Suinn-Lew Asian Self-Identity Acculturation Scale Research Articles

Richard M. Suinn (1933-2024).

Richard M. Suinn, an eminent psychologist known for his work in cognitive behavioral therapy (CBT), sports psychology, ethnic minority issues, and professional association leadership, passed away on January 5, 2024, in Fort Collins, Colorado, at the age of 90 years. Suinn was born on May 8, 1933, in Hawai'i. Suinn was an expert in anxiety management and developed the widely used Mathematics Anxiety Rating Scale. He was the first psychologist appointed team psychologist to a U.S. Olympic team, applying his CBT expertise to five Olympic teams. Suinn developed the Suinn-Lew Asian Self-Identity Acculturation Scale, the most widely used measure of Asian American acculturation. He served as a president of the American Psychological Association (APA) where he opened the door for APA presidents of color, and the Association of Behavioral and Cognitive Therapies (ABCT) and a member of the Board of Directors of APA, the American Psychological Foundation, American Board of Professional Psychology, Association for the Advancement of Psychology, ABCT, and the Asian American Psychological Association (AAPA). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Acculturation, food-related and general parenting, and body weight in Chinese-American children

Parents' food-related and general parenting behaviors may vary according to cultural background, with consequences for child eating behavior and weight. A better understanding of food-related and general parenting behaviors adopted by Chinese-American parents, and the relationships of all of these behaviors with child weight, is essential to aid the development of culturally appropriate interventions to prevent obesity in Chinese-American children. We investigated cross-sectional relationships of acculturation with parental feeding behaviors assessed with the Child Feeding Questionnaire, Parent Feeding Styles Questionnaire and Caregiver's Feeding Styles Questionnaire, and general parenting behaviors assessed with the Parenting Styles and Dimensions Questionnaire, in a sample of Chinese-American parents of 5–12 year-old children (n = 233). Parental level of acculturation was assessed using the Suinn-Lew Asian Self-Identity Acculturation scale. We performed generalized linear regressions to explore associations of acculturation levels with parental feeding and general parenting subscales and also associations of these factors with child body mass index (BMI) z-score. Acculturation was associated with higher scores on Responsiveness in feeding, lower scores on subscales assessing controlling feeding behaviors (Restriction, Pressure to eat, Demandingness in feeding), lower scores on non-nutritive feeding behaviors (Emotional feeding, Instrumental feeding), and greater likelihood of an indulgent feeding style. With regard to general parenting, acculturation was associated with lower scores on subscales assessing authoritarian parenting. Parental Prompting/Encouragement to eat was associated with lower child BMI z-score, while authoritarian parenting subscales were associated with higher BMI z-score. An appreciation of the impact of cultural variation on food-related and general parenting may help to inform the development of culturally-sensitive obesity prevention interventions.

Validating the Suinn-Lew Asian Self-Identity Acculturation Scale Among Middle Eastern Migrants: Linear Versus Orthogonal Approaches

: The current study aimed at validating the 26-item Suinn-Lew Asian Self-Identity Acculturation scale (SL-ASIA) using confirmatory factor analysis (CFA) in first-generation young adult Middle Eastern (ME) migrants, and also exploring the agreement between the outcomes of linear and orthogonal approaches of acculturation using SL-ASIA. The CFA and convergent and discriminant validity measures were employed to validate the original linear SL-ASIA and the subsequently designed orthogonal SL-ASIA for first-generation young adult ME migrants in Australia (n = 382). Cohen’s Kappa coefficient was used to measure the agreement between classifications obtained by the linear and orthogonal methods of measuring acculturation. The CFAs of the initial six-factor 21-item linear scale and the two-factor five-item orthogonal scale indicated poor fits. However, after model specification and validation, satisfactory fit and validity indices were achieved for the modified scales. The validated linear SL-ASIA comprised five factors and 15 items, and the validated orthogonal SL-ASIA comprised two factors and four items. The Kappa coefficient showed a high level of consistency between the linear and orthogonal models of acculturation, confirming that the use of either scale can lead to similar research outcomes. The study also supports the use of the validated linear and/or orthogonal scales to measure acculturation. This finding responds to the existing gap in the literature that until now, no acculturation scale is validated for ME migrants, and also no study is conducted to validate the orthogonal SL-ASIA.

