A Cluster Randomized Controlled Trial of a Lay Health Worker Intervention to Increase Healthy Eating and Physical Activity Among Vietnamese Americans

A Cluster Randomized Controlled Trial of a Lay Health Worker Intervention to Increase Healthy Eating and Physical Activity Among Vietnamese Americans

ORIGINAL RESEARCH — Volume 17 — April 30, 2020

Jane Jih, MD, MPH, MAS1,2,3; Susan L. Stewart, PhD4; Thien-Nhien Luong, MPH5; Tung T. Nguyen, MD1; Stephen J. McPhee, MD1; Bang H. Nguyen, DrPH, MPP6 (View author affiliations)

Suggested citation for this article: Jih J, Stewart SL, Luong T, Nguyen TT, McPhee SJ, Nguyen BH. A Cluster Randomized Controlled Trial of a Lay Health Worker Intervention to Increase Healthy Eating and Physical Activity Among Vietnamese Americans. Prev Chronic Dis 2020;17:190353. DOI: http://dx.doi.org/10.5888/pcd17.190353external icon.

PEER REVIEWED

On This Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Summary

What is already known on this topic?

Although disparities in healthy eating and physical activity exist between Asian Americans, including Vietnamese Americans, and the non-Hispanic white population, few intervention studies have been conducted among them.

What is added by this report?

A lay health worker intervention was efficacious in increasing both healthy eating and physical activity knowledge and self-reported behaviors among Vietnamese Americans.

What are the implications for public health practice?

A lay health worker–led intervention was a feasible, accessible, and efficacious approach to address disparities in healthy eating and physical activity knowledge and behaviors and to promote health equity among Vietnamese Americans.

Abstract

Introduction

Americans have low levels of knowledge of and adherence to recommendations for healthy eating of fruits and vegetables and for physical activity (HEPA). We conducted a cluster randomized controlled trial of a lay health worker intervention to increase HEPA among Vietnamese Americans.

Methods

We randomized 64 lay health workers to 2 intervention arms. Each lay health worker recruited 10 participants aged 50 to 74. From 2008 to 2013, using flip charts, lay health workers led 2 educational sessions on HEPA (intervention) or colorectal cancer (comparison). We assessed HEPA knowledge and self-reported behaviors by preintervention and postintervention surveys 6 months apart.

Results

Of the 640 participants, 50.0% were female, 38.4% had lived in the United States for 10 years or fewer, and 71.4% reported limited English proficiency. Knowledge of the recommended intake of fruits and vegetables (≥5 servings daily) increased from 2.6% to 60.5% in the intervention group (n = 311) and from 2.9% to 6.7% in the comparison group (n = 316) (intervention vs comparison change, P < .001). Knowledge of the physical activity recommendation (≥150 minutes weekly) increased from 2.6% to 62.4% among intervention participants and from 1.0% to 2.5% among comparison participants (P < .001). Consumption of 5 or more daily servings of fruits and vegetables increased more in the intervention group (8.4% to 62.1%) than in the comparison group (5.1% to 12.7%) (P < .001). Participants reporting 150 minutes or more of physical activity weekly increased from 28.9% to 54.0% in the intervention group and from 38.0% to 46.8% in the comparison group (intervention vs comparison change, P = .001).

Conclusion

A lay health worker intervention increased both healthy eating and physical activity knowledge and self-reported behaviors among older Vietnamese Americans.