Addressing Filipino American Cardiovascular Health Disparities in Hawai‘i.
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2017-05
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Cardiovascular Disease (CVD) is the leading cause of death in the United States (U.S.). Among Filipino Americans (FAs), CVD is the leading cause of death among males and second among females. Research indicates a high prevalence of hypertension and behavioral risk factors associated with CVD. Culturally relevant health interventions targeted for FAs can increase their participation in healthy behaviors, leading to an improvement in their overall health. The purpose of this dissertation was to advise the development of culturally targeted health interventions. Shedding light on FA CVD-related disparities allows for effective programming in Hawai‘i’s Federally Qualified Health Centers (FQHCs).
This dissertation was comprised of three studies. Study 1 analyzed four years of Hawai‘i’s Behavioral Risk Factor Surveillance System (BRFSS) data (2011 to 2014). Findings confirmed that FAs in Hawai‘i were less physically active, smoked more, and were more obese than other Asian subgroups. Contrary to the national literature, FAs in Hawai‘i reported the lowest CVD prevalence of the five ethnic groups in the sample, after controlling for sociodemographic and health care access variables.
Study 2 was a systematic literature review of CVD-related programs tailored to FAs. Few articles were found, confirming need for more published research on improving CVD health of FAs. Described interventions found success by attending to FA cultural values, food, social relationships, and family. Analysis of the articles also suggested that interventions should employ word of mouth recruitment strategies to successfully reach FA communities.
Study 3 used qualitative methods to explore essential strategies to successfully attract FAs to CVD prevention programs in Hawai‘i’s Federally Qualified Health Centers (FQHCs). Three key themes emerged. First, FQHCs should understand FA issues, context, and culture. Next, multiple levels of buy-in are necessary when creating health programs and interventions. Last, FQHCs should follow specific tips for successful health interventions (e.g., employing FA staff, flexible scheduling).
Taken together, findings confirm the need for culturally tailored programs to support FA populations. Further, FAs experience a high prevalence of disease-related (e.g., hypertension, diabetes) and behavioral risk factors associated with CVD. Hawai‘i’s FQHCs, are well positioned to implement CVD prevention interventions tailored to the FA community.
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cardiovascular disease, Filipino, Asian American, health education, Federally Qualified Health Centers
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