Asian Americans constitute the fastest growing racial/ethnic group in the U.S. and the largest group is the Chinese, 69% of whom are immigrants and 46% of whom have limited English proficiency. Cardiovascular health is an under-addressed health issue among Chinese Americans who have a greater proportionate mortality compared to non-Hispanic whites for hypertensive heart disease and cerebrovascular disease. Chinese Americans also eat less than the recommended amounts of vegetables and fruits and less than half adhere to a low-salt diet. Furthermore, Chinese Americans with cardiovascular disease may use both a Western biomedical and a Chinese medicine/Chinese medicinal-foods approach to the treatment and maintenance of their cardiovascular health, often without consulting their healthcare providers about their culture-based health practices. Providers are also often uncertain as to how to best advise their patients that apply both a biomedical and integrative approach to their health because there are few resources available that integrate Chinese medicine and biomedicine for nutrition.
Aim 1: Create a Chinese – English heart healthy integrative nutritional counseling guide that adheres to current biomedical nutrition standards and Chinese medicine principles and is acceptable to biomedical providers and Chinese American patients with cardiovascular disease.
• First in Part A, we will conduct approximately 30-60 minute one-on-one audio-recorded cognitive interviews with 6-12 Chinese medicine providers or lay experts without a license (in their language of choice: English or Chinese (Cantonese or Mandarin)) that have expertise and experience regarding Chinese medicinal foods and heart-related conditions. This does not involve DGIM.
• Second in Part B, we will conduct approximately 30-60 minute one-on-one audio-recorded interviews with 8- • 12 licensed biomedical healthcare providers (including but not limited to general internists, nurse practitioners, dietitians/nutritionists, cardiologists, neurologists and nephrologists) and licensed Chinese medicine providers (approximately 4-6 of each type of provider) that care for Chinese American patients with cardiovascular disease. This may involve DGIM practitioners.
• Third in Part C, we will conduct audio-recorded focus group interviews in Chinese language (Cantonese or Mandarin) with DGIM Chinese American patients with cardiovascular disease defined broadly as hypertension, stroke, dyslipidemia, coronary heart disease and congestive heart failure. This will involve DGIM patients.
Aim 2: Implementation and dissemination of the integrative nutritional counseling guide through patient education sessions to Chinese Americans at Mt Zion DGIM, 1-3 provider education sessions at Mt Zion DGIM and online.