Chinese Immigrant Parents’ Perspectives on Psychological Well-Being, Acculturative Stress, and Support: Implications for Multicultural Consultation

ABSTRACTThis study investigated Chinese immigrant parents’ perspectives on Chinese immigrant children’s psychological well-being, acculturative stress, and sources of support. We conducted focus groups with 22 Chinese immigrant parents of school-aged children (16 mothers and 6 fathers); obtained participants’ sociocultural and linguistic backgrounds and acculturation levels through a self-developed questionnaire and the Suinn-Lew Asian Self-Identity Acculturation Scale; and coded and analyzed the verbatim transcripts of the focus groups through deductive and inductive procedures. Results yielded 8 definitions of psychological well-being, 2 acculturative and 6 general themes of stresses, and 3 themes of support. A comparison of the results with previous research findings reveals convergent views regarding essence in psychological well-being, acculturative stresses, sources of support, and wanted interventions at home and school among Chinese immigrant parents, adolescents, and mental health providers. The common and different perspectives between parents and children on these issues provide a helpful reference for multicultural consultation.

Health Examination Is Not a Priority for Less Acculturated Asian Americans.

This study examines the associations between acculturation and three health examination behaviors (physical, dental, and eye exams) among 846 Chinese, Korean, and Vietnamese Americans. The study was part of a randomized, community-based trial on liver cancer prevention that targeted Asian Americans in Washington DC metropolitan area. Acculturation was assessed using Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, acculturation clusters, and length of stay. Health examination behaviors in the last 2years were self-reported. Potential confounders such as age, gender, ethnicity, income, marital status, self-rated health status, health insurance, and having a regular physician were adjusted. Increased acculturation was associated with greater receipt of preventive services when acculturation was measured by SL-ASIA and acculturation clusters. Compared to those in the "Asian" cluster, those in the "American" cluster and "bicultural" clusters were more likely to have physical exams (American odds ratio (OR)=1.83, 95% confidence interval (CI) 0.99, 3.88; bicultural OR=1.11; 95% CI 0.72, 1.70), dental exams (American OR=1.99, 95% CI 1.09, 3.65; bicultural OR=1.83, 95% CI 1.21, 2.78), and eye exams (American OR=4.48, 95% CI 2.67, 7.66; bicultural OR=1.92, 95% CI 1.31, 2.81). A gradient was observed in these associations with the American cluster having stronger associations than the bicultural cluster. Interaction was found between acculturation and gender for receipt of a physical exam. Future studies are needed to further explicate how access to health care impacts the association between acculturation and health examinations among Asian Americans.

A Reliability Generalization of the Suinn-Lew Asian Self-Identity Acculturation Scale

A reliability generalization was conducted on studies that reported use of the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA), published between 1987 and 2013. For inclusion in this meta-analysis, each study had to have reported a Cronbach’s alpha reliability coefficient for its sample. Data from 83 Cronbach’s alpha coefficients representing 12,992 participants were analyzed; only 67 out of 193 published studies (43.52%) reported reliability scores for their sample. The reliability scores produced by the SL-ASIA ranged from .62 to .96 with an average of .91 ( SD = 0.07); therefore, all of the reported reliability scores for this instrument were in the acceptable to excellent range. Our results demonstrate that SL-ASIA continues to be an instrument with strong psychometric properties when used with diverse populations, and it is therefore appropriate for continued use with studies on acculturation.

Longitudinal Effects of Acculturation on Alcohol Use among Vietnamese and Cambodian Immigrant Women in the USA.

Recent studies indicate that alcohol use is increasing among Asian American populations and that acculturation impacts alcohol use among immigrants in the USA. We investigated the longitudinal relationship between three domains of acculturation (traditionalism, biculturalism, assimilation) and alcohol use among 302 Vietnamese and Cambodian women in Washington State. Data were obtained from the Cross Cultural Families Project (CCF), a 5-year longitudinal investigation of a random sample of Vietnamese and Cambodian immigrant families living in Washington State. Alcohol use was measured with a three item scale assessing frequency and quantity of use, and binge drinking. Acculturation was measured with the Suinn-Lew Asian Self-Identity Acculturation Scale. Linear mixed effects regression models were estimated to assess the impact of acculturation on alcohol use among the overall sample and among a sub-sample of only women who consumed any alcohol. A majority of the sample, 73.2%, reported no alcohol use. In the overall sample, none of the three acculturation domains were significantly associated with drinking. Among a sub-sample of only those who reported any alcohol use, however, a greater degree of traditional cultural identification (β = -0.94, SE= 0.44, P= 0.03) and a greater degree of biculturalism (β = -1.33, SE= 0.53, P =0.01) were associated with lower levels of use. Our findings suggest that acculturation did not impact alcohol use prevalence but that it did affect the drinking pattern among alcohol consumers. Clinicians should be cognizant that certain aspects of cultural identification are important contributors to drinking behavior among alcohol consumers in these populations.

