes living in New York City. Methods Participants were recruited at clinic- and community-based venues. The intervention consisted of 6 monthly, CHW-facilitated group sessions on topics related to management of diabetes. Surveys were collected at baseline and follow-up time points. Study outcomes included clinical, behavioral, and satisfaction measures for participants, as well as qualitative measures from CHWs. Results Improvements were seen in diabetes knowledge, exercise and diet to control diabetes, frequency of checking feet, medication compliance, and self-efficacy of health and physical activity from baseline to 12 months. Additionally, there were decreases in A1C, weight, and body mass index. Program evaluation revealed a high acceptability of the intervention, and qualitative findings indicated that CHWs helped overcome barriers and facilitated program outcomes through communal concordance, trust, and leadership. Conclusions The intervention demonstrated high acceptability and suggested efficacy in improving diabetes management outcomes among Bangladeshi immigrants in an urban setting. The US Bangladeshi population will continue to increase, and given the high rates of diabetes, as well as linguistic and economic barriers faced by this community, effective and culturally tailored health interventions are needed to overcome barriers and provide support for diabetes management.

Sources of Health Information Among Select Asian American Immigrant Groups in New York City

Health information can potentially mitigate adverse health outcomes among ethnic minority populations, but little research has examined how minorities access health information. The aim of this study was to examine variations in the use of health information sources among Asian American (AA) subgroups and to identify differences in characteristics associated with the use of these sources. We analyzed data from a foreign-born community sample of 219 Asian Indians, 216 Bangladeshis, 484 Chinese, and 464 Koreans living in New York City. Results found that use of health information sources varied by AA subgroup. Print media source use, which included newspapers, magazines, and/or journals, was highest among Chinese (84%), Koreans (75%), and Bangladeshis (80%), while radio was most utilized by Chinese (48%) and Koreans (38%). Television utilization was highest among Bangladeshis (74%) and Koreans (64%). Koreans (52%) and Chinese (40%) were most likely to use the Internet to access health information. Radio use was best explained by older age and longer time lived in the United States, while print media were more utilized by older individuals. Results also highlighted differences in native-language versus non-native-language media sources for health information by subgroup. Media sources can be used as a vehicle to disseminate health information among AAs.

Recommendations for Implementing Policy, Systems, and Environmental Improvements to Address Chronic Diseases in Asian Americans, Native Hawaiians, and Pacific Islanders

Emphasis has increased recently on disseminating high-impact, population-wide strategies for the prevention of chronic diseases. However, such strategies are typically not effective at reaching Asian Americans, Native Hawaiians, Pacific Islanders, or other underserved communities. The objectives of this article were to 1) present the methods of the Strategies to Reach and Implement the Vision of Health Equity program in which 15 community-based organizations in the United States and the Pacific region implemented evidence-based policy, systems, and environmental improvements in their local communities and 2) provide recommendations for using these tailored approaches in other communities and geographic locations. Further support is needed for organizations in tailoring these types of population-wide strategies. Implementing population health improvements should be adapted to maximize effectiveness to decrease chronic diseases in these populations and ultimately eliminate racial/ethnic health disparities.

Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders.

Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of

Emerging South Asian Americans and Health

2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.

Visualizing Reach of Racial and Ethnic Approaches to Community Health for Asian Americans: the REACH FAR Project in New York and New Jersey

Two growing South Asian populations in America are Bangladeshis and Pakistanis. These relatively new groups to the South Asian American community are nonetheless experiencing tremendous population growth. Both groups are similar to other South Asians, yet also quite different in other ways. For instance, Pakistani and Bangladeshi Americans have lower socioeconomic status and are more linguistically isolated compared to other South Asians. The chapter presents a description of the unique experiences of these two groups in America, and how the combination of environmental and personal factors affects the health of Pakistani and Bangladeshi Americans.

Best Practices for Partnering with Ethnic Minority-Serving Religious Organizations on Health Promotion and Prevention

The REACH FAR (Racial and Ethnic Approaches to Community Health for Asian Americans) project in New York and New Jersey is guided by a multisector coalition made up of the New York University Center for the Study of Asian American Health, the New York City Department of Health and Mental Hygiene, 4 communitybased organizations: UNITED SIKHS, serving the Asian Indian population; Diabetes Research, Education, and Action for Minorities, serving the Bangladeshi community; Kalusugan Coalition, Inc., serving the Filipino community; and Korean Community Services of Metropolitan New York, Inc., serving the Korean community; and other organizations and groups serving these communities. The map shows locations in 2016 of faith-based organizations that served as implementation sites for Keep on Track, an intervention consisting of nutrition and hypertension management/cardiovascular disease prevention strategies for Asian American communities. Implementation sites are located in Asian American population clusters. Lines on the map, representing the number of participants in the Keep on Track program, provide a visual representation of service delivery and reach of the REACH FAR project.

Primary care physicians’ attitudes and beliefs about cancer clinical trials

Faith-based organizations (FBOs) serve as effective sites for community-based health promotion, but there is a lack of research on this work in ethnic minority-serving religious institutions such as mosques, temples, and gurdwaras. This article will share best practices, challenges, and special considerations in engaging these sites through two projects: Racial and Ethnic Approaches to Community Health for Asian Americans (REACH FAR) and Muslim Americans Reaching for Health and Building Alliances (MARHABA). We also discuss the Consolidated Framework for Implementation Research and how we used this framework in the two projects to facilitate implementation of health promotion initiatives within ethnic minority-serving religious institutions. To successfully implement such initiatives within these sites, efforts should leverage trusted internal and external relationships through iterative engagement, include adaptable interventions, and address sustainability from the outset.

Improving Access to Healthy Foods for Asian Americans, Native Hawaiians, and Pacific Islanders: Lessons Learned from the STRIVE Program

Background/Aims: Cancer clinical trials give patients access to state-of-the-art treatments and facilitate the translation of findings into mainstream clinical care. However, patients from racial and ethnic minority groups remain underrepresented in clinical trials. Primary care physicians are a trusted source of information for patients, yet their role in decision-making about cancer treatment and referrals to trial participation has received little attention. The aim of this study was to determine physicians’ knowledge, attitudes, and beliefs about cancer clinical trials, their experience with trials, and their interest in appropriate training about trials. Methods: A total of 613 physicians in the New York City area primarily serving patients from ethnic and racial minority groups were invited via email to participate in a 20-min online survey. Physicians were asked about their patient population, trial knowledge and attitudes, interest in training, and personal demographics. Using calculated scale variables, we used descriptive statistical analyses to better understand physicians’ knowledge, attitudes, and beliefs about trials. Results: A total of 127 physicians completed the survey. Overall, they had low knowledge about and little experience with trials. However, they generally had positive attitudes toward trials, with 41.4% indicating a strong interest in learning more about their role in trials, and 35.7% indicating that they might be interested. Results suggest that Black and Latino physicians and those with more positive attitudes and beliefs were more likely to be interested in future training opportunities. Conclusion: Primary care physicians may be an important group to target in trying to improve cancer clinical trial participation among minority patients. Future work should explore methods of educational intervention for such interested providers.

A Mixed Methods Examination of Communication between Oncologists and Primary Care Providers among Primary Care Physicians in Underserved Communities

Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) experience a large burden from certain chronic disease-related risk factors. The STRIVE Program funded four AANHPI community-based organizations (CBOs) to implement culturally adapted community gardens and farmers’ markets to increase access to healthy foods. Key CBO informant interviews were conducted to understand processes and lessons learned.