Cardiovascular Risk in the Filipino Community
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Cardiovascular Risk in the Filipino Community Formative Research from Daly City and San Francisco, California U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute A collaborative report from the National Heart, Lung, and Blood Institute, the Asian & Pacific Islander American Health Forum, and West Bay Pilipino Multi-Services, Inc. Table of Contents Acknowledgements........................................................................................................................ iii I. Forward................................................................................................................................v II. Executive Summary.............................................................................................................1 III. Introduction..........................................................................................................................2 IV. Methodology........................................................................................................................2 A. Community-Based Partner.............................................................................................2 B. Data Collection ..............................................................................................................2 C. Interviewer Training ......................................................................................................3 D. Translation of Research Instruments .............................................................................3 E. Data Feedback................................................................................................................3 V. Demographics ......................................................................................................................4 VI. Results..................................................................................................................................6 A. What Does the Heart Symbolize?..................................................................................6 B. Concept of Health ..........................................................................................................6 C. Pevention and Causes of Poor Health or Illness ............................................................6 D. Major Health Concerns..................................................................................................6 E. Filipino Lifestyle in the United States and in the Philippines .......................................7 i. Nutrition.............................................................................................................7 ii. Physical Activity................................................................................................9 iii. Stress..................................................................................................................9 iv. Tobacco............................................................................................................10 v. Alcohol.............................................................................................................11 F. Personal Health ............................................................................................................12 i. Perceptions of Obesity .....................................................................................12 ii. Factors Associated With Cardiovascular Disease............................................12 iii. Perceptions of High Blood Pressure ................................................................13 iv. Perceptions of High Blood Cholesterol ...........................................................13 v. Perceptions of Heart Disease ...........................................................................13 vi. Alternative Health Care Services.....................................................................14 G. Engaging in Healthy Behaviors ...................................................................................14 i. Confidence in Maintaining Heart Healthy Habits ...........................................14 ii. Motivations and Barriers for Physical Activity ...............................................15 H. Health Education and Promotion.................................................................................15 i. Health Information Sources .............................................................................15 ii. Engaging Community Residents in Heart Health............................................16 iii. Problems Acquiring Medical Help or Services ...............................................17 iv. Feedback on NHLBI Publications ...................................................................17 i VII. Discussion..........................................................................................................................17 A. Assets in the Community.............................................................................................17 B. Awareness of Health Issues ........................................................................................17 C. Factors That Increase Risk of Cardiovascular Disease................................................18 D. Motivations and Barriers for Physical Activity ...........................................................19 E. Prevention and Intervention Strategies ........................................................................19 VIII. Limitations of the Study.....................................................................................................21 IX. Conclusion .........................................................................................................................22 X. Appendices.........................................................................................................................23 A. Appendix A: Training Materials..................................................................................24 i. Key Informant Interview Training Protocol ....................................................25 ii. Key Informant Interview Training Handout....................................................26 iii. Indepth Interview Training Protocol................................................................30 iv. Indepth Interview Training Handout ...............................................................31 B. Appendix B: Interview Guides ....................................................................................37 i. Focus Group Guide..........................................................................................38 ii. Key Informant Interview Guide.......................................................................45 iii. Indepth Interview Guide ..................................................................................52 C. Appendix C: Interview Guides (Tagalog)...................................................................65 i. Key Informant Interview Guide.......................................................................66 ii. Indepth Interview Guide ..................................................................................73 ii Acknowledgements Advisory Committee Magelende McBride, Ph.D., M.S.N., R.N. Community Liaison Curtiss Takada Rooks, Ph.D. Consultant Asian and Pacific Islander American Health Forum staff Tracy L. Buenavista, B.A. Research Assistant Roselyn N. Calangian Project Assistant Tessie Guillermo Former Executive Director Betty Hong, M.P.H. Former Director, Community Health Development Division Susana M. Lowe, Ph.D. Project Coordinator Shobha Srinivasan, Ph.D. Research Director Principal Investigator Joon Ho Yu Tobacco and Cancer Coordinator West Bay Pilipino Multi-Services, Inc., staff and volunteers Daisy Cruz Interviewer Grace Cruz Interviewer iii West Bay Pilipino Multi-Services, Inc., staff and volunteers (continued) Cheryl Deocampo Interviewer Pia Galindo Interviewer Edwin D. Jocson Executive Director Eric M. Landas Interviewer Divine Marcelo Interviewer Sherille Pedron Interviewer National Heart, Lung, and Blood Institute, Office of Prevention, Education, and Control staff Matilde Alvarado, M.S.N., R.N. Coordinator, Minority Health Education and Outreach Activities Robinson Fulwood, Ph.D., M.S.P.H. Senior Manager for Public Health Program Development Ellen Sommer, M.B.A. Public Health Advisor Juliana Tu, M.S., C.H.E.S. Community Health Specialist We would especially like to thank the members of the Filipino community in Daly City and San Francisco, California, who generously gave their time, effort, and invaluable insight for this report. iv I. Forward The Healthy People 2010 report outlines the current status of the Nation’s health and the projected health objectives to be reached by the end of the decade. The two main goals of Healthy People 2010 are to increase the quality and years of healthy life and to end disparities in the burden of disease. The NHLBI is committed to meeting the goals set forth in Healthy People 2010, including ending the burden of disease for all racial and ethnic groups. The Institute has developed programs and initiatives to address high blood pressure, high blood cholesterol, early warning signs of heart attack, asthma, obesity, and sleep disorders. With this report on the Filipino community, we are gaining a greater understanding of the AAPI subgroups that have been largely overlooked. In fact, Filipinos are rarely studied even though they represent the third largest