Acculturation, Dietary Behaviors, and Body Mass Index among Vietnamese American Adults

ObjectiveTo examine the association of acculturation level with dietary behaviors and body mass index (BMI) in adult Vietnamese Americans.MethodsA cross‐sectional online survey assessed acculturation level using the Suinn‐Lew Asian Self Identity Acculturation Scale (SL‐ASIA), dietary behaviors, and the BMI of 257 adult Vietnamese Americans across America.ResultsMean (SD) age was 24(8.45) years, BMI 22.9(4.46) and acculturation 3.08(0.46) on a scale of 1‐5. Vietnamese Americans with lower acculturation scores (<3.1, median) were more likely to report higher consumption of non‐starchy vegetables (p<0.005) and green‐leafy vegetables (p<0.035) than more acculturated Vietnamese Americans. Female gender and being married were also associated with healthier dietary behaviors.ConclusionPublic health campaigns promoting increased consumption of fruits and vegetables targeted to male, unmarried and more acculturated Vietnamese Americans may be beneficial to this population.

Obesity prevention behaviors among Asian Indian American adolescents: A pilot study

T number of children at risk for overweight and/or obesity has increased dramatically in the last decade worldwide. Overweight in children is associated with the development of cardiovascular disease later in life. Although much is known about race differences in obesity among adults, less is known about race and ethnic differences among Asian Indian adolescents. The purpose of this feasibility study was to evaluate obesity prevention behaviors of Asian Indian adolescent females and determine the relationship of these behaviors to cardiovascular risk factors. A cross sectional descriptive design was used to obtain baseline data regarding knowledge of and engagement in health behaviors needed to maintain a healthy weight (i.e., obesity prevention behaviors). In addition, self efficacy to adopt obesity prevention behaviors and level of acculturation were assessed. BMI, percent body fat, waist circumference, and blood pressure were measured and evaluated with respect to ageappropriate norms to provide an index of cardiovascular risk. A convenience sample (N=20) of female Asian Indians 14-18 years of age were enrolled from churches. After participant and parental consent, participants completed self report questionnaires that ask about demographic and health history, knowledge of and engagement in physical activity, healthy diet as well as self efficacy to adopt these behaviors, and sleeping behaviors. To quantify engagement in physical activity, participants wore an accelerometer for 7 days, which objectively recorded their level and intensity of physical activity. Pittsburgh Sleep Quality Index assessed the sleep duration and quality. As the level of acculturation may modify study outcomes, the Suinn-Lew Asian Self-Identity Acculturation Scale are also administered. Lastly, this study explored the usefulness of a novel technology to assess food intake and physical activity. For this purpose, participants are asked to complete a 3-day food diary using the web-based USDA SuperTracker in combination with photo-documentation of their meals. Descriptive statistics was used to determine the demographic characteristics and for all study variables. Cardiovascular risk factors (BMI, waist circumference, and blood pressure) are compared to age/gender appropriate percentiles based on population norms, as referenced in the Research Plan. Relationships among variables are determined by calculating the Pearson’s Product Moment Correlation coefficient.

Values, Behaviour and Identity: Acculturation of Indian Immigrant Men in Australia

Over 20 million Indians live outside India, and they constitute a major immigrant population in popular westerns nations like the USA, Australia, Canada and the UK. However, there is paucity of scientific information on acculturation of Indian immigrants. The present investigation was part of a larger study on sexuality and sexual health involving a community sample of adult Indian men living in Australia. All three dimensions of acculturation (i.e. behaviour, values and identity) were measured using the Suinn–Lew Asian Self-Identity Acculturation scale (SL-ASIA, 26-items). Two hundred and six participants completed the SL-ASIA scale, and the mean score was 2.28 (SD 0.46) representing a bicultural pattern. A large proportion (n = 93, 45 %) of Indian men expressed that they hold on to Indian values. On the other hand, a similar proportion (n = 75, 44 %) responded bicultural behavioural pattern and over half of all participants (n = 119, 58 %) did self identify themselves as bicultural. A weak, positive and significant correlation was found between length of residence and unilinear measure of acculturation among Indian migrant men. Those who lived in the metropolitan cities of India, prior to migration to Australia, had significantly higher scores of unilinear acculturation (meaning more Western) than those who lived in non-metropolitan cities. Significant difference was observed in values and self-identity domains of bilinear measures of acculturation among Indian men based on their place of residence prior to migration to Australia. As with past studies, biculturalism was the dominant acculturation pattern in the present study. In contrast, Indian immigrant men tended to hold on to Indian values. This finding highlights that migration, among Indian immigrant men, could have varying effect on different dimensions of acculturation. Also, it confirms the emerging concept of ‘cultural values’ as an acculturation variable and its importance in acculturation studies. Length of residence in a new society and place of residence prior to migration seem to play a vital role in the acculturation pattern of migrants, and such contextual factors need further investigation. Policy and practical implications are discussed, and recommendations have been made for future research.

