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



June 15, 2023

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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.