KARE: Korean American Alzheimer Research and Education

Asian-Americans have been observed to be proportionately more affected than other racial/ethnic groups by stroke and cardiovascular disease, which remain major causes of death in Asian-Americans. However, Asian-Americans are less likely to possess cardiovascular health knowledge compared to other race-ethnic groups. Poor health literacy and language barriers contribute to health disparities, potentially leading to reduced utilization of health services and missed opportunities for health interventions. Traditional cultural beliefs, unique social networks and unconventional sources of health knowledge may lead to avoidance of prompt medical treatment. These factors have been under-investigated; no prior study has formulated modern strategies to overcome these barriers in Asian-American seniors. Needs assessments in Asian elderly populations have shown that cultural relevancy of health interventions was essential for success, requiring programs to include cultural, social, and environmental factors to address specific health beliefs. We will conduct a qualitative study to understand health behaviors among Korean-American (KA) and Chinese-American (CA) seniors; design an innovative culturally-adapted text-messaging intervention centered around the AHA’s Life’s Simple 7 initiative; and perform a pilot study to test its acceptability and feasibility in targeted populations. Specific Aim 1: To explore how explanatory models of cardiovascular health frame Korean-American (KA) and Chinese-American (CA) seniors’ health behaviors by using community-partnered research methods. Form a Community Advisory Board to help with project design and implementation, administer surveys in native language to KA and CA seniors regarding cardiovascular health, sources of health information, and support networks. Frame health questions around the American Heart Association (AHA) Life’s Simple 7 (LS7) components of cardiovascular health (blood pressure, cholesterol, blood sugar, physical activity, health nutrition, weight loss, smoking cessation). Conduct focus groups to explore CA and KA cultural ideas of health. Hypothesis 1. KA and CA seniors have specific cultural beliefs that influence how they think about health, and consequently, what their health behaviors and patterns are. KA and CA seniors have low levels of knowledge regarding cardiovascular health risk factors. Specific Aim 2. To investigate design and implementation of a novel text-messaging intervention in a culturally appropriate, individually tailored context for KA and CA seniors. Explore opinions on intervention, preferences for frequency of messaging, tone, format, network, and content via surveys and focus groups. Hypothesis 2. KA and CA seniors are engaged and interested in text-messaging, and have preferences on the tone, format, network, and content of the proposed intervention. Specific Aim 3. To use information gathered to design two community-partnered, culturally tailored pilot intervention, one for KA and one for CA seniors: an 8-week intensive cardiovascular health curriculum and 6-month text-messaging intervention. Primary outcomes will be acceptability and feasibility of the pilot interventions. Secondary outcomes will be improvement of cardiovascular risk factors, stroke knowledge, and self-efficacy. Hypothesis 3. The interventions will be appropriate and feasible for KA and CA seniors. This pilot intervention can be used to direct further text-messaging and technology-based culturally tailored studies aimed at efficacy outcomes in these vulnerable populations.