Cultural and Linguistic Validation of Foreign Psychometric Instrument -an example of adapting the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) Scale, from English to Indonesian Language-

This article is to share best practices ofthe author in validating foreign researchinstruments into Indonesian Language.The words of Cultural and LinguisticValidation may not be something newanymore, but the scientific work on theproper cultural and linguistic validation offoreign instruments into Indonesian Lan-guage, in Indonesia, especially psychomet-ric instruments, is probably rarely done.Report of that is very limited, if there isany. Nevertheless, any comments andcritics to this article are most welcomed.

The consumption of more vegetables and less meat is associated with higher levels of acculturation among Mongolians in South Korea

Although Mongolian immigrants are a rapidly growing population in South Korea, the 2 countries have distinct diets because of climatic and geographical differences. The Mongolian diet is mostly animal-based with few vegetables and fruits, whereas the Korean diet is largely plant based. The purpose of this study was to examine the association between acculturation and dietary intakes among Mongolians living in South Korea. We hypothesized that higher levels of acculturation would be associated with higher vegetable, fruit, and plant-based food intakes among Mongolian immigrants. A total of 500 Mongolian immigrants participated in this study conducted between December 2010 and May 2011. To measure the acculturation level, we developed an acculturation scale based on the Suinn-Lew Asian self-identity acculturation scale. Dietary intakes were assessed using the 24-hour dietary recall method. Associations between acculturation and dietary intakes were investigated using a general linear model adjusted for demographic characteristics. The participants were grouped into either a low-acculturation group or a high-acculturation group. The high-acculturation group reported significantly higher consumption of vegetables and rice and significantly lower consumption of meat, potatoes, and flour products compared with their low-acculturation counterparts. However, a higher level of acculturation was also significantly related to a higher intake of sodium. These findings could be used to tailor nutrition programs to different acculturation levels.

Acculturation and Cancer Screening Among Asian Americans: Role of Health Insurance and Having a Regular Physician

Cancer is the leading cause of death among Asian Americans, but screening rates are significantly lower in Asians than in non-Hispanic Whites. This study examined associations between acculturation and three types of cancer screening (colorectal, cervical, and breast), focusing on the role of health insurance and having a regular physician. A cross-sectional study of 851 Chinese, Korean, and Vietnamese Americans was conducted in Maryland. Acculturation was measured using an abridged version of the Suinn-Lew Asian Self-Identity Acculturation Scale, acculturation clusters, language preference, length of residency in the US, and age at arrival. Age, health insurance, regular physician, gender, ethnicity, income, marital status, and health status were adjusted in the multivariate analysis. Logistic regression analysis showed that various measures of acculturation were positively associated with the odds of having all cancer screenings. Those lived for more than 20 years in the US were about 2-4 times [odds ratio (OR) and 95 % confidence interval (CI) colorectal: 2.41 (1.52-3.82); cervical: 1.79 (1.07-3.01); and breast: 2.11 (1.25-3.57)] more likely than those who lived for less than 10 years to have had cancer screening. When health insurance and having a regular physician were adjusted, the associations between length of residency and colorectal cancer [OR 1.72 (1.05-2.81)] was reduced and the association between length of residency and cervical and breast cancer became no longer significant. Findings from this study provide a robust and comprehensive picture of AA cancer screening behavior. They will provide helpful information on future target groups for promoting cancer screening.

