Danielle Kim | Biola University (original) (raw)

Teaching Documents by Danielle Kim

by Jayon Lee, Megan Wheeldon, Caitlin Chong, Vaneetha Christopher, Lily Howard, Kendra Corman, Michael Lessard-Clouston, Maura Lopez, Riley Wall, Kazue Suzuki, Bree Williams, and Danielle Kim

This is an edited collection with 47 annotations written by students in my Intercultural Communic... more This is an edited collection with 47 annotations written by students in my Intercultural Communication for Teachers class in spring 2013.

Papers by Danielle Kim

Molecular Cancer Therapeutics, 2009

Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal... more Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal, acral lentiginous, and chronically sun-damaged melanomas. We have identified the first human melanoma cell line with an endogenous L576P mutation, the most common KIT mutation in melanoma (∼30-40%). In vitro testing demonstrated that the cell viability of the L576P mutant cell line was not reduced by imatinib, nilotinib or sorafenib small molecule KIT inhibitors effective in non-melanoma cells with other KIT mutations. However, the viability of the mutant cells was reduced by dasatinib at concentrations as low as 10 nM (P =0.004). Molecular modeling studies found that the L576P mutation induces structural changes in KIT that reduce the affinity for imatinib (ΔΔGbind = -2.52 kcal/mol) but not for dasatinib (ΔΔGbind = +0.32 kcal/mol). Two metastatic melanoma patients with the L576P KIT mutation were treated with dasatinib, including one patient previously treated with imatinib. Both patients had marked reduction (>50%) and elimination of tumor FDG-avidity by PET imaging after dasatinib treatment. This data supports the selective inhibitory effect of dasatinib against cells harboring the most common KIT mutation in melanoma, and thus has therapeutic implications for acral lentiginous, chronic sun damaged, and mucosal melanomas.

The use of community health workers (CHWs) or lay health advisors has been increasingly popular a... more The use of community health workers (CHWs) or lay health advisors has been increasingly popular as an effective means of secondary prevention for cardiovascular health in hard-to- reach, underserved populations. Yet, published evaluations of the CHW training programs are rare. The purpose of this article is to report the results of an evaluation of a CHW training program for hypertension

Journal of community health, 2002

With the current wave of Asian immigration to the United States, awareness of their use of tradit... more With the current wave of Asian immigration to the United States, awareness of their use of traditional medicine, often in combination with Western medicine, is an increasingly salient issue for health care professionals. This paper describes the use of traditional and Western medicine by Korean American elderly and factors that are associated with their health-seeking behaviors and health service utilization. Data were obtained from a convenience sample of 205 Korean elderly immigrants through interview. The findings revealed that health service utilization among Korean American elderly covered a broad spectrum of health resources, including the use of Western medicine, the traditional Korean medicine (hanbang), or both Western and traditional clinics. In addition, health insurance status and the source of health care were found to relate to the types of health service that Korean American elderly chose to utilize. Better understanding of patterns of health service utilization may i...

International Journal of Nursing Studies, 2010

What is already known about the topic?

Patient Education and Counseling, 2012

Objective-While the role of health literacy in chronic disease management is well documented, few... more Objective-While the role of health literacy in chronic disease management is well documented, few intervention studies have been reported. A major barrier to designing and implementing such interventions is the lack of valid health literacy tools. This study developed and tested a novel health literacy scale for individuals with high blood pressure (HBP).

Nuclear Fusion, 2001

The extensive design effort for KSTAR has been focused on two major aspects of the KSTAR project ... more The extensive design effort for KSTAR has been focused on two major aspects of the KSTAR project mission -steady-state-operation capability and advanced tokamak physics. The steady state aspect of the mission is reflected in the choice of superconducting magnets, provision of actively cooled in-vessel components, and long pulse current drive and heating systems. The advanced tokamak aspect of the mission is incorporated in the design features associated with flexible plasma shaping, double null divertor and passive stabilizers, internal control coils and a comprehensive set of diagnostics. Substantial progress in engineering has been made on superconducting magnets, the vacuum vessel, plasma facing components and power supplies. The new KSTAR experimental facility with cryogenic system and deionized water cooling and main power systems has been designed, and the construction work is under way for completion in 2004.

