To lower the high rate of heart disease among Filipino-Americans, the community needs heart health interventions rooted in Filipino cultural values, according to a new analysis by public health researchers at the University of Hawaiʻi at Mānoa.

Filipino-Americans comprise 20 percent of the growing Asian-American population and are overrepresented in important workforces, including healthcare and the military. Cardiovascular disease is the leading cause of death among Filipino-American males and second among Filipino-American females.

Further, they have a high prevalence of hypertension and behavioral risk factors associated with these cardiovascular and other chronic conditions, such as obesity, alcohol consumption and physical inactivity.

Filipino-Americans place a high importance on family relationships and often hold gatherings and celebrations with traditional foods. The community also values spirituality, caring for others and a tradition of obligation and reciprocity.

“We found that incorporating these values into interventions is an effective way to improve heart health,” said Professor Kathryn L. Braun, who worked on the study and is the director of the UH Office of Public Health Studies. Lead researcher on the study, Jermy-Leigh Domingo, is a recent UH Mānoa public health graduate.

For their analysis, the authors looked at eight previous studies that involved healthcare workers using culturally tailored interventions to increase Filipino-Americans’ participation in heart disease prevention programs. The researchers looked at whether these interventions worked and also identified their key components. Four of the previous studies were done in Hawaiʻi, while the others were performed on the mainland.

“In some interventions, healthcare workers offered suggestions for small changes that could be made in serving traditional Filipino foods, such as grilling fish rather than frying it,” Braun said.

Other interventions focused on a recognition of the importance of family relationships. For example, since turning down food is frowned upon, it is vital to get the whole family on board for support rather than focusing on the single individual with heart disease, the researchers said.

Few interventions involved finding ways to increase physical activity, however, dancing is popular among Filipino-Americans and may be an area to target in future studies.

“Our research is part of a growing body of evidence that shows that public health efforts that are tailored to reach people of certain cultures are effective in lowering the rates of chronic diseases,” Domingo said. Other factors include the ethnicity of healthcare workers, educational materials and the settings of interventions.