A cluster analytic examination of acculturation and health status among Asian Americans in the Washington DC metropolitan area, United States

Previous studies reported mixed findings on the relationship between acculturation and health status among Asian Americans due to different types of acculturation measures used or different Asian subgroups involved in various studies. We aim to fill the gap by applying multiple measures of acculturation in a diverse sample of Asian subgroups.A cross sectional study was conducted among Chinese, Korean and Vietnamese Americans in Washington D.C. Metropolitan Area to examine the association between health status and acculturation using multiple measures including the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, clusters based on responses to SL-ASIA, language preference, length of stay, age at arrival in the United Sates and self-identity. Three clusters (Asian (31%); Bicultural (47%); and American (22%)) were created by using a two-step hierarchical method and Bayesian Information Criterion values. Across all the measures, more acculturated individuals were significantly more likely to report good health than those who were less acculturated after adjusting for covariates. Specifically, those in the American cluster were 3.8 times (95% Confidence Interval (CI): 2.2, 6.6) more likely and those in the Bicultural cluster were 1.7 times more likely (95% CI: 1.1, 2.4) to report good health as compared to those in the Asian cluster. When the conventional standardized SL-ASIA summary score (range:−1.4 to 1.4) was used, a one point increase was associated with 2.2 times greater odds of reporting good health (95% CI: 1.5, 3.2). However, the interpretation may be challenging due to uncertainty surrounding the meaning of a one point increase in SL-ASIA summary score.Among all the measures used, acculturation clusters better approximated the acculturation process and provided us with a more accurate test of the association in the population. Variables included in this measure were more relevant for our study sample and may have worked together to capture the multifaceted acculturation process.

Relationship of Chinese American Parental Perceptions, Feeding Practices, Styles and Level of Acculturation to Their Child's BMI

To examine the relationships among parental perceptions, concerns, feeding practices, feeding styles, level of acculturation, and children’s weight status in Chinese Americans. The Chinese American population is increasing, as is the prevalence of overweight and obesity in its children. We need to understand parental perceptions and feeding practices to design appropriate programs. A cross-sectional study of parents across a wide SES range with children 5 to 10 years old (n=680) used a self-reported survey instrument that included the validated Child Feeding Questionnaire, Caregiver’s Feeding Styles Questionnaire, and Suinn-Lew Asian Self-Identity Acculturation Scale. Descriptive statistics, correlations, and analysis of variance (ANOVA). The prevalence of overweight was 11.7% and obesity 12.1%. Children’s %BMI for age was significantly positively correlated to parental perceptions of child and their own weight status (p<.001), and concerns about child weight (p<.05); and negatively correlated to the feeding practice of pressure to eat (p<.001) and with the feeding style of both demandingness and responsiveness, but not to parental level of acculturation (PLA). PLA was positively correlated with perceived responsibility (perception) (p<.001), monitoring (practice), and the feeding style of responsiveness and negatively correlated with pressure to eat (p<.001). Level of parental acculturation was also correlated with length stay in USA (p<.001), education (p<.001), and family income (p<.001). Children’s %BMI is correlated to some parental concerns, but negatively to pressure to eat, demandingness and responsiveness, opposite to findings in other samples. This finding suggests that cultural differences are important to explore in studies of parental feeding practices and feeding styles.

Investigating obesity risk-reduction behaviours and psychosocial factors in Chinese Americans

The purpose of this research was to examine the attitudes, beliefs and behaviours related to obesity risk reduction in Chinese Americans. A questionnaire was administered to a convenience sample of 300 US-born and foreign-born Chinese Americans residing in the New York metropolitan area, ranging from 18 to 40 years of age. Obesity risk reduction behaviours and psychosocial variables derived from the Theory of Planned Behaviour and Health Belief Model were measured. Acculturation was assessed using a modified Suinn-Lew Asian Self-Identity Acculturation Scale. Frequency distributions were delineated and stepwise regression analyses were analysed for different acculturation groups. 65% of the respondents were female and the mean age of the sample was 26 years. Respondents indicated the most commonly practised behaviour to be eating home-cooked meals instead of restaurant-prepared foods. Perceived barriers to adopting obesity risk-reduction behaviours included convenience of consuming fast foods, cost, lack of time to prepare home-cooked meals, and the physical environment of unhealthy foods. In predicting intention to perform obesity risk-reduction behaviours, attitude was significant for 'western-identified' individuals. In 'Asian-identified' individuals, perceived behavioural control, self-efficacy and perceived benefits were salient. Nutrition educators working with Chinese Americans need to address self-efficacy in preparing plant-based, home-cooked meals and making healthy choices at fast-food restaurants with portion control. Concrete and perceived barriers such as lack of time and convenience need to be addressed in nutrition education interventions. Educators need to identify new channels and media outlets to disseminate practical, easy-to-implement behaviours for obesity risk reduction that are socially acceptable.

