Recommendations for Implementing Policy, Systems, and Environmental Improvements to Address Chronic Diseases in Asian Americans, Native Hawaiians, and Pacific Islanders

Arista P, Tepporn E, Kwon S, Rideout C, Patel S, Chung M, Bautista R, Trinh-Shevrin C, Ko-Chin K
Source: Prev Chronic Dis
Publication Year: 2014
Patient Need Addressed: Chronic Conditions, Food insecurity
Demographic Group: Racial and ethnic minority groups
Type of Literature: White
link: https://www.ncbi.nlm.nih.gov/pubmed/25412025
Abstract

Emphasis has increased recently on disseminating high-impact, population-wide strategies for the prevention of chronic diseases. However, such strategies are typically not effective at reaching Asian Americans, Native Hawaiians, Pacific Islanders, or other underserved communities. The objectives of this article were to 1) present the methods of the Strategies to Reach and Implement the Vision of Health Equity program in which 15 community-based organizations in the United States and the Pacific region implemented evidence-based policy, systems, and environmental improvements in their local communities and 2) provide recommendations for using these tailored approaches in other communities and geographic locations. Further support is needed for organizations in tailoring these types of population-wide strategies. Implementing population health improvements should be adapted to maximize effectiveness to decrease chronic diseases in these populations and ultimately eliminate racial/ethnic health disparities.

Insights Results

Overview of article

  • Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs) are a rapidly growing population in the United States. Although Asian Americans and NHPIs are regarded as a “model minority community” with universally high levels of education and wealth, recent census data indicate otherwise
  • Gaps in the literature and a lack of disaggregated data on nutrition and physical activity prevent in-depth understanding of the health of Asian Americans and NHPIs. However, some research does indicate poor nutrition patterns for certain Asian American and NHPI subgroups, including Chinese, Filipinos, Japanese, and Native Hawaiians. Similarly, studies suggest that contributors to poor nutrition among Asian Americans and NHPIs are the convenience and availability of American fast food, lack of access to traditional foods, and exposure to Western-style diets and unhealthy options
  • The objective of this article was to present the methods of the Strategies to Reach and Implement the Vision of Health Equity (STRIVE) program in which community-based organizations (CBOs) implemented policy, systems, and environmental (PSE) improvements in their local communities and provide recommendations for using these tailored approaches in other communities

Results

  • The following 5 key recommendations build on lessons learned during the STRIVE program and should be considered by organizations working with Asian Americans and NHPIs to implement PSE improvements or similar population-wide health strategies: 1) Involve CBOs to achieve PSE improvements; 2) Select CBOs with the capacity and infrastructure to implement population-wide strategies; 3) Provide culturally sensitive training and technical assistance; 4) Collect and analyze disaggregated data; and 5) Use a co-lead structure as a means to implement project

Key takeaways/implications

  • To accomplish the STRIVE program’s goals, the co-lead institutions selected CBOs according to their organizational capacity and estimated reach. They were required to have a multisector partnership and use a community health needs assessment and policy scan to support the development and implementation of their PSE-focused community action plan. These preparatory steps were essential to accomplishing the goal, to strengthen and expand a national network of Asian American and NHPI stakeholders focused on PSE improvements. Recommendations from the program demonstrate how such an approach should be adapted to maximize effectiveness and mitigate racial and ethnic health disparities
  • This analysis of the STRIVE program has at least 2 limitations. First, disaggregated data for Asian Americans and NHPIs were lacking at the community level. Second, much of the data for the community health and policy scan and for measuring reach were not up-to-date. Because of these limitations, the data on reach in this analysis are only estimates
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