Objectives: Examine the social influence of adult children on the cardiovascular-related health behaviors of older South Asian (SA) immigrants to inform lifestyle interventions.Design: This mixed-methods study used data from an ancillary study of social networks (2014-2018) in the Mediators of Atherosclerosis in South Asians Living in America cohort. Phase 1 was a quantitative analysis of self-reported diet and physical activity among SA adults (n = 448, mean age = 58 years, SD 8.4) who named at least one adult child to their social network. The Alternative Healthy Eating Index (AHEI) was used to measure parents' diet; higher numbers indicate a healthier diet (range 0-110). Phase 2 was a thematic content analysis of in-depth qualitative interviews from a subsample of these parents (n = 23, mean age = 55, SD 7.6).Results: Parents with an adult child in their network who consumed uncooked vegetables daily had mean parental AHEI score 1.5 points higher (adjusted p-value = 0.03) than those who had a child in the network who ate uncooked vegetables less often. When at least one adult child in their network ate fresh fruit daily compared to less frequently or when at least one child ate non-SA food daily compared to less frequently, mean parental AHEI scores were higher by 2.0 (adjusted p-value = 0.01) and 1.6 (adjusted p-value = 0.03) points respectively. Parents with an adult child in their network who exercised at least weekly were more likely to meet guideline-recommended physical activity levels than parents with children who exercised less often (76% v. 56%, adjusted p-value = 0.02). Adult children provided social support and were seen as 'role models' for healthy behavior, especially when adopting Western health behaviors.Conclusion: Positive role modeling and support from adult children were important facilitators of healthy behavior change in older SA immigrants and can inform health behavior interventions for SA adults.

Aims

To examine the association between social network body size and body size norms in South Asian adults.

Methods

Participants (n = 766) from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (2014-2018) provided detailed information about their five closest network members. Participants' perceptions of their network members' body sizes, their own body size (self-body size), and a healthy body size for men and women (body size norms) were assessed using the Stunkard 9-figure scale. Adjusted hierarchical linear regression models were used to examine associations between the average body size of network members and perceived body size norms.

Results

Participants' average age was 59.1 years (SD = 9.2) and 44.1% were women. Participants reported an average network body size of 4.0 (SD = 1.1). The average body size norm for male and female Stunkard images was 3.6 (SD = 1.0) and 3.4 (SD = 0.8), respectively. Social network body size was positively associated with increasing body size norms (β-coefficient = 0.31, 95% CI: 0.26, 0.36), independent of self-body size.

Discussion

Social networks may influence body size norms in South Asian adults. Long-term follow up of the MASALA cohort will determine if social network body size and body size norms are associated with weight- control behaviors and weight change.

Introduction

There are few longitudinal studies about South Asians (SAs) and little information about recruitment and retention approaches for this ethnic group.

Methods

We followed 906 SAs enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort for 5 years. Surviving participants were invited for a second clinical exam from 2015 to 2018. A new wave of participants was recruited during 2017-2018. We assessed the yields from different methods of recruitment and retention.

Results

A total of 759 (83%) completed the second clinical exam, and 258 new participants were enrolled. Providing a nearby community hospital location for the study exam, offering cab/shared ride reimbursement, and conducting home visits were the most effective methods for enhancing retention. New participant recruitment targeted women and individuals with lower socioeconomic status, and we found that participant referrals and active community engagement were most effective. Mailing invitational letters to those identified by electronic health records had very low yield.

Conclusion

Recruitment and retention strategies that address transportation barriers and increase community engagement will help increase the representation of SAs in health research.