Acculturative status and psychological well-being in an Asian American sample.

We sought to examine the relationship between acculturative status and positive psychological functioning (i.e., psychological well-being) in a sample of 96 Asian Americans. Using a supplemental item from the Suinn-Lew Asian Self-Identity Acculturation Scale, we classified participants into one of three acculturative statuses: Asian-Identified (n 56), Western-Identified (n 20), and Bicultural-Identified (n 20). We used Ryff’s (1989) Scales of Psychological Well-Being as a comprehensive measure of well-being, in addition to other commonly used indicators of well-being such as life satisfaction and depressed mood. We hypothesized that BiculturalIdentified individuals would show greater well-being relative to Asian-Identified and Western-Identified individuals as a result of these latter groups experiencing acculturative stress and bicultural stress, respectively. Results of a priori contrast tests largely confirmed our hypothesis, revealing the predicted pattern among four of six subscales of subjective well-being. Implications for future work examining Asian Americans’ well-being and mental health are discussed.

Asian American Adolescents' Willingness to Donate Organs and Engage in Family Discussion about Organ Donation and Transplantation

Despite the growing need for organ donation among Asian Americans, studies suggest that they are reluctant to donate. To examine the association of attitudes and knowledge about organ donation and transplantation with willingness to donate and willingness to engage in family discussion about organ donation among Asian American adolescents. A cross-sectional study. The Big Island of Hawaii. Self-identified Asian American adolescents (Japanese, Chinese, Filipino, Korean), ages 16 to 17 years old, and each adolescent's parent or guardian. Asian American adolescents provided demographic information and completed the Modified Organ Donation Attitude Survey, the Organ Donation and Transplantation Knowledge Survey, and the Suinn-Lew Asian Self-Identity Acculturation Scale. A parent or guardian also provided demographic information. Linear regression analyses were used to examine the associations with willingness to donate and to engage in family discussion about organ discussion. Willingness to donate was associated with positive knowledge related to general aspects about organ donation and cultural limitations in receiving an organ transplant, a high level of acculturation, and a low level of negative attitudes (R2 = 0.402, F = 18.86, P = .005). Asian American adolescents with approving or positive attitudes were likely to engage in family discussion about organ donation (R2 = 0.195, F = 27.93, P = .005). To reinforce and maintain high levels of knowledge and positive attitudes, organ donation education is most likely needed in high schools.

Relationship Between Acculturation and Attitudes Toward Gay Men and Lesbians in the Vietnamese American Community

We examined the impact of acculturation on attitudes toward gay men and lesbians in the Vietnamese American community. We recruited 114 Vietnamese American participants at a large community organization. The Suinn–Lew Asian Self-Identity Acculturation Scale (Suinn, 1992) was used to measure participants' acculturation levels, while the Attitudes Toward Lesbian and Gay Men Scale (Herek, 2004) was used to measure participants' attitudes toward homosexuality. It was hypothesized that Vietnamese Americans with higher levels of acculturation would have more positive attitudes toward homosexuality. The results supported this hypothesis. Additionally, we found a complicated pattern of results explaining attitudes based on acculturation level, age, and gender.

Acculturation and BMI Among Chinese, Korean and Vietnamese Adults

The objective of this study is to examine the association between acculturation and BMI among Asian Americans using multiple measures of acculturation. Data of 847 Chinese, Korean and Vietnamese recruited for a health education program in Maryland during 2009 to 2010 were used. Acculturation was measured by the short version of Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA) and its individual components. Height and weight were measured by trained staff. Multiple linear regressions were used to estimate the association between acculturation and BMI. After adjusting for age, gender, education, income, marital status, and ethnicity, SL-ASIA (β=0.71, SE=0.28), having education in the US (β=0.56, SE=0.28), younger age of arrival (0-5years: β=3.32, SE=0.76, 6-10years: β=1.55, SE=0.78), self identified as Americans (β=1.51, SE=0.77) and equal preference of Asian/American food in restaurants (β=0.92, SE=0.28) were significantly associated with increased BMI. The association between acculturation and BMI was stronger among men than women, strongest among Chinese and weakest among Vietnamese. Acculturation was moderately associated with increased BMI among Asian Americans and this association varied by measures of acculturation. The association of acculturation and BMI was moderated by sex and ethnicity groups.