People from Korea and South Asia who emigrate to the West may become at increased risk of developing diabetes, obesity, and cardiovascular disease, due to changes in dietary and physical activity practices. The average body mass index for members of these Asian immigrant communities increases with each new generation, which increases the risk for chronic disease.
Researchers are assessing the needs and resources of selected Asian immigrant communities in New York City to determine the communities’ health behaviors and capacity for making personal, policy, and environmental changes. To help promote change, the researchers are establishing Project RICE (Reaching Immigrants through Community Empowerment), a program in which community health workers (CHWs) deliver a diabetes-prevention intervention.
In the first phase of the study, CHWs receive training on many topics, including conducting focus groups and interviews, and administering surveys. Researchers want to learn about local access to health care and the barriers that members of these communities face, their attitudes toward diabetes prevention, and their behaviors that can affect their risk of developing the disease. Because respondents may have limited English proficiency, surveys and focus groups are conducted in native languages as needed. Participants receive phone cards or other small incentives for their input. The researchers use the information collected to design or select an intervention.
CHWs deliver the selected intervention as a six-month program—several times over 36 months—to different groups of participants. In total, 120 Korean individuals and 120 South Asian individuals will participate in the program; each set of 120 is compared with a control group. Items for comparison include steps the participants are taking to stay healthy, such as being screened for diabetes and whether their spouse and friends support their healthy habits.
The researchers hypothesize that after receiving the intervention, the participants will know more about diabetes and how to prevent it and that they will increase exercise, follow a healthy diet, and successfully navigate the health care system. The investigators anticipate that people who receive the intervention will also improve their health and fitness indicators such as body mass index, hip-to-waist ratio, and glucose test results.
The intervention will be implemented, tested, and evaluated using the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance).