A focus group study of fish consumption behaviors among Asian women in Milwaukee, Wisconsin.

Consumption of locally caught fish provides health benefits but can be a route of exposure to methylmercury and other persistent environmental contaminants. Previous studies found that Asian women of childbearing age (WCBA) in the Milwaukee area have high levels of exposure through fish consumption but limited awareness of fish advisories. We conducted a focus group project to understand the influence of culture, attitudes, and beliefs on the fish consumption habits of Chinese, Hmong, and Karen WCBA who reside in the Milwaukee area to develop culturally appropriate educational materials. A total of 19 women aged 18-50 years identifying as Chinese, Hmong, or Karen were recruited. Three focus groups were held, each consisting of 6-7 participants from one ethnicity. Focus group transcripts were thematically analyzed and coded based on the integrated behavioral model. Nutritional benefits and availability were the most common reasons to eat locally caught fish. All participants were aware of risks associated with eating fish, yet few knew ways to mitigate risk and maximize benefits. Participants expressed interest in receiving health messages from trusted sources and recommended that messaging target families rather than just individuals. Participants who were confident in their self-efficacy expressed a greater likelihood of following health message guidelines. Results suggest providing culturally appropriate educational materials in preferred languages to Asian communities via local community organizations may increase self-efficacy and adherence to fish advisories. Future projects will evaluate the effectiveness of self-affirmation messaging among Asian WCBA and assess changes in fish consumption based on message content.

Diabetes Telehealth Solutions: Improving Self-Management Through Remote Initiation of Continuous Glucose Monitoring.

The purpose of this study was to evaluate feasibility of initiating continuous glucose monitoring (CGM) through telehealth as a means of expanding access. Adults with type 1 diabetes (N = 27) or type 2 diabetes using insulin (N = 7) and interest in starting CGM selected a CGM system (Dexcom G6 or Abbott FreeStyle Libre), which they received by mail. CGM was initiated with a certified diabetes care and education specialist providing instruction via videoconference or phone. The primary outcome was days per week of CGM use during the last 4 weeks. Hemoglobin A1c (HbA1c) was measured at baseline and 12 weeks. Participant self-reported outcome measures were also evaluated. All 34 participants (mean age, 46 ±â€…18 years; 53% female, 85% white) were using CGM at 12 weeks, with 94% using CGM at least 6 days per week during weeks 9 to 12. Mean HbA1c decreased from 8.3 ±â€…1.6 at baseline to 7.2 ±â€…1.3 at 12 weeks (P < .001) and mean time in range (70-180 mg/dL, 3.9-10.0 mmol/L) increased from an estimated 48% ±â€…18% to 59% ±â€…20% (P < .001), an increase of approximately 2.7 hours/day. Substantial benefits of CGM to quality of life were observed, with reduced diabetes distress, increased satisfaction with glucose monitoring, and fewer perceived technology barriers to management. Remote CGM initiation was successful in achieving sustained use and improving glycemic control after 12 weeks as well as improving quality-of-life indicators. If widely implemented, this telehealth approach could substantially increase the adoption of CGM and potentially improve glycemic control for people with diabetes using insulin.