1. Obesity and Chronic Disease Prevention in Boston Chinatown: Obesity and Chronic Disease Prevention in Boston Chinatown: Collaborative efforts between Tufts University Public Health and Community Agency Partners Virginia Chomitz Milken Institute Public Health Summit March 1, 2016

2. ADAPT Community Partners ADAPT Community Partners Addressing Disparities in Asian Populations through Translational Research We are a community-academic partnership whose mission is to assess, improve and promote health and wellness among underserved Asian American communities in the Greater Boston area through research, education and advocacy.

3. CDC Community Action Process for community health impact Mobilize and engage communityAssess needs and assetsPlanImplementTrack / Evaluate

4. Boston Chinatown : Boston Chinatown : cultural, economic hub for Chinese community

5. Chinatown: Dense, about 6,000 Chinese individuals in a 10-square block area. Median household income $14,829 37% of residents overall below federal poverty level. more than half of those over 65 60% of residents less than a high school education. One-third of residents overall are non-proficient in English. 70% of those over 65 years 79% do not own their home, and most work locally in the food and accommodation industries. Boston Asian American Population Mobilize and engage community Boston Public Health Commission. Health of Boston 2012-2013:

6. Significance: Obesity & diabetes in Asian Americans Asians at increased risk for diabetes and at lower adiposity thresholds than other race/ethnic groups ( Palaniappan et al, Int J Obes 2011; Lee et al. Diabetes Care. 2011 ) Grundy, Circulation, 2002

7. ADAPT history and structure History of uneasy Town / Gown relations Coalition originally proposed as a community engagement project for CTSI (translational research) application Funded since 2011 – monthly meetings, partial funding for coordinator, meeting attendees, annual symposium Mobilize and engage community

8. Community-identified Research Questions / Needs Gentrification: preserving culture and community Economic development: Transitioning out of “immigrant business model” for fairer workers’ wages Lack of jobs Green space: improving environment Affordable housing Sociological: similarities/dissimilarities of Chinatown’s subpopulations/and generational Parent Involvement in Schools Assess needs and assets

9. ADAPT member obesity-related needs assessment projects Obesity / chronic disease related needs assessment Healthy eating and physical activity among young children: Healthy Chinatown (children /parent s) Health of Boston Chinatown needs assessment survey (adults) Housing and health: One Greenway affordable housing project (families) Assess needs and assets

10. Selected results from needs assessments “Centers can tell teachers that sometimes it is okay to say “no” to the child or their families who give them pressure, but sometimes it is not okay that a younger teacher talks back to an elder” Assess needs and assets

11. Examples of Pilot Obesity Interventions Baby Steps: Pediatric nutrition and oral health intervention Comparative Effectiveness: Diabetes management among elders Plan Implement Track / Evaluate

12. Community Health and Capacity improvement in Boston Chinatown Mobilize and engageAssessPlanImplementTrack / Evaluate Piloted interventions to promote healthy weight in Boston Chinatown Plans for on-going tracking & evaluation Successful collaborations demonstrate potential for capacity development, health improvement, and reduction of disparities. Community improvements in obesity prevention as a result of ADAPT efforts: Staff development and trainings in physical activity and healthy eating provided at child-care centers, At least one playground renovated by the city, Several center-based play areas were opened to community use. Completed first steps in community health improvement: community engagement, needs assessment, and program planning

13. Future Tufts Community Impact Efforts On-going ADAPT work – Strategic planning & subcommittees based on alignment of priorities / expertise – Community capacity building through meetings and research dissemination Collective impact project Grant applications – NIH Disparities Grant - U54 Nurturing other relationships (ie. MIT)

14. Contributors: Academic Partners Tufts University School of Medicine: Public Health & Community Medicine Virginia Rall Chomitz, PhD Carolyn Leung Rubin, EdD Susan Koch-Weser, ScD Kenneth Kwan Ho Chui, PhD, MPH Mohan Thanikachalam, MD Aviva Must, PhD Tufts Clinical and Translational Science Institute Karen Freund, MD Community Partners Boston Chinatown Neighborhood Center (BCNC) Asian Women for Health Greater Boston Chinese Golden Age Center Asian Task Force Against Domestic Violence Asian Community Development Center (ACDC) Action for Boston Community Development (ABCD) Chinatown Residents Association

15. THANK YOU QUESTIONS?? Virginia Rall Chomitz, PhD Assistant Professor Tufts University School of Medicine: Public Health & Community Medicine 136 Harrison Avenue Boston, MA 02111 Virginia.chomitz@tufts.edu