Alona Angosta, PhD, APRN, NP-C University of Nevada, Las Vegas School of Nursing

Transcription

1 The Effects of Ballroom Dance on Blood Pressure, Heart Rate, Weight, Waist Circumference, and Body Mass Index among Filipino Americans: A Feasibility Study Alona Angosta, PhD, APRN, NP-C University of Nevada, Las Vegas School of Nursing

2 Disclosures Author Name: Alona D. Angosta Acknowledgement: This project was supported by grants from the National Center for Research Resources (5P20RR ) and the National Institute of General Medical Sciences (8 P20 GM ) Conflict of Interests: None Learning Objectives: Discuss the population statistics of Asian Americans based on the 2010 United States (US) census Describe the immigration history and cardiac health of Filipino Americans Discuss the effects of ballroom dance on hemodynamic and anthropometric measures

3 Immigration History Filipino migration to US occurred n 3 waves: Elite scholars to secure higher education and those who came to Hawaii and California as farm workers and laborers 1800 s - early 1900 s U.S. Military recruits, health care employment (nurses, physicians) 1950 s - mid 1960 s Employment & family reunification 1960 s Source: Dela Cruz et al., 2002

4 Distribution of Asian American Population Selected Groups in the United States #6 Japanese #5 Koreans #1 Chinese #4 Vietnamese #3 Asian Indians #2 Filipinos Source: US Census, 2010

5 Filipino Americans Filipino American population in the US increased by 38.9%, from Total Filipinos in US: 2,649,973 Nevada has the highest growth of Filipinos nationwide, an increase of 142% within 10 years Highest concentration of Filipinos: southern Nevada Relocation to Nevada due to economic opportunities Source: National Federation of Filipino American Associations (NaFFAA) 2011, US Census, 2010

6 Health issues Cardiovascular disease: Leading cause of death Risk factors prevalent among Filipino Americans Hypertension Diabetes Dyslipidemia Physical inactivity/lack of regular exercise Obesity (central adiposity) Smoking Source: Araneta & Barrett-Connor, 2005; Araneta, Araneta et al., 2006 ; Dalusung-Angosta, 2010; dela Cruz and Galang, 2008; Gentilucci et al., 2008; Health Forum, 2000; Kim et al., 2008; Langenberg et al., 2007 ; Ursua et al. 2013; Ye et al., 2009.

7 Purpose Evaluate the effects of ballroom dance on resting blood pressure, heart rate, weight, waist circumference, and body mass index of 41 Filipino Americans between the ages of years old

8 Theoretical Framework Neuman Systems Model Major concepts Stressor s Reaction to stressors Major constructs Lines of defenses Level of prevention (as nursing interventions) Physical activity supports the lines of defenses (J. Fawcett, personal communication, May 6, 2014)

9 Methodology

10 Design & Sample Pre & post experimental design without a control arm Power analysis for medium effect size: 36 was necessary to achieve a power of 80% with alpha Filipino Americans between years old met the study criteria Sample criteria

11 Setting Study was held at a ballroom dance studio southern Nevada Dances were taught by professional dance instructors Types of dance: Salsa, Cha-Cha, & Rumba Type of music: Latin

12 Outcome Measures Weight: Each participant was measured at baseline and at 12 weeks using the same Omron digital weighing scale Waist circumference (WC): WC was measured using a nonstretchable measuring tape (Gulick II Tape Measure). The WC was measured to the nearest centimeter between the lower margin of the participant s last palpable rib and at the top of the iliac crest. Two measurements were taken, the average score was used Source: World Health Organization, 2008

13 Outcome Measures Body mass index (BMI): Height and weight were used to measure BMI using the NHLBI BMI calculator mobile app Blood pressure (BP): BP was measured using a manual blood pressure monitor. Two BP measurements were taken and the average score was used Heart rate (HR): Resting heart rate (apical pulse) was measured using a stethoscope

14 Procedures IRB approval Recruitment techniques (flyer, media) Eligibility Health screening Physical Activity Readiness questionnaire

15 Analysis Paired t-tests Pearson's r

16

17 Results

18 Week 1 Outcome Week 12 Mean (SD) Mean (SD) r Systolic blood pressure (8.3) (11.6).54** (1.64) Diastolic blood pressure 81.0 (7.7) 78.9 (6.9).48** (1.22) Heart rate 72.2 (8.2) 73.7 (8.6).58** 1.54 (1.27) (21.4) (21.0).99** -.77 (.58) Waist circumference in cm 89.6 (9.6) 90.5 (7.7).61**.93 (1.29) Body mass index 26.1 (3.3) 26.0 (3.3).98** -.13 (.10) Weight in lbs Note: * p <.05; ** p <.01 Mean Diff. (SE)