Patient Education and Counseling, 2010

Nurse telephone counseling can improve the management of chronic conditions, but the effectivenes... more Nurse telephone counseling can improve the management of chronic conditions, but the effectiveness of this approach in underserved populations is unclear. This study evaluated the use of bilingual nurse-delivered telephone counseling in Korean Americans (KAs) participating in a community-based intervention trial to improve management of hypertension. KAs were randomized to receive 12 months of hypertension-related telephone counseling that was more intensive (bi-weekly) or less intensive (monthly). Counseling logs were kept for 360 KAs who completed the pre- and post-intervention evaluations. The overall success rate for the intervention was 80.3%. The level of success was significantly influenced by the dose of counseling, employment status, and years of US residence. Over the 12-month counseling period, both groups showed improvement with regard to medication-taking, alcohol consumption, and exercise but not smoking, with no significant group differences. Bilingual telephone counseling could reach monolingual KAs and improve their hypertension management behavior. Bilingual nurse telephone counseling may have wide applicability, serving as an effective means of disseminating evidence-based chronic disease management guidelines to a linguistically isolated community with limited health resources and information.

Molecular Cancer Therapeutics, 2009

Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal... more Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal, acral lentiginous, and chronically sun-damaged melanomas. We have identified the first human melanoma cell line with an endogenous L576P mutation, the most common KIT mutation in melanoma (∼30-40%). In vitro testing demonstrated that the cell viability of the L576P mutant cell line was not reduced by imatinib, nilotinib or sorafenib small molecule KIT inhibitors effective in non-melanoma cells with other KIT mutations. However, the viability of the mutant cells was reduced by dasatinib at concentrations as low as 10 nM (P =0.004). Molecular modeling studies found that the L576P mutation induces structural changes in KIT that reduce the affinity for imatinib (ΔΔGbind = -2.52 kcal/mol) but not for dasatinib (ΔΔGbind = +0.32 kcal/mol). Two metastatic melanoma patients with the L576P KIT mutation were treated with dasatinib, including one patient previously treated with imatinib. Both patients had marked reduction (>50%) and elimination of tumor FDG-avidity by PET imaging after dasatinib treatment. This data supports the selective inhibitory effect of dasatinib against cells harboring the most common KIT mutation in melanoma, and thus has therapeutic implications for acral lentiginous, chronic sun damaged, and mucosal melanomas.

Journal of Immigrant and Minority Health, 2007

While increasing numbers of researchers are targeting ethnic minorities in order to address their... more While increasing numbers of researchers are targeting ethnic minorities in order to address their health disparities, the unique health needs of Korean Americans are not well known to the mainstream community, and only relatively few systematic research studies have been conducted in this "hard-to reach" population. The purpose of this paper is to describe the barriers to recruiting participants for health promotion research and to identify facilitators in the community that can contribute to this effort. We have analyzed data pertaining to the 14 studies we have conducted since 1998, which included a total sample of about 2,400 Korean Americans. We describe in detail the unique recruitment challenges that we have faced in regard to the culture, language, sociodemographic characteristics of the participants, such as gender and age, and other community level barriers. Multiple strategies at different levels (individual and community) to address these issues are discussed.

Journal of Immigrant and Minority Health, 2011

While the need for understanding the issue of health literacy among ethnic minority groups with l... more While the need for understanding the issue of health literacy among ethnic minority groups with limited English skills is rapidly increasing in the US, it is difficult to find valid and useful health literacy tools for certain linguistic minorities. This study was designed to validate the Korean translation of Rapid Estimate of Adult Literacy in Medicine (REALM) and Test of Functional Health Literacy in Adults-Short form (S-TOFHLA). Korean REALM and S-TOFHLA were administered to 98 Korean American women, together with REALM-English. Participants were first-generation immigrants who were educated in Korea. Both Korean REALM and S-TOFHLA resulted in a negatively-skewed distribution. REALM-English yielded well-distributed groups with significant correlations with Korean REALM and S-TOFHLA (Spearman's rho = 0.30, P = 0.003 and 0.22, P = 0.03, respectively). Educational level was significantly correlated with REALM-English and Korean S-TOFHLA (Spearman's rho = 0.39, P = 0.000 and 0.25, P = 0.014), but not with REALM-Korean. The translation of REALM and S-TOFHLA into the Korean language did not lead to a valid assessment of health literacy. A more systematic approach is needed to assess health literacy in immigrants with limited English skills, particularly those with a phonetic primary language. Meanwhile, REALM-English could be used as a crude health literacy test for individuals with some English skills.

