Asian-Americans With Diabetes: Assessing the Intervention PICOT question: How do Asian-Americans with newly diagnosed type 2 diabetes perceive barriers to implementing dietary and lifestyles changes to reduce A1C levels in the first 3 months after diagnosis?

Evaluation plan

Although Asian cuisines have traditionally been regarded as healthier than Westernized diets because of their high fiber and vegetable content, relatively low levels of sugar, and their emphasis on rice vs. highly sweetened starchy grains, this has been changing in recent years as Asian-Americans adapt increasingly Westernized eating habits (McNeely 2004). In fact, "Asian-Americans are almost twice as likely to develop diabetes as the general population in the United States, and of those who develop the disease, more than 95% are diagnosed with type 2 diabetes," which is strongly correlated with obesity and poor exercise and dietary habits ("Asian-Americans with Diabetes," 2015). Asian-Americans are also more likely to develop type 2 diabetes at relatively lower BMIs than other demographic groups. "At a lower BMI, Asians tend to accumulate more body fat compared to Caucasians" ("Asian-Americans with Diabetes," 2015). Because a healthy body size may be lower on average for Asians this often causes doctors to ignore potential red flags such as elevated weight until it is too late (McNeely 2004). Simply using BMI indexes in a generic fashion for all patient population groups is not ideal.

Methods

The purpose of this study will be to assess the effectiveness...

The emphasis will be on adapting the diet to preferences specifically tailored to Asian-American palates and food selection. For example, for patients that were raised in more traditional food environments, encouraging a shift back to eating as they did when younger might be helpful. For adolescent patients with parents who may have been raised in food-deprived environments that have overcompensated with over-nutrition, family interventions may be required to emphasize what is a healthy body type and to dissociate the connection between food and love. For all patients, the stress will be on reducing BMI and body fat to meet criteria specific to their needs, versus those of a generalized population. Support will be offered regarding weight loss efforts from counselors and personal trainers will offer exercise advice. Goals will be set for patients depending upon individual needs (including age, gender, and degree of physical mobility) but a minimum of 30 minutes of exercise everyday would be the mandatory for each patient, even if only in the form of light walking.
Variables

Counseling will be specifically designed to address patients' cultural needs as they arise. For example, "many Asian patients refuse the initial consultation with a dietitian because they don't understand the role of nutrition in managing their diabetes, and adhere to the traditional view that characterizes physicians as the…