title: Randomized controlled trial lifestyle interventions for Asian Americans: a systematic review.
abstract: OBJECTIVE
  Asian Americans are the fastest-growing race in the United States. However, they are largely underrepresented in health research, particularly in lifestyle interventions. A systematic review was conducted to analyze the characteristics and quality of lifestyle intervention literature promoting changes in physical activity (PA), diet, and/or weight management targeting Asian Americans.
  
  
  METHODS
  A systematic electronic database search identified randomized controlled clinical trials (RCTs), involving lifestyle interventions for Asian Americans, published from 1995 to 2013 conducted in the US. Data extraction was conducted from August through December 2013.
  
  
  RESULTS
  Seven RCTs met the review criteria. Cross-study comparisons were difficult due to diversity in: RCT intervention designs, cultural appropriateness, outcome measures, sample size, and race/ethnic groups. Overall, risk of bias and cultural appropriateness scores were moderate to low. Five out of seven RCTs showed significant between group differences for PA, diet, and weight. In general, sample sizes were small or lacked sufficient power to fully analyze intervention efficacy.
  
  
  CONCLUSIONS
  Evidence of the efficacy for lifestyle interventions among Asian Americans was mixed. Recommendations include: more rigorous RCT designs, more objective measures, larger Asian American sample sizes, culturally appropriate interventions, individual tailoring, maintenance phase with support, and providing education and modeling of lifestyle behaviors.
authors.affiliation: University of California San Francisco, Institute for Health & Aging/Department of Social and Behavioral Science, 3333 California St., Suite 340, San Francisco, CA 94118, USA. Electronic address: Melinda.Bender@ucsf.edu.
authors.forename: Melinda S
authors.initials: MS
authors.lastname: Bender
authors.affiliation: University of California San Francisco, Institute for Health & Aging/Department of Social and Behavioral Science, 3333 California St., Suite 340, San Francisco, CA 94118, USA. Electronic address: Jiwon.Choi@nursing.ucsf.edu.
authors.forename: JiWon
authors.initials: J
authors.lastname: Choi
authors.affiliation: University of California San Francisco, Medical Center at Mount Zion, H.M. Fishbon Memorial Library, 1600 Divisadero St., Room A-116, San Francisco, CA 94115, USA. Electronic address: Gloria.Won@ucsfmedctr.org.
authors.forename: Gloria Y
authors.initials: GY
authors.lastname: Won
authors.affiliation: University of California San Francisco, Institute for Health & Aging/Department of Social and Behavioral Science, 3333 California St., Suite 340, San Francisco, CA 94118, USA. Electronic address: Yoshimi.Fukuoka@nursing.ucsf.edu.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Fukuoka
mesh_terms: D001213:Asian; D004032:Diet; D015444:Exercise; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D018401:Sample Size; D015431:Weight Loss
keywords: Asian Americans; Diet; Lifestyle intervention; Physical activity; Randomized controlled trial; Systematic review; Weight
references.citation: Lancet. 2004 Jan 10;363(9403):157-63
references.pmid: 14726171
references.citation: Int J Behav Nutr Phys Act. 2008 Nov 06;5:56
references.pmid: 18990237
references.citation: Health Educ Behav. 2009 Apr;36(2):366-80
references.pmid: 18077657
references.citation: Can J Appl Sport Sci. 1985 Sep;10(3):141-6
references.pmid: 4053261
references.citation: Am J Lifestyle Med. 2013 Nov-Dec;7(6):395-404
references.pmid: 27547170
references.citation: Diabetes Care. 2002 Sep;25(9):1504-10
references.pmid: 12196418
references.citation: Calif J Health Promot. 2011 Sep;9(2):40
references.pmid: 24159268
references.citation: Obesity (Silver Spring). 2009 Dec;17 Suppl 3:S43-8
references.pmid: 19927146
references.citation: Am J Epidemiol. 1976 Sep;104(3):225-47
references.pmid: 961690
references.citation: Ann Epidemiol. 2005 Apr;15(4):257-65
references.pmid: 15780772
references.citation: J Obes. 2013;2013:437369
references.pmid: 23691286
references.citation: Diabetes Care. 2006 Jul;29(7):1675-88
references.pmid: 16801602
references.citation: N Engl J Med. 2002 Feb 7;346(6):393-403
references.pmid: 11832527
references.citation: Am J Clin Nutr. 2010 Mar;91(3):502-9
references.pmid: 20089734
references.citation: BMJ. 2012 Mar 15;344:e1454
references.pmid: 22422870
references.citation: Control Clin Trials. 2002 Dec;23(6):728-56
references.pmid: 12505249
references.citation: Nurs Res. 2011 Nov-Dec;60(6):393-404
references.pmid: 22048557
references.citation: Circulation. 2010 Sep 21;122(12):1242-52
references.pmid: 20733105
references.citation: J Consult Clin Psychol. 1983 Jun;51(3):390-5
references.pmid: 6863699
references.citation: Diabetes Care. 2011 Jun;34(6):1249-57
references.pmid: 21617109
references.citation: BMC Public Health. 2012 Jun 07;12:413
references.pmid: 22676147
references.citation: Diabetes Care. 2010 Nov;33(11):2477-83
references.pmid: 20693348
references.citation: J Sports Med Phys Fitness. 2001 Dec;41(4):479-85
references.pmid: 11687767
references.citation: Patient Educ Couns. 2010 Jul;80(1):130-4
references.pmid: 19945816
references.citation: J Clin Psychol. 2011 Feb;67(2):166-75
references.pmid: 21105069
references.citation: Int J Behav Nutr Phys Act. 2006 Sep 26;3:33
references.pmid: 16999874
references.citation: J Obes. 2011;2011:348293
references.pmid: 21052533
references.citation: Prev Med. 2014 Aug;65:1-6
references.pmid: 24736092
references.citation: Health Educ Behav. 2003 Apr;30(2):133-46
references.pmid: 12693519
references.citation: J Public Health Manag Pract. 2013 Mar-Apr;19(2):162-8
references.pmid: 23358295
references.citation: Am J Health Promot. 2009 Jul-Aug;23(6):S33-56
references.pmid: 19601486
references.citation: J Community Health. 2013 Dec;38(6):1030-41
references.pmid: 23813322
references.citation: Am J Public Health. 2011 Apr;101(4):751-8
references.pmid: 21330590
references.citation: Soc Work. 2009 Apr;54(2):167-74
references.pmid: 19366165
references.citation: BMJ. 2011 Oct 18;343:d5928
references.pmid: 22008217
references.citation: Cochrane Database Syst Rev. 2011 Jul 06;(7):CD002137
references.pmid: 21735388
references.citation: Circulation. 2010 Jul 27;122(4):406-41
references.pmid: 20625115
references.citation: Psychiatr Serv. 2010 Aug;61(8):774-82
references.pmid: 20675835
references.citation: Soc Sci Med. 2010 Jun;70(12):1997-2005
references.pmid: 20378226