Editorial

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APIN editorial

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Ethnic and Gender Differences in Psychosocial Factors in Native Hawaiian, other Pacific Islanders, and Asian American Adults with Type 2 Diabetes

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better social support. Approaches to diabetes treatment decisions should include ethnic and cultural differences that may impact treatment outcomes

Feasibility of a group-based self-management program for ethnically diverse people with HIV/AIDS in Hawaii

HIV/AIDS has transformed from a terminal to a chronic health condition affecting individuals for decades rather than years. Yet the development of care models that enhance client-focused HIV disease management skills is still in progress, especially in HIV resource-poor locales. This pilot study tested the feasibility of implementing the group-based Positive Self-Management Program (PSMP) to participants recruited from Oahu, Hawaii. The PSMP is a self-management program developed at Stanford University. A paucity of data exists on the efficacy of implementing the specialized PSMP that addresses unique needs of persons living with HIV. With a focus on enhancing self-efficacy beliefs, examples of topics addressed during seven weekly 2-hr group sessions include managing the physiological and psychological aspects of HIV, adherence to treatment regimes, symptom management, and fostering healthy lifestyle behaviors. Using a randomized waitlist control design, participants were recruited via convenience sampling and active outreach. The manualized PSMP was delivered by trained seropositive lay leaders. The completion rate for those who attended any sessions was 93.5%. The average attendance rate was 85%. The majority of participants reported being comfortable in the PSMP group setting and very satisfied with program activities. Almost all participants reported that the PSMP was a useful and easy method to learn new ways of managing their illness. The majority (93.8%) were most satisfied with skill development in goal setting and action planning. Implementation of the program for persons living with HIV in Hawaii was feasible. Lessons learned for future research and application to practice are discussed

The lived experience of Pacific Island women with a “big body” size

This phenomenological study explored the lived experience with big body size of Pacific Island women who migrated to Hawaii. Giorgi’s descriptive phenomenological approach was utilized in this study. A purposive sample included six Pacific Island women. Five of the six women had migrated to Hawaii from the island nations of Micronesia. The sixth participant was a Native Hawaiian who had lived in Micronesia and had returned to Hawaii. The collection and transcription of data were done by the first author. Data were categorized into themes independently by the three authors and bracketing was maintained throughout the study. The women identified the dichotomy of big body versus small body and the connotation of each body size in how they viewed the world around them. They shared their lifestyle and transitional changes in trying to adapt and ‘fit’ into the new lifestyle in Hawaii. These changes impacted their eating habits and work schedule, level of activity, and financial security. The women identified biopsychosocial concerns in their lives and the need to re-evaluate their big body size in relation to their health and physical and psychosocial changes. Implications for future research are to include a diverse representation of women from island countries within the Pacific Basin. The results of this study provided valuable information related to cultural relevance and sensitivity in working with Pacific Island women in managing their health

The effect of a cognitive–behavioral intervention on diet and exercise among Asian Americans and Pacific Islanders with type 2 diabetes

Type 2 diabetes accounts for 90% to 95% of all diabetic cases with Asian Americans and Pacific Islanders particularly at risk. The purpose was to assess the effects of a cognitive–behavioral intervention (CBI) on diet and exercise among Asian Americans and Pacific Islanders with type 2 diabetes. Using a double-blinded, two-arm randomized clinical trial (n = 207), data on diet and exercise were analyzed before and after a 6-week CBI. Over time, treatment group showed a decrease in kcals and increase in steps compared with control group; however, results were not statistically significant. Treatment group had lower kcals of trans-fat, saturated fat, sugar, alcohol, caffeine, and dietary fiber compared with the control group. Older subjects and females had significantly lower caloric intake (p \u3c .01). Females exercised less and took fewer steps compared with males (p \u3c .05). CBI may be effective in lowering calorie intake and increasing physical activity among Asian Americans and Pacific Islanders with type 2 diabetes. Significant differences in gender and age point to the need for individualized research and treatment targeting this group

Associations between Psychosocial and Physiological Factors and Diabetes Health Indicators in Asian and Pacific Islander Adults with Type 2 Diabetes

The associations between psychosocial and physiological factors and diabetes' health indicators have not been widely investigated among Asians and Pacific Islanders. We hypothesize that health behaviour and depression are directly or indirectly associated with diabetes' health indicators such as BMI, glycemic control, general health, and diabetes quality of life. Our hypothesis was tested through a structural equation modelling (SEM) approach. Questionnaires that assessed health behaviour, depression, general health, diabetes quality of life, and haemoglobin A1c (HbA1c), along with patients' demographic information, were obtained from 207 Asian and Pacific Islander adults with type 2 diabetes. IBM SPSS Amos 20 was used for the SEM analysis at 5% level of significance, and the goodness fit of the SEM model was also evaluated. The final SEM model showed that diet and exercise and foot care had positive associations, while depression had a negative association with diabetes' health indicators. The results highlighted the importance of exercise and depression in diabetes patients' BMI, glycemic control, general health, and quality of life, which provide evidence for the need to alleviate patients' depression besides education and training in diet and exercise in future intervention studies among Asians and Pacific Islanders with type 2 diabetes

Proceedings of the 2018 Asian American/Pacific Islander Nurses Association Conference: Local to Global--Future Directions for Research on Health Disparities

The Asian American / Pacific Islander Nurses Association’s 15th Annual International Conference was held September 22-23, 2018 at the Hilton Garden Inn, located in Southpoint, Durham, S.C. with 43 research presenters. The conference theme was Local to Global: Future Directions for Research on Health Disparities with a dozen internationally well-known leaders around the world as keynote and special session speakers. Drs. Hyeoneui Kim, PhD, MPH, RN; Duke University School of Nursing and Jeeyae Choi, PhD, RN; University of North Carolina Wilmington School of Nursing were co-chairs and led the conference topics which addressed the current trends and future directions of health disparity research among AAPIs. The abstracts published here represent concurrent sessions focusing on the topics of: Nurses as Leaders- from Bedside to Board Room Moderator; Emerging Evidence and Future Directions of Clinical Practice; Paradigm Shift in Nursing Education to Influence Patient and Staff Safety and Patient Care Outcomes; Culturally Tailored Chronic Disease Care to Improve Patient Satisfaction and Patient Care Outcomes; The Use of Technology in Nursing Research; and Leveraging Technology for Practice, Research, Education. As the only journal focusing on (API) health and nursing we hope these topics give a flavor of areas important to API