R01 Projects

Unveiling Possibilities, Igniting Change: Advancing Asian Health and Equity

R01 Projects

Homestyles: Shaping HOME Environments and LifeSTYLE Practices to Reduce Cardiometabolic Disease Risk

Carol Byrd-Bredbenner, Zhao, Wu, Hoover

The disproportionate burden of cardiometabolic disease and physiological dysregulation among Asians compelled the World Health Organization to recommend differential Body Mass Index (BMI) cut off points for overweight and obesity. US Chinese are at increased risk for cardiometabolic disease and comorbidities, including obesity, type 2 diabetes mellitus (DM), and hypertension. Key social determinants of health further exacerbate these health conditions through low access to healthy foods, limited physical activity space and supports, psychosocial stress, urban noise interrupted nighttime sleep, limited knowledge of how to prepare available food healthfully, low awareness of nutritional and health needs, and low English proficiency rates.

HomeStyles is a multi-domain (diet, physical activity, sleep), multi-level (individual, family, home environment), behaviorally focused (Social Cognitive Theory), intensive (10 weeks) intervention that promotes realistic, effective changes to diet, physical activity, and sleep behaviors that participants implement in partnership with their families. We will implement this intervention in a 2-arm RCT with 400 Chinese adults with elevated BMI (WHO Asian cutoff >23) and self-reported DM or hypertension to achieve the following aims: 

• Aim1: Culturally and linguistically adapt the multi-component and family-oriented HomeStyles intervention through community-engaged approaches (focus groups, cognitive interviews, key informant interviews) in US Chinese populations in New York and New Jersey (NY/NJ).  

• Aim 2: Conduct a 10-week, 2-arm RCT to test intervention efficacy on: Subjective health behaviors (dietary intake [fruit, vegetable, fiber, sugar], physical activity, self-efficacy) and Objective health outcomes (HbA1C, waist circumference, BMI) at baseline, and 3 and 6 months. Hypothesis: Participants randomized to the treatment condition will have greater improvements in both subjective health behaviors and objective health outcomes than those in the control condition. Exploratory aim: To examine participants’ spouse and family reported dietary intake and physical activity behaviors.  

NYUCI-ES: Psychosocial Intervention to Improve Health Outcomes for Chinese and Korean ADRD Caregiver

-Bei Wu, Mary Mittleman, Cho, Liu, Sengupta, Hoover, Simon

The physical and emotional demands of dementia caregiving can have enormous negative effects on caregivers’ physical and mental health. Dementia caregivers have increased risk of hypertension and diabetes, compared to non-caregivers, especially in Chinese American and Korean American dementia caregivers. This study will conduct a two-arm randomized controlled trial to test the efficacy of a culturally tailored version of the NYU Caregiver Intervention (NYUCI) plus enhanced support (ES) through online chat groups (the NYUCI plus WeChat/Kakaotalk [population social media app for Chinese/Korean] peer support which we call the NYUCI-ES in reducing health risks for cardiometabolic disease among older Chinese and Korean-American adults caring for relatives with ADRD.

The NYUCI has proven efficacy in reducing psychological outcomes among largely White samples of caregivers of persons with ADRD and has been widely replicated and translated in the USA and elsewhere. This study will provide the first large- scale test of the potential effects of the NYUCI-ES, a multicomponent intervention that includes individual and family counseling and ongoing support via support group and online chat groups and ad hoc (on demand) counseling. In collaboration with community organizations across the New York and northern New Jersey metropolitan area, we will enroll 300 caregivers of people with ADRD (150 Chinese and 150 Korean) in this study. The public health significance of these findings will likely have an impact on health care policy for CGs from diverse underserved ethnic and cultural backgrounds, potentially reducing morbidity, and improving their quality of life.