***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose and Methods . To describe medication profile , diet , and exercise/physical activity  in hypertensive Korean Americans , a convenience sample of 100 hypertensive Korean Americans ( KAs ) at two KA health clinics were interviewed by bilingual Korean nurses using questions from the 1988 - 1994 Third National Health and Nutrition Examination Survey ( NHANES III ) . One hundred age- and gender-matched hypertensive non-Hispanic Whites and 100 Blacks were r and omly selected from the NHANES III data set , and results were compared to describe the health disparities in lifestyle choices among the three groups . Results . The medication profile among the three groups was similar . A majority of members of all three groups had been told by health professionals to exercise for hypertension . KAs made significantly less effort to reduce salt in their diets than did members of the other two groups ( p < .05 ) . Fewer KAs than non-Hispanic Whites or Blacks were following their health professionals’advice to control or lose weight for their high blood cholesterol levels . KAs had the lowest body mass index and were older and more educated than members of the other two groups . KAs ’ primary reasons for using the KA clinic were the respect they received and the use of the Korean language . Implication s. KA health professionals need to teach their patients more about the importance of health-promoting lifestyles for hypertension and its contributing factors . More KA hypertensive patients should follow the advice of health professionals on healthy lifestyles . Nurses should continue to treat patients with respect and provide care with sensitivity to language needs of patients INTRODUCTION Korean Americans are one of the most underserved ethnic/linguistic minority groups owing to cultural and institutional barriers ; there is an urgent need for culturally competent diabetes management programs in the Korean American community for those with type 2 diabetes . The purpose of this study was to test the effectiveness of a community-based , culturally tailored , multimodal behavioral intervention program in an ethnic/linguistic minority group with type 2 diabetes . DESIGN An RCT with waitlist comparison based on the Predisposing , Reinforcing , and Enabling Constructs in Education/environmental Diagnosis and Evaluation (PRECEDE)-Policy , Regulatory , and Organizational Constructs in Educational and Environmental Development ( PROCEED ) and self-help models . Data were collected between September 2010 and June 2013 and were analyzed in August-December 2014 . Statistical significance was set at p<0.05 . SETTING / PARTICIPANTS In a naturally occurring community setting , a total of 250 Korean Americans with type 2 diabetes were r and omized into an intervention group ( n=120 ) or a control group ( n=130 ) . INTERVENTION The intervention consisted of key self-management skill-building activities through 12 hours of group education sessions , followed by integrated counseling and behavioral coaching by a team of RNs and community health workers . MAIN OUTCOME MEASURES Primary ( clinical ) outcomes were hemoglobin A1c , glucose , total cholesterol , and low-density lipoprotein at baseline and at 3 , 6 , 9 , and 12 months . Secondary ( psychosocial and behavioral ) outcomes included diabetes-related quality of life , self-efficacy , adherence to diabetes management regimen , and health literacy . RESULTS During the 12-month project , the intervention group demonstrated 1.0%-1.3 % ( 10.9 - 14.2 mmol/mol ) reductions in hemoglobin A1c , whereas the control group achieved reductions of 0.5%-0.7 % ( 5.5 - 7.7 mmol/mol ) . The differences between the two groups were statistically significant . The intervention group showed statistically significant improvement in diabetes-related self-efficacy and quality of life when compared with the control group . CONCLUSIONS RN/community health worker teams equipped with culturally tailored training can be effective in helping an ethnic/linguistic minority group manage diabetes in the community Objectives To determine the relationship between the reduction in salt intake that occurred in Engl and , and blood pressure ( BP ) , as well as mortality from stroke and ischaemic heart disease ( IHD )  . Design Analysis of the data from the Health Survey for Engl and . Setting and participants Engl and , 2003 N=9183 , 2006 N=8762 , 2008 N=8974 and 2011 N=4753 , aged ≥16 years .  Outcