Motivating people to sustain healthy lifestyles using persuasive technology: A pilot study of Korean Americans with prediabetes and type 2 diabetes

Kim, Miyong T.,Kim, Kim Byeng,Nguyen, Tam H.,Ko, Jisook,Zabora, Jim,Jacobs, Elizabeth,Levine, David Elsevier 2019 Patient education and counseling Vol.102 No.4

<P><B>Abstract</B></P> <P><B>Objective</B></P> <P>To test the efficacy of a hybrid model of the self-help intervention program (hSHIP), which combines a mobile version of SHIP (mSHIP) and personal coaching, to address unique cultural and motivational factors for optimal self-management of type 2 diabetes and prediabetes among Korean Americans (KAs).</P> <P><B>Methods</B></P> <P>A single-group feasibility study design was used. The hSHIP utilizes texts and motivational counseling based on well-tested intervention content for KAs. To facilitate the dissemination of hSHIP, we developed a web application adopting the principles of persuasive technology to motivate behavior changes.</P> <P><B>Results</B></P> <P>Feasibility assessment found that hSHIP was well accepted by both participants and community health workers who delivered the intervention. An average of 1.3% A1C reduction (from 7.8% to 6.5%) was achieved by KAs with diabetes (n = 165), 51.5% of whom lowered their A1C below 6.5% in 6-months. No one with prediabetes (n = 50) progressed to diabetes. Other clinical outcomes (e.g., weight, depression, and blood pressure) also improved significantly; 41.2% were able to reduce or discontinue antidiabetic drugs.</P> <P><B>Conclusion</B></P> <P>The feasibility and initial efficacy of hSHIP were demonstrated.</P> <P><B>Practice implication</B></P> <P>This hybrid diabetes self-management model is a viable tool for traditionally underserved groups with diabetes or prediabetes.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We tested feasibility of a hybrid diabetes care model in an ethnic minority group. </LI> <LI> Our model combined a digital touch of mHealth and a human touch of CHWs. </LI> <LI> About a half (51.5%) lowered their hemoglobin A1C below 6.5% in 6 months. </LI> <LI> Many (41.2%) stopped/reduced antidiabetic drugs but still managed their diabetes. </LI> <LI> Weight, depression and blood pressure were also significantly improved. </LI> </UL> </P>

Factors Related to Risk of Cardiovascular Disease Among Older Korean Chinese With Hypertension

이춘옥,한혜라,김지윤,Miyong T. Kim 한국간호과학회 2011 Asian Nursing Research Vol.5 No.3

Purpose: The purpose of this study was to assess the prevalence of cardiovascular disease (CVD) risk factors among older Korean Chinese with hypertensiondone of the most underserved and understudied ethnic minority groups in China. In addition, factors underlying the risk of CVD were examined. Methods: A total of 334 participants were recruited at the Community Health Service Center in Yanji,China. Data regarding socioeconomic, health-related, psychosocial, and other CVD risk factors were collected between June and October 2009. In this cross-sectional study, factors related to the risk of CVD were assessed by multivariate logistic regression; the Framingham Risk Score was used to measure the risk of CVD. Results: The prevalence of dyslipidemia, diabetes, and current smoking were 75.4%, 6.6%, and 23.1%respectively. Participants who lived alone were twice as likely to have a high risk of CVD (10-year risk of CVD 15%; odds ratio [OR], 2.00; 95% confidence interval [CI], 1.13e3.54). Those with a higher education level and greater knowledge about hypertension were at 57% and 62% reduced risk for CVD (OR, 0.43;95% CI, 0.21e0.92 and OR, 0.38; 95% CI, 0.15e0.95, respectively). Conclusion: Future intervention should include strategies to addressing social isolation and also focus on older Korean Chinese with low education. Knowledge enhancement program is warranted for the prevention of CVD in this population.

