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Chen J.-L.,University of California at San Francisco | Kwan M.,North East Medical Services
Clinical Pediatrics | Year: 2015

A pretest and posttest study design was used to test a healthy weight management intervention with overweight and/or obese Chinese American children. Children attended 8-weekly small group sessions while parents attended a single 2-hour parent workshop. Children had their weight, height, blood pressure, waist and hip circumference, and fast lipids data assessed and completed several questions questionnaires regarding food choices, self-efficacy, and knowledge at baseline, 2 months, and 6 months. Parents completed questionnaires regarding demographic, acculturation level and family environment. We found significant reduction of body mass index, waist/hip ratio, systolic blood pressure and improvement of child's eating style, physical activity knowledge, self-efficacy, and children's quality of life at 6-month follow-up. In addition, significant improvement of high-density lipoprotein cholesterol and decrease in triglyceride were found at 6-month follow-up. Improvement of nutrition self-efficacy and decreased stimulus environment were associated with decreased body mass index in overweight and obese Chinese American children. © SAGE Publications.

Chen J.-L.,University of California at San Francisco | Kwan M.,North East Medical Services | Liu K.,North East Medical Services | Yu F.,San Francisco State University
Journal of Pediatric Nursing | Year: 2015

Childhood obesity is one of the most prevalent public health concerns. Method: A pre and post study design was used to explore the efficacy of an obesity prevention program.Children had weight, height, blood pressure, and waist circumference measured, and completed self-reported questionnaires on food intake, knowledge, self-efficacy, and health-related quality of life. Parents completed demographic and acculturation surveys. Results: Seventy children participated in the study. Results demonstrated significant reduction of BMI, systolic blood pressure, and fast food consumption and improvement of self-efficacy, knowledge, and quality of life. Discussion: Childhood obesity intervention is feasible and has short-term efficacy. © 2015 Elsevier Inc.

This study examines the relationship between the anatomical location of traditional acupuncture points and their clinical indications as stated in two textbooks of traditional Chinese medicine (TCM). The following relationships are noted: (1) The acupuncture points in the trunk and their stated effects on the internal organs in the trunk have a segmental relationship-that is, acupuncture points within certain spinal segments in the trunk affect the functioning of the organs that receive autonomic innervation from the same spinal segments. This is consistent with the concept of segmental acupuncture and the idea that acupuncture may act via the somatic sympathetic refl ex with a spinal pathway to affect the trunk organs. (2) The acupuncture points in the trunk and extremities have a musculoskeletal effect that is local or regional, but not distal. This is consistent with some of the models of acupuncture mechanisms on musculoskeletal effects in the Western medical acupuncture approach. (3) The acupuncture points on the head and neck preferentially affect the nearest organ. This presumably refl ects the belief in TCM that acupuncture can somehow regulate the functioning of the proximal organ. No clear relationship can be identifi ed between the myotome level of the acupuncture points in the extremities and their non-musculoskeletal clinical indications.

Kwan C.M.L.,University of California at San Francisco | Mullan J.T.,University of California at San Francisco | Chun K.M.,University of San Francisco | Kwong Y.,Donaldina Cameron House | And 2 more authors.
Clinical Gerontologist | Year: 2014

This study examined whether social relationships were linked to health among Chinese Americans with diabetes, and whether age moderated these links given the norm of respect for the elderly. Chinese American immigrants with type 2 diabetes (n= 163) provided questionnaire and laboratory data. Relationships were assessed with diabetes family instrumental support, emotional support, and conflicts, as well as general support. Health was assessed with subjective health, depressive symptoms, and glucose regulation. When relationship predictors were examined simultaneously, more conflicts and less general support were associated with more depressive symptoms, after adjusting for covariates. More emotional support was associated with better glucose regulation only for midlife, not older, participants. Findings underscore cultural and life-stage considerations in studying social determinants of health. Copyright © Taylor & Francis Group, LLC.

Mukhtar N.A.,University of California at San Francisco | Toy B.C.,University of California at San Francisco | Burman B.E.,University of California at San Francisco | Yu A.,University of California at San Francisco | And 8 more authors.
Journal of General Internal Medicine | Year: 2015

Background: Hepatitis B (HBV) represents a significant health disparity among medically underserved Asian and Hawaiian/Pacific Islander (API) populations. Studies evaluating adherence to HBV screening and vaccination guidelines in this population are limited. Objective: The purpose of this study was to evaluate HBV screening and vaccination practices using both provider self-report and patient records. Design: Medical records for 20,574 API adults were reviewed retrospectively and primary care providers were surveyed to evaluate rates and adherence to HBV screening and vaccination guidelines. Participants: The study included primary care providers and their adult API patients in the San Francisco safety-net healthcare system. Main Measures: Patient, practice, and provider factors, as well as HBV screening and vaccination practices, were assessed using provider survey constructs and patient laboratory and clinical data. Generalized linear mixed models and multivariate logistic regression analyses were used to identify factors associated with recommended HBV screening and vaccination. Key Results: The mean age of patients was 52 years, and 63.4 % of patients were female. Only 61.5 % underwent HBV testing, and 47.4 % of HBV-susceptible patients were vaccinated. Of 148 (44.8 %) responding providers, most were knowledgeable and had a favorable attitude towards screening, but 43.2 % were unfamiliar with HBV guidelines. HBV screening was positively associated with favorable provider attitude score (OR per unit 1.80, 95 % CI 1.18–2.74) and negatively associated with female patient sex (OR 0.82, 95 % CI 0.73–0.92), a higher number of clinic patients per week (OR per 20 patients 0.46, 95 % CI 0.28–0.76), and provider barrier score (OR per unit 0.45, 95 % CI 0.24–0.87). HBV vaccination was negatively associated with provider barrier score (OR per unit 0.48, 95 % CI 0.25–0.91). Conclusions: Rates of HBV screening and vaccination of API patients in this safety-net system are suboptimal, and provider factors play a significant role. Efforts to cultivate positive attitudes among providers and expand healthcare system resources to reduce provider barriers to HBV care are warranted. © 2014, Society of General Internal Medicine.

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