Abstract
BackgroundSouth Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD). This pilot study evaluated a culturally-salient, community-based healthy lifestyle intervention to reduce ASCVD risk among South Asians.MethodsThrough an academic-community partnership, medically underserved South Asian immigrants at risk for ASCVD were randomized into the South Asian Heart Lifestyle Intervention (SAHELI) study. The intervention group attended 6 interactive group classes focused on increasing physical activity, healthful diet, weight, and stress management. They also received follow-up telephone support calls. The control group received translated print education materials about ASCVD and healthy behaviors. Primary outcomes were feasibility and initial efficacy, measured as change in moderate/vigorous physical activity and dietary saturated fat intake at 3- and 6-months. Secondary clinical and psychosocial outcomes were also measured.ResultsParticipants’ (n = 63) average age was 50 (SD = 8) years, 63 % were female, 27 % had less than or equal to a high school education, one-third were limited English proficient, and mean BMI was 30 kg/m2 (SD ± 5). There were no significant differences in change in physical activity or saturated fat intake between the intervention and control group. Compared to the control group, the intervention group showed significant weight loss (−1.5 kg, p-value = 0.04) and had a greater sex-adjusted decrease in hemoglobin A1C (−0.43 %, p-value <0.01) at 6 months. Study retention was 100 %.ConclusionsThis pilot study suggests that a culturally-salient, community-based lifestyle intervention was feasible for engaging medically underserved South Asian immigrants and more effective at addressing ASCVD risk factors than print health education materials.Trial registrationNCT01647438, Date of Trial Registration: July 19, 2012Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2401-2) contains supplementary material, which is available to authorized users.
Highlights
South Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD)
Diet and physical activity counseling is recommended for all individuals with ASCVD risk factors [16], few lifestyle interventions exist for the 3.4 million South Asians living in the U.S The majority of evidence-based lifestyle interventions have been developed and tested in predominantly White or African American populations [17]
Our prior research found that existing lifestyle interventions were not reaching South Asians because interventions did not address the sociocultural determinants of diet, physical activity, weight, and health [19,20,21,22,23,24,25]
Summary
South Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD). This pilot study evaluated a culturally-salient, community-based healthy lifestyle intervention to reduce ASCVD risk among South Asians. Diet and physical activity counseling is recommended for all individuals with ASCVD risk factors [16], few lifestyle interventions exist for the 3.4 million South Asians living in the U.S The majority of evidence-based lifestyle interventions have been developed and tested in predominantly White or African American populations [17]. Translating evidence-based lifestyle interventions across an increasingly diverse U.S population and with underserved populations is a major challenge [26]
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