Partnering with Asian Language Schools to Promote Diabetes Literacy William Hsu, MD April 6-7, 2011 ADA 4 th Disparities Partnership Forum Disclosure: Multi-Cultural Advisory Board Member, Novo Nordisk
The Asian American Population At a lower body weight, twice as likely to develop diabetes compared to Whites Nearly half of all Asian New Yorkers have either diabetes or prediabetes (NHANES, 2007) Diverse Ethnicities and languages* Cultural Practices Immigration histories Socioeconomic status Physiology The Asian American population is expected to increase 213% by 2050 *The 2006-2008 American Community Survey multiyear data lists every language reported by at least one person in the sample period. Of the languages other than English spoken at home, 81 were Asian and Pacific Island languages.
Asian Clinic Culturally Appropriate Care Research Clinical & Education Studies Asian American Diabetes Initiative (AADI) Outreach Local, national and international events & collaborations Education Patient Ed Materials Professional Ed Trilingual Website
Challenges: Diabetes in the AA Community Diverse Historically overlooked due to model minority myth Cultural beliefs and explanatory models for health and disease Socio-economic factors Access to culturally appropriate resources Traditional medicine Cross cultural care and education
Promising Practice: Asian Language Schools Major cultural gateway for first generation Asian families in the U.S. Widespread throughout different AA communities Each school varies in size, space, and program Shared community space where families gather on a regular basis Safe, structured, and accessible Opportunity for sustainable community partnership
The Japanese Language School of Greater Boston (JLSGB) Established in 1975 to maintain and strengthen Japanese language skills of children living in Greater Boston Classes held on Saturdays at Medford High School Over 700 students, 3-17 years old Courses include Japanese language, culture, math, and history Extracurricular activities
JLSGB Outreach Goals Empower the Japanese American Sandwich Generation in the Greater Boston area to better manage health of the whole family Provide culturally and linguistically appropriate information and resources Foster JLSGB as community partner in promoting health literacy, specifically on preventing diabetes and its complications
Structure *All presentations and materials were bilingual *Key contacts from JLSGB and AADI collaborated throughout planning and implementation process Visit 1 (June) Presentation on diabetes basics and nutrition A1C screening by trained college student volunteers Consultation with Joslin medical and nutrition staff Visit 2 (Sept) Presentation on diabetes and oral health Content based on feedback from Visit 1 Q&A session Opportunity for follow up assessment and engagement and continued engagement
Outcomes Bilingual surveys provided at end of both visits Assess DM knowledge and general lifestyle Obtain feedback on presentation Attendees asked to rate their agreement with specific statements (1=strongly disagree 5=strongly agree) 48 attendees for Visit 1 The session provided information that was useful. 4.65 Today s session provided me with ways to manage my health 4.49 60 people screened. Average A1C was 5.4±0.36 52 attendees for Visit 2 20 of these attendees were returnees from Visit 1 All returnees answered that they had shared what they learned at previous session with someone else 60% started to exercise or exercised more as a result of Visit 1 75% made some dietary changes since last visit
Lessons Learned and Next Steps Asian language schools such as JLSGB are critical in addressing health disparities in Asian American communities. Blood test based screenings should be performed in a culturally sensitive context Partnership fosters trust and continuous relationship with community Practice is sustainable and replicable