Department of Communication Studies, University of San Francisco, San Francisco, CA, USA.
Asian American Research Center on Health, San Francisco, CA, USA.
J Altern Complement Med. 2021 Aug;27(8):657-668. doi: 10.1089/acm.2020.0558. Epub 2021 May 12.
This study describes the development and feasibility of Integrative Nutritional Counseling (INC), a Chinese medicine (CM)+biomedicine-based nutrition curriculum for Chinese Americans with type 2 diabetes. Although Chinese Americans often incorporate CM principles into their diet, scant research has explored how to integrate CM with biomedical nutrition standards in a culturally appropriate manner or if such a program could improve diabetes self-management. This is a 1-month pre-post study design including three points of contact: baseline, in-person class, and 1-month follow-up. Participants ( = 15) were Cantonese-speaking/reading Chinese Americans diagnosed with type 2 diabetes who had used some form of CM/medicinal foods in the last 12 months. The INC program included baseline surveys and a CM intake interview conducted by a licensed acupuncturist. The acupuncturist generated a CM diagnosis, which was shared with the participant, and used this diagnosis to tailor brief nutrition education. To bolster this brief education, a bilingual registered dietitian provided a 2-h group education class in Cantonese to all participants, during which time participants also received a Chinese/English INC booklet. Participants completed surveys immediately after the class and at 1-month follow-up, with qualitative exit interviews. Participants reported improved attitudes and dietary habits aligning directly with INC, and improvement in biomedically valued measures of type 2 diabetes, such as weight loss, and CM-valued measures of digestion/elimination and hot/cold feeling. Satisfaction with INC was high, but challenges included confusion with some INC information, structural barriers, and comorbidities. Chinese Americans with type 2 diabetes and interventionists found integrative nutrition approaches acceptable and feasible. Future research should examine INC with a larger population and explore optimal delivery of INC given reported challenges.
这项研究描述了综合营养咨询（INC）的发展和可行性，这是一种基于中医（CM）和生物医学的营养课程，针对的是 2 型糖尿病的华裔美国人。尽管华裔美国人经常将 CM 原则融入他们的饮食中，但很少有研究探讨如何以一种文化上适当的方式将 CM 与生物医学营养标准相结合，或者这样的计划是否可以改善糖尿病的自我管理。这是一项为期 1 个月的前后研究设计，包括三个接触点：基线、面对面课程和 1 个月随访。参与者（n=15）为讲粤语/阅读中文的华裔美国人，他们被诊断患有 2 型糖尿病，在过去 12 个月中曾使用过某种形式的 CM/药用食品。INC 计划包括基线调查和由持牌针灸师进行的 CM 摄入量访谈。针灸师做出 CM 诊断，并与参与者分享，然后根据该诊断为其提供简短的营养教育。为了加强这一简短的教育，一位双语注册营养师以粤语向所有参与者提供了 2 小时的小组教育课程，在此期间，参与者还收到了一本中文/英文的 INC 小册子。参与者在课程结束后和 1 个月随访时立即完成了调查，并进行了定性的退出访谈。参与者报告称，他们的态度和饮食习惯得到了改善，这与 INC 直接相关，并且在生物医学上有价值的 2 型糖尿病指标（如体重减轻）和 CM 上有价值的消化/排泄和冷热感觉指标也得到了改善。对 INC 的满意度很高，但也存在一些挑战，包括对一些 INC 信息的混淆、结构性障碍和合并症。2 型糖尿病的华裔美国人和干预者认为综合营养方法是可以接受和可行的。未来的研究应该在更大的人群中检验 INC，并探索在报告的挑战下 INC 的最佳交付方式。