Journal of Immigrant and Minority Health, 2010

Despite well-known benefits of health care utilization for the effective management of chronic di... more Despite well-known benefits of health care utilization for the effective management of chronic diseases, the underlying mechanism of understanding health care utilization in ethnic minority population has not been systematically explored. The purpose of this paper is to examine the predictive ability of a health care utilization model by analyzing the interplay between predisposing, enabling, and need factors. The sample consisted of hypertensive Korean American immigrants (KAIs) 40-64 years of age who participated in a self-help intervention for high blood pressure care (SHIP-HBP). Using structured questionnaires, data were collected from 445 KAIs at baseline and analyzed with path analysis. Insurance status and relevant medical history were not just strong direct effects but also carried the most total effect on the health care utilization of these patients. Life priorities, years of residence in the US and perceived income level exerted indirect effects through the participants' insurance status. Our statistical analysis indicated a good fit for the proposed model (x 2 = 28.4, P = 0.29; NFI = 0.91; CFI = 0.99; RMSEA = 0.02). Overall, the model explained 18% of the variance in health care utilization of hypertensive KAIs. These findings strongly support a need to improve access to health care for KAIs by introducing a variety of community resources and building sustainable community infrastructures.

Journal of Cross-Cultural Gerontology, 2007

Today's Korean American elderly are predominantly first-generation immigrants who face stern chal... more Today's Korean American elderly are predominantly first-generation immigrants who face stern challenges of acculturation, which is often associated with depression. Social support has been identified as an effective personal resource for alleviating acculturative stress and achieving better mental health outcomes. The purposes of this study were to describe available sources of social support utilized by Korean elders and to examine the relationships among acculturative stress, social support, and depression. In particular, social support was operationalized as an integrative concept encompassing the size of the social network, satisfaction with the support received, and appraisals of the level of social support. This study was a secondary data analysis of an existing survey of 205 elderly Korean immigrants (≥60 years) in a major metropolitan city on the East coast. Adult children were found to be the main source of support utilized by elders, even when the elder had a living spouse. Hierarchical multiple regression analysis revealed that higher acculturative stress and lower social support were associated with higher depression scores after demographics and health status were controlled for, whereas network size and satisfaction with support were not. Future interventions should address the cultural/social needs of these immigrants, not only by reinforcing their existing social network but also by providing additional support for their family members to prevent social isolation and depression in the population.

Journal of Community Health, 2007

This report describes the management and control of high blood pressure (HBP) in a sample of midd... more This report describes the management and control of high blood pressure (HBP) in a sample of middle-aged (40 to 64 years) Korean Americans (KAs) with HBP. Participants in the Self-Help Intervention Program for HBP care (SHIP-HBP), a culturally tailored clinical trial for HBP management in KAs through lifestyle approaches, underwent baseline assessments to determine HBP control status and knowledge, beliefs, and practices related to HPB control. Data were stratified by sex. In all, 445 Korean patients are described. About 55% of the sample were receiving antihypertensive therapy, and less than one-third had controlled BP (< 140/90 mm Hg). Sex differences were observed in terms of clinical characteristics and anti-hypertensive medication use: women were more likely than men to have controlled BP and lower diastolic BP and to have been on HBP medication. Lower rates of smoking, drinking, and overweight or obesity were also observed more frequently in women. Most participants agreed that taking anti-hypertensive medication lowered BP. When asked what the most important behavioral factor was for controlling BP, about a quarter reported cutting down on salt, followed by exercise and medication taking. While poor HBP control remains a common problem that contributes to significant cardiovascular morbidity and mortality, particularly among ethnic minorities, our findings underscore the need to test the beneficial effects of primary and secondary prevention programs, suitably modified to meet the language, cultural, and individual needs of this high-risk population of hypertensive patients.

