Randomized controlled trial lifestyle interventions for Asian Americans: A systematic review

Objective. Asian Americans are the fastest-growing race in the United States. However, they are largely under-represented 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. Method. 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. Conclusion. 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. (C) 2014 Elsevier Inc. All rights reserved.