Diet, acculturation, and health in Chinese-American women.

다국어 초록 (Multilingual Abstract)

<italic>Background</italic>. One Healthy People 2000 objective is to target disease risk factors in special populations. Asian-Americans are a fast-growing minority group, and Chinese-Americans are the largest Asian subgroup in North America. Adoption of Western dietary patterns, e.g., high-fat, low fruit/vegetable diets (dietary acculturation) may be implicated in higher rates of chronic diseases in North American-dwelling Chinese compared to those living in Asia. However, there is little published information about the dietary practices of Chinese in North America.
<italic>Objectives</italic>. Our aims were to (a) develop and evaluate culturally appropriate and practical instruments to assess food habits and dietary changes, and (b) collect information necessary for the design and implementation of nutrition interventions for Chinese-Americans.
<italic>Methods</italic>. Using the PRECEDE framework as a model, we conducted 30 qualitative interviews and 2 focus groups with less acculturated Chinese women in Seattle, WA in their native language, soliciting information regarding usual food consumption, knowledge and beliefs about diet/disease, and factors influencing dietary change. Using these data, we designed six dietary survey instruments and piloted them on 170 Chinese women in Seattle and Vancouver, BC.
<italic>Results</italic>. Dietary acculturation, sociodemographic characteristics, and psychosocial (predisposing, enabling, reinforcing) factors affecting diet play important roles in the changing diets of Chinese immigrants. Women with high socioeconomic characteristics are most likely to acculturated in terms of diet. Reinforcing and enabling factors were more predictive of acculturation than predisposing factors. High acculturation was associated with higher fat-behaviors and daily fruit/vegetable servings. The survey instruments we developed from qualitative data performed reasonably well, as we generally obtained similar results from both the qualitative and quantitative processes.
<italic>Conclusions</italic>. Dietary acculturation appears to be a passive and gradual process, primarily driven by daily life issues such as social support, cost, and convenience. Interventions in Chinese-Americans should differ based on level of acculturation. For acculturated individuals, emphasis should be placed on resumption of the traditional Chinese diet and on healthy modifications of Western foods, while less acculturated immigrants should be encouraged to maintain Chinese eating patterns. Combining qualitative and quantitative paradigms provides important groundwork for the design, implementation, and evaluation of nutrition interventions for minority populations.