The Journal of Clinical Hypertension, 2010

The primary objective of this study was to investigate the factors affecting the level of complia... more The primary objective of this study was to investigate the factors affecting the level of compliance of home blood pressure monitoring (HBPM) and its relation to blood pressure (BP) control among hypertensive adults in a community setting. A total of 377 middle-aged Korean Americans with high BP participated in this study. Along with structured behavioral education, the participants were instructed to measure their BP 3 times in a row upon waking and thrice again at bedtime, at least 2 or more times a week for 48 weeks. Using multivariate logistic regression, the authors examined the patterns and factors affecting HBPM and its relation to BP control status. The analyses revealed that older participants were more compliant with the HBPM instruction than were younger participants (adjusted odds ratio [OR], 5.29; 95% confidence interval [CI], 1.77-15.81) and those with more depressive symptoms were less compliant (OR, 0.19; 95% CI, 0.04-0.88). Participants who were more compliant to HBPM instruction were 4 times more likely than those who were noncompliant to have controlled their BP by the end of the intervention period (OR, 4.28; 95% CI, 1.79-10.23). These results suggest that the participants who checked their BP regularly at home had a stronger tendency to achieve BP control. J Clin Hypertens (Greenwich).

The Journal of Clinical Hypertension, 2008

Many Korean American persons have hypertension, but competing life priorities often prevent them ... more Many Korean American persons have hypertension, but competing life priorities often prevent them from attending health-promotion educational activities. Using principles of community-based participatory research, the authors conducted a prospective clinical trial to determine the effectiveness of a mailed vs an in-class culturally tailored education intervention. A total of 380 hypertensive Korean American persons from the Baltimore/Washington area were assigned to a more intense inclass education group or a less intensive mail education group. Evaluation of postintervention blood pressure (BP) outcomes revealed that significant reductions in systolic BP (13.3 mm Hg and 16.1 mm Hg, respectively) and diastolic BP (9.5 mm Hg and 10.9 mm Hg) and increases in BP control rates (42.3% and 54.3%) were achieved in both groups. No significant differences in BP outcomes between groups, however, were found. In conclusion, education by mail was an effective strategy for improving BP control and may be a viable approach for other immigrant groups if the education materials address their cultural needs.

Journal of Advanced Nursing, 2008

Aim-This paper is a report of a study designed to explore the caregiving experiences of Korean Am... more Aim-This paper is a report of a study designed to explore the caregiving experiences of Korean Americans.

Archives of Psychiatric Nursing, 2005

A correlational, cross-sectional study with multivariate analysis was conducted to identify facto... more A correlational, cross-sectional study with multivariate analysis was conducted to identify factors that influence the depression experience in 154 Korean immigrants. Based on the stress-health outcome framework, four variables (i.e., sense of mastery, socioeconomic status, social support, and acculturation) were tested for their mediating effects between stress and depression experienced by Korean Americans. Path analyses showed that the negative effect of life stress on depression was buffered by higher levels of sense of mastery and social support in the Korean sample. Implications for future cross-cultural depression research and preventive strategies against depression in immigrant populations are discussed. D

American Journal of Hypertension, 2014

Great strides have been made in improving heart health in the United States during the last 2 dec... more Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy. The effect of a multimodal Self-Help Intervention Program on the Control of High Blood Pressure (HBP) was tested in a community-based clinical trial for Korean American seniors. Of 440 seniors enrolled, 369 completed the study (184 in the intervention group and 185 in the control group; mean age = 70.9±5.3 years). The intervention group received 6 weekly educational sessions on HBP management skill building, including health literacy training, followed by telephone counseling and home blood pressure (BP) monitoring for 12 months. Findings support that the Self-Help Intervention Program on the Control of HBP was effective in controlling BP in this ethnic/linguistic minority population. The BP control rates for the intervention and control groups were 49.5% vs. 43.2% at baseline, 58.5% vs. 42.4% at 6 months, 67.9% vs. 52.5% at 12 months, and 54.3% vs. 53.0% at 18 months. Significant changes were observed over time in some psychobehavioral outcomes, including self-efficacy for BP control, medication adherence behavior, HBP knowledge, and depression. The study findings suggest that the multimodal Self-Help Intervention Program on the Control of HBP is effective at promoting optimal HBP control for this ethnic/linguistic minority population. NCT00406614.

by Jayon Lee, Megan Wheeldon, Caitlin Chong, Vaneetha Christopher, Lily Howard, Kendra Corman, Michael Lessard-Clouston, Maura Lopez, Riley Wall, Kazue Suzuki, Bree Williams, and Danielle Kim

This is an edited collection with 47 annotations written by students in my Intercultural Communic... more This is an edited collection with 47 annotations written by students in my Intercultural Communication for Teachers class in spring 2013.