Food Sources of Sodium in Korean Americans With Type 2 Diabetes: Implications for Cardiovascular Disease

Ko, Jisook,Timmerman, Gayle M.,Kim, Kim B.,Kim, Miyong T. SAGE Publications 2019 Journal of transcultural nursing Vol.30 No.2

Aging IQ Intervention with Older Korean Americans: A Comparison of Internet-Based and In-Class Education

Yuri Jang,Hyunwoo Yoon,C. Nathan Marti,Miyong T. Kim 한국노인복지학회 2017 한국노인복지학회 학술발표논문집 Vol.7 No.1

Knowledge, Behaviors and Prevalence of Reproductive Tract Infections: A Descriptive Study on Rural Women in Hunchun, China

Chunyu Li,Hae-Ra Han,이종은,Myungken Lee,Youngja Lee,Miyong T. Kim 한국간호과학회 2010 Asian Nursing Research Vol.4 No.3

Purpose The aim of the study was to assess the prevalence, knowledge and behavior about reproductive tract infections (RTIs) among rural Chinese women in Hunchun, China. Methods The study employed a cross-sectional research design with a convenience sample of 190 participants who had received microfinancing. Data were collected by trained research staff, utilizing face to face interviews and physical examinations. Results About 1 in 5 participants (20.3%) had had more than 5 pregnancies and 26.7% had had 3 or more abortions. More than half (57.3%) of study participants had an RTI at the time of examination, and 92.3% reported having had at least one RTI symptom. Nearly half (49.6%) of the women who exhibited RTI symptoms reported no utilization of any healthcare services. Age, number of pregnancies, RTI knowledge,and behavior were found to be significant correlates in the sample. Conclusions The prevalence of RTI among low-income rural Chinese women were extremely high, indicating the urgent need for effective and culturally sensitive health education, particularly targeted to the poor rural population.

Improving Access to Mental Health Services for Korean American Immigrants: Moving Toward a Community Partnership Between Religious and Mental Health Services

Hochang B. Lee,,Jennifer A. Hanner,조성진,Hae-Ra Han,Miyong T. Kim 대한신경정신의학회 2008 PSYCHIATRY INVESTIGATION Vol.5 No.1

Korean Americans (KAs) with psychiatric service needs underutilizes the mainstream mental health services in United States (US). Barriers to mental health service access among KAs reflect their unique heritage and culture. More than two-thirds of KAs identify themselves as Christians, and Korean clergy have influential roles in daily lives of vast majority of KAs. By working with the Korean clergy, a small voluntary organization such as the Association of Korean American Psychiatrists could provide invaluable assistance in removing the barriers to mental health services for KAs. Korean Americans (KAs) with psychiatric service needs underutilizes the mainstream mental health services in United States (US). Barriers to mental health service access among KAs reflect their unique heritage and culture. More than two-thirds of KAs identify themselves as Christians, and Korean clergy have influential roles in daily lives of vast majority of KAs. By working with the Korean clergy, a small voluntary organization such as the Association of Korean American Psychiatrists could provide invaluable assistance in removing the barriers to mental health services for KAs.

Psychometric Evaluation of Hill-Bone Medication Adherence Subscale

송영신,Hae-Ra Han,Hee-Jung Song,Soohyun Nam,Tam Nguyen,Miyong T. Kim 한국간호과학회 2011 Asian Nursing Research Vol.5 No.3

Purpose: Medication adherence is an essential part of the management and control of high blood pressure (HBP). Although the Hill-Bone Medication Adherence (HBMA) scale is one of the most frequently used instruments for measuring HBP medication adherence, the psychometric properties of the scale have never been tested among Korean Americans, a population that experiences a disproportionately high prevalence of HBP. Therefore, the objective of this study is to validate a Korean version of the HBMA subscale (HBMA-K). Method: We used two, independent samples of Korean Americans (KAs) (combined n ¼ 525) who participated in community-based intervention trials for HBP control. To develop the HBMA-K, the original scale was translated into Korean and then back translated into English. Reliability was assessed by calculating the Cronbach’s alpha. Exploratory factor analysis (EFA) was done to assess construct validity. We also calculated the Pearson’s correlation coefficients between the scale and theoretically driven variables such as blood pressure, knowledge, and HBP belief to test concurrent validity. Results: The EFA revealed a one-factor solution with eight items, explaining 35.4% of the variance. Cronbach’s alpha was .80. The 8-item HBMA-K scale was significantly associated with systolic blood pressure (BP) (r ¼ .18, p < .01), diastolic BP (r ¼ .24, p < .01), HBP knowledge (r ¼ .13, p < .01), and HBP belief score (r ¼ .18, p < .05). Conclusions: The 8-item HBMA-K scale is a valid and reliable instrument for measuring medication adherence among KAs with HBP. It can be easily administered at community and clinical settings to screen hypertensive patients with low medication adherence.