HomeStyles: Shaping HOME Environments and LifeSTYLE Practices to Reduce Cardiometabolic Disease Risk

Research Project 1 – HomeStyles – Abstract Individuals of Chinese heritage now are the largest and fastest growing segment of the US Asian population. US Chinese have sociodemographic characteristics and culture that differ substantially from other US Asians, and therefore, differ in social determinants of health, health status, and disease risk. US Chinese adults are at increased risk for cardiometabolic disease, related conditions (obesity, type 2 diabetes mellitus, hypertension), and systemic inflammation that promotes disease onset and progression. Immigration to a new country can substantially impact the gut microbiome which may promote systemic inflammation. Our pilot interventions indicate a high-fiber diet rich in whole grains reduced inflammation and improved obesity. Additionally, our USDA supported, evidence based HomeStyles intervention has demonstrated feasibility, acceptability, and efficacy in improving lifestyle behaviors and home environments associated with obesity risk in families. A lack of linguistically, culturally tailored interventions to their specific health needs makes it difficult for US Chinese to implement healthy lifestyle behaviors and reduce health risks. We are not aware of any intervention tailored for US Chinese that could attenuate modifiable cardiometabolic risk factors, understand physiological sequelae, and bridge health equity. Thus, the overall goal of this R01 proposal is to test the efficacy of HomeStyles in improving health outcomes in US Chinese in NY/NJ. Proposal aims are to: A) Culturally adapt the HomeStyles intervention through community-engaged approaches. B) Conduct a 10-week, 2-armed RCT to test HomeStyles intervention efficacy on health outcomes (dietary intake, physical activity, self-efficacy, HbA1C, waist circumference, and BMI), hypothesizing that participants randomized to the treatment condition will have greater improvements in health outcomes than control comparators. C) Examine associations between intervention participation and gut microbiota/systemic inflammation and test hypotheses that a whole-grain rich diet adopted by those in the intervention group will increase anti-inflammatory gut bacteria, reduce inflammatory gut bacteria, and lower systemic inflammation. This proposal’s aims parallel NIMHD’s specific interests, as well as RFA MD-21-007. This includes interventions, like HomeStyles, that aim to ameliorate health inequities in minority populations and reduce multiple common risk factors (e.g., obesity, poor nutrition, physical inactivity, insufficient sleep, systemic inflammation) for multiple chronic diseases as well as address multi-generational chronic disease risk and protective factors. A culturally adapted HomeStyles intervention holds great potential for improving our knowledge about health disparity in the US Chinese population, understanding translational mechanisms toward comorbidities, informing family and community-oriented interventions through sustainable engagement, and serving as a model for health interventions for this audience.