Molecular Cancer Therapeutics, 2009

Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal... more Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal, acral lentiginous, and chronically sun-damaged melanomas. We have identified the first human melanoma cell line with an endogenous L576P mutation, the most common KIT mutation in melanoma (∼30-40%). In vitro testing demonstrated that the cell viability of the L576P mutant cell line was not reduced by imatinib, nilotinib or sorafenib small molecule KIT inhibitors effective in non-melanoma cells with other KIT mutations. However, the viability of the mutant cells was reduced by dasatinib at concentrations as low as 10 nM (P =0.004). Molecular modeling studies found that the L576P mutation induces structural changes in KIT that reduce the affinity for imatinib (ΔΔGbind = -2.52 kcal/mol) but not for dasatinib (ΔΔGbind = +0.32 kcal/mol). Two metastatic melanoma patients with the L576P KIT mutation were treated with dasatinib, including one patient previously treated with imatinib. Both patients had marked reduction (>50%) and elimination of tumor FDG-avidity by PET imaging after dasatinib treatment. This data supports the selective inhibitory effect of dasatinib against cells harboring the most common KIT mutation in melanoma, and thus has therapeutic implications for acral lentiginous, chronic sun damaged, and mucosal melanomas.

The use of community health workers (CHWs) or lay health advisors has been increasingly popular a... more The use of community health workers (CHWs) or lay health advisors has been increasingly popular as an effective means of secondary prevention for cardiovascular health in hard-to- reach, underserved populations. Yet, published evaluations of the CHW training programs are rare. The purpose of this article is to report the results of an evaluation of a CHW training program for hypertension

Journal of community health, 2002

With the current wave of Asian immigration to the United States, awareness of their use of tradit... more With the current wave of Asian immigration to the United States, awareness of their use of traditional medicine, often in combination with Western medicine, is an increasingly salient issue for health care professionals. This paper describes the use of traditional and Western medicine by Korean American elderly and factors that are associated with their health-seeking behaviors and health service utilization. Data were obtained from a convenience sample of 205 Korean elderly immigrants through interview. The findings revealed that health service utilization among Korean American elderly covered a broad spectrum of health resources, including the use of Western medicine, the traditional Korean medicine (hanbang), or both Western and traditional clinics. In addition, health insurance status and the source of health care were found to relate to the types of health service that Korean American elderly chose to utilize. Better understanding of patterns of health service utilization may i...

International Journal of Nursing Studies, 2010

What is already known about the topic?

Patient Education and Counseling, 2012

Objective-While the role of health literacy in chronic disease management is well documented, few... more Objective-While the role of health literacy in chronic disease management is well documented, few intervention studies have been reported. A major barrier to designing and implementing such interventions is the lack of valid health literacy tools. This study developed and tested a novel health literacy scale for individuals with high blood pressure (HBP).

Nuclear Fusion, 2001

The extensive design effort for KSTAR has been focused on two major aspects of the KSTAR project ... more The extensive design effort for KSTAR has been focused on two major aspects of the KSTAR project mission -steady-state-operation capability and advanced tokamak physics. The steady state aspect of the mission is reflected in the choice of superconducting magnets, provision of actively cooled in-vessel components, and long pulse current drive and heating systems. The advanced tokamak aspect of the mission is incorporated in the design features associated with flexible plasma shaping, double null divertor and passive stabilizers, internal control coils and a comprehensive set of diagnostics. Substantial progress in engineering has been made on superconducting magnets, the vacuum vessel, plasma facing components and power supplies. The new KSTAR experimental facility with cryogenic system and deionized water cooling and main power systems has been designed, and the construction work is under way for completion in 2004.