19 Limitations & Recommendations Small sample Selection bias Limited setting Self reported height First-generation Filipinos Further research: st nd Groups comparison (1 & 2 generations) Large samples in more than one setting Extend to other ethnic groups Include serum markers

20 Conclusion This study indicates that ballroom dance improves blood pressure and weight among Filipino Americans Ballroom dance is a culturally appropriate physical activity intervention May be considered as an alternative exercise among first-generation Filipino Americans Looking through the lens of the Neuman Systems Model, ballroom dance will strengthen the lines of defenses, decrease stressor and reaction stressor; thus reducing the risk of cardiovascular disease and improving the overall wellness of Filipino Americans

21 Acknowledgements This project was supported by grants from the National Center for Research Resources (5P20RR ) and the National Institute of General Medical Sciences (8 P20 GM )

22 References Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Smith, S. C., Jr. (2009). Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120, Araneta, M. R. & Barrett-Connor, E. (2005). Ethnic differences in visceral adipose tissue and type 2 diabetes: Filipino, African-American, and White women. Obesity Research, 13(8), Araneta, M. R., Morton, D. J., Lantion-Ang, L., Grandinetti, A., Lim-Abrahan, M. A., Chang, H., Wingard, D. L. (2006). Hyperglycemia and type 2 diabetes among Filipino women in the Philippines, Hawaii, and San Diego. Diabetes Research and Clinical Practice, 71, Dalusung-Angosta, A. (2010). Coronary heart disease knowledge and risk factors among Filipino-Americans connected to primary care services (Doctoral dissertation). University of Hawaii at Manoa. ProQuest Dissertations and Theses database.

23 References Dela Cruz, F. A., & Galang, C. B. (2008). The illness beliefs, perceptions, and practices of Filipino Americans with hypertension. Journal of the Academy of Nurse Practitioners, 20, Dela Cruz, F. A., McBride, M. R., Compas, L. B., Calixto, P. R., & Van Derveer, C. P. (2002). White paper on the health status of Filipino Americans and 60 recommendations for research. Nursing Outlook, 50, 7-15 Gentilucci, U. V., Picardi, A., Manfrini, S., Khaszrai, Y. M., Fioriti, E., Altomare, M., Pozzili, P. (2008). Westernization of the Filipino population resident in Rome: Obesity, diabetes, and hypertension. Diabetes Metabolism Research & Reviews, 24, Health Forum (2003). Cardiovascular risk in the Filipino community. Retrieved from International Diabetes Federation (2006). The IDF consensus worldwide definition of the metabolic syndrome. Retrieved from

24 References Kiepe, M. S., Stockigt, B., & Keil, T. (2012). Effects of dance therapy and ballroom dances on physical and mental illnesses: A systematic review. The Arts in Psychotherapy, 39(5), Kim, H. S., Park, S. Y., Grandinetti, A., Holck, P. S., & Waslien, C. (2008). Major dietary patterns, ethnicity, and prevalence of type 2 diabetes in rural Hawaii. Nutrition, 24, Langenberg, C., Araneta, M. G., Bergstrom, J., Marmot, M., & Barrett-Connor, E. (2007). Diabetes and coronary heart disease in Filipino-American women. Diabetes Care, 30, National Federation of Filipino American Associations (2011). US Census: Filipinos in the U.S. increased by 38%; Nevada has the fastest growing population. Retrieved from National, Heart, Lung, Blood Institute. Aim for a healthy weight: Calculate your body mass index. Retrieved from Neuman, B. & Fawcett, J. (2002). The Neuman Systems Model Prentice Hall. th (4 ed.). Upper Saddle River, NJ:

25 References United States Census (2012, October 10). The Asian population: 2010 census briefs. Retrieved from Ursua, R. A., Islam, N. S., Aguilar, D. E., Wyatt, L. C., Tandon, S. D., Abesamis-Mendoza, N., Trinh-Shevrin, C. (2013). Predictors of hypertension among Filipino immigrants in the Northeast US. Journal of Community Health, 38(5), doi: /s World Health Organization (2008). Waist circumference and waist-hip ratio: A report of WHO expert consultation. Retrieved from Ye, J., Rust, G., Baltrus, P., & Daniels, E. (2009). Cardiovascular risk factors among Asian Americans: Results from a national health interview survey. Annals of Epidemiology, 19,