Patient Education and Counseling, 2010

Nurse telephone counseling can improve the management of chronic conditions, but the effectivenes... more Nurse telephone counseling can improve the management of chronic conditions, but the effectiveness of this approach in underserved populations is unclear. This study evaluated the use of bilingual nurse-delivered telephone counseling in Korean Americans (KAs) participating in a community-based intervention trial to improve management of hypertension. KAs were randomized to receive 12 months of hypertension-related telephone counseling that was more intensive (bi-weekly) or less intensive (monthly). Counseling logs were kept for 360 KAs who completed the pre- and post-intervention evaluations. The overall success rate for the intervention was 80.3%. The level of success was significantly influenced by the dose of counseling, employment status, and years of US residence. Over the 12-month counseling period, both groups showed improvement with regard to medication-taking, alcohol consumption, and exercise but not smoking, with no significant group differences. Bilingual telephone counseling could reach monolingual KAs and improve their hypertension management behavior. Bilingual nurse telephone counseling may have wide applicability, serving as an effective means of disseminating evidence-based chronic disease management guidelines to a linguistically isolated community with limited health resources and information.

Molecular Cancer Therapeutics, 2009

Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal... more Point mutations in the KIT receptor tyrosine kinase gene have recently been identified in mucosal, acral lentiginous, and chronically sun-damaged melanomas. We have identified the first human melanoma cell line with an endogenous L576P mutation, the most common KIT mutation in melanoma (∼30-40%). In vitro testing demonstrated that the cell viability of the L576P mutant cell line was not reduced by imatinib, nilotinib or sorafenib small molecule KIT inhibitors effective in non-melanoma cells with other KIT mutations. However, the viability of the mutant cells was reduced by dasatinib at concentrations as low as 10 nM (P =0.004). Molecular modeling studies found that the L576P mutation induces structural changes in KIT that reduce the affinity for imatinib (ΔΔGbind = -2.52 kcal/mol) but not for dasatinib (ΔΔGbind = +0.32 kcal/mol). Two metastatic melanoma patients with the L576P KIT mutation were treated with dasatinib, including one patient previously treated with imatinib. Both patients had marked reduction (>50%) and elimination of tumor FDG-avidity by PET imaging after dasatinib treatment. This data supports the selective inhibitory effect of dasatinib against cells harboring the most common KIT mutation in melanoma, and thus has therapeutic implications for acral lentiginous, chronic sun damaged, and mucosal melanomas.

Journal of Immigrant and Minority Health, 2007

While increasing numbers of researchers are targeting ethnic minorities in order to address their... more While increasing numbers of researchers are targeting ethnic minorities in order to address their health disparities, the unique health needs of Korean Americans are not well known to the mainstream community, and only relatively few systematic research studies have been conducted in this "hard-to reach" population. The purpose of this paper is to describe the barriers to recruiting participants for health promotion research and to identify facilitators in the community that can contribute to this effort. We have analyzed data pertaining to the 14 studies we have conducted since 1998, which included a total sample of about 2,400 Korean Americans. We describe in detail the unique recruitment challenges that we have faced in regard to the culture, language, sociodemographic characteristics of the participants, such as gender and age, and other community level barriers. Multiple strategies at different levels (individual and community) to address these issues are discussed.

Journal of Immigrant and Minority Health, 2011

While the need for understanding the issue of health literacy among ethnic minority groups with l... more While the need for understanding the issue of health literacy among ethnic minority groups with limited English skills is rapidly increasing in the US, it is difficult to find valid and useful health literacy tools for certain linguistic minorities. This study was designed to validate the Korean translation of Rapid Estimate of Adult Literacy in Medicine (REALM) and Test of Functional Health Literacy in Adults-Short form (S-TOFHLA). Korean REALM and S-TOFHLA were administered to 98 Korean American women, together with REALM-English. Participants were first-generation immigrants who were educated in Korea. Both Korean REALM and S-TOFHLA resulted in a negatively-skewed distribution. REALM-English yielded well-distributed groups with significant correlations with Korean REALM and S-TOFHLA (Spearman's rho = 0.30, P = 0.003 and 0.22, P = 0.03, respectively). Educational level was significantly correlated with REALM-English and Korean S-TOFHLA (Spearman's rho = 0.39, P = 0.000 and 0.25, P = 0.014), but not with REALM-Korean. The translation of REALM and S-TOFHLA into the Korean language did not lead to a valid assessment of health literacy. A more systematic approach is needed to assess health literacy in immigrants with limited English skills, particularly those with a phonetic primary language. Meanwhile, REALM-English could be used as a crude health literacy test for individuals with some English skills.

Journal of Immigrant and Minority Health, 2010

Despite well-known benefits of health care utilization for the effective management of chronic di... more Despite well-known benefits of health care utilization for the effective management of chronic diseases, the underlying mechanism of understanding health care utilization in ethnic minority population has not been systematically explored. The purpose of this paper is to examine the predictive ability of a health care utilization model by analyzing the interplay between predisposing, enabling, and need factors. The sample consisted of hypertensive Korean American immigrants (KAIs) 40-64 years of age who participated in a self-help intervention for high blood pressure care (SHIP-HBP). Using structured questionnaires, data were collected from 445 KAIs at baseline and analyzed with path analysis. Insurance status and relevant medical history were not just strong direct effects but also carried the most total effect on the health care utilization of these patients. Life priorities, years of residence in the US and perceived income level exerted indirect effects through the participants' insurance status. Our statistical analysis indicated a good fit for the proposed model (x 2 = 28.4, P = 0.29; NFI = 0.91; CFI = 0.99; RMSEA = 0.02). Overall, the model explained 18% of the variance in health care utilization of hypertensive KAIs. These findings strongly support a need to improve access to health care for KAIs by introducing a variety of community resources and building sustainable community infrastructures.

Journal of Cross-Cultural Gerontology, 2007

Today's Korean American elderly are predominantly first-generation immigrants who face stern chal... more Today's Korean American elderly are predominantly first-generation immigrants who face stern challenges of acculturation, which is often associated with depression. Social support has been identified as an effective personal resource for alleviating acculturative stress and achieving better mental health outcomes. The purposes of this study were to describe available sources of social support utilized by Korean elders and to examine the relationships among acculturative stress, social support, and depression. In particular, social support was operationalized as an integrative concept encompassing the size of the social network, satisfaction with the support received, and appraisals of the level of social support. This study was a secondary data analysis of an existing survey of 205 elderly Korean immigrants (≥60 years) in a major metropolitan city on the East coast. Adult children were found to be the main source of support utilized by elders, even when the elder had a living spouse. Hierarchical multiple regression analysis revealed that higher acculturative stress and lower social support were associated with higher depression scores after demographics and health status were controlled for, whereas network size and satisfaction with support were not. Future interventions should address the cultural/social needs of these immigrants, not only by reinforcing their existing social network but also by providing additional support for their family members to prevent social isolation and depression in the population.

Journal of Community Health, 2007

This report describes the management and control of high blood pressure (HBP) in a sample of midd... more This report describes the management and control of high blood pressure (HBP) in a sample of middle-aged (40 to 64 years) Korean Americans (KAs) with HBP. Participants in the Self-Help Intervention Program for HBP care (SHIP-HBP), a culturally tailored clinical trial for HBP management in KAs through lifestyle approaches, underwent baseline assessments to determine HBP control status and knowledge, beliefs, and practices related to HPB control. Data were stratified by sex. In all, 445 Korean patients are described. About 55% of the sample were receiving antihypertensive therapy, and less than one-third had controlled BP (< 140/90 mm Hg). Sex differences were observed in terms of clinical characteristics and anti-hypertensive medication use: women were more likely than men to have controlled BP and lower diastolic BP and to have been on HBP medication. Lower rates of smoking, drinking, and overweight or obesity were also observed more frequently in women. Most participants agreed that taking anti-hypertensive medication lowered BP. When asked what the most important behavioral factor was for controlling BP, about a quarter reported cutting down on salt, followed by exercise and medication taking. While poor HBP control remains a common problem that contributes to significant cardiovascular morbidity and mortality, particularly among ethnic minorities, our findings underscore the need to test the beneficial effects of primary and secondary prevention programs, suitably modified to meet the language, cultural, and individual needs of this high-risk population of hypertensive patients.

The Journal of Clinical Hypertension, 2010

The primary objective of this study was to investigate the factors affecting the level of complia... more The primary objective of this study was to investigate the factors affecting the level of compliance of home blood pressure monitoring (HBPM) and its relation to blood pressure (BP) control among hypertensive adults in a community setting. A total of 377 middle-aged Korean Americans with high BP participated in this study. Along with structured behavioral education, the participants were instructed to measure their BP 3 times in a row upon waking and thrice again at bedtime, at least 2 or more times a week for 48 weeks. Using multivariate logistic regression, the authors examined the patterns and factors affecting HBPM and its relation to BP control status. The analyses revealed that older participants were more compliant with the HBPM instruction than were younger participants (adjusted odds ratio [OR], 5.29; 95% confidence interval [CI], 1.77-15.81) and those with more depressive symptoms were less compliant (OR, 0.19; 95% CI, 0.04-0.88). Participants who were more compliant to HBPM instruction were 4 times more likely than those who were noncompliant to have controlled their BP by the end of the intervention period (OR, 4.28; 95% CI, 1.79-10.23). These results suggest that the participants who checked their BP regularly at home had a stronger tendency to achieve BP control. J Clin Hypertens (Greenwich).

The Journal of Clinical Hypertension, 2008

Many Korean American persons have hypertension, but competing life priorities often prevent them ... more Many Korean American persons have hypertension, but competing life priorities often prevent them from attending health-promotion educational activities. Using principles of community-based participatory research, the authors conducted a prospective clinical trial to determine the effectiveness of a mailed vs an in-class culturally tailored education intervention. A total of 380 hypertensive Korean American persons from the Baltimore/Washington area were assigned to a more intense inclass education group or a less intensive mail education group. Evaluation of postintervention blood pressure (BP) outcomes revealed that significant reductions in systolic BP (13.3 mm Hg and 16.1 mm Hg, respectively) and diastolic BP (9.5 mm Hg and 10.9 mm Hg) and increases in BP control rates (42.3% and 54.3%) were achieved in both groups. No significant differences in BP outcomes between groups, however, were found. In conclusion, education by mail was an effective strategy for improving BP control and may be a viable approach for other immigrant groups if the education materials address their cultural needs.

Journal of Advanced Nursing, 2008

Aim-This paper is a report of a study designed to explore the caregiving experiences of Korean Am... more Aim-This paper is a report of a study designed to explore the caregiving experiences of Korean Americans.

Archives of Psychiatric Nursing, 2005

A correlational, cross-sectional study with multivariate analysis was conducted to identify facto... more A correlational, cross-sectional study with multivariate analysis was conducted to identify factors that influence the depression experience in 154 Korean immigrants. Based on the stress-health outcome framework, four variables (i.e., sense of mastery, socioeconomic status, social support, and acculturation) were tested for their mediating effects between stress and depression experienced by Korean Americans. Path analyses showed that the negative effect of life stress on depression was buffered by higher levels of sense of mastery and social support in the Korean sample. Implications for future cross-cultural depression research and preventive strategies against depression in immigrant populations are discussed. D

American Journal of Hypertension, 2014

Great strides have been made in improving heart health in the United States during the last 2 dec... more Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy. The effect of a multimodal Self-Help Intervention Program on the Control of High Blood Pressure (HBP) was tested in a community-based clinical trial for Korean American seniors. Of 440 seniors enrolled, 369 completed the study (184 in the intervention group and 185 in the control group; mean age = 70.9±5.3 years). The intervention group received 6 weekly educational sessions on HBP management skill building, including health literacy training, followed by telephone counseling and home blood pressure (BP) monitoring for 12 months. Findings support that the Self-Help Intervention Program on the Control of HBP was effective in controlling BP in this ethnic/linguistic minority population. The BP control rates for the intervention and control groups were 49.5% vs. 43.2% at baseline, 58.5% vs. 42.4% at 6 months, 67.9% vs. 52.5% at 12 months, and 54.3% vs. 53.0% at 18 months. Significant changes were observed over time in some psychobehavioral outcomes, including self-efficacy for BP control, medication adherence behavior, HBP knowledge, and depression. The study findings suggest that the multimodal Self-Help Intervention Program on the Control of HBP is effective at promoting optimal HBP control for this ethnic/linguistic minority population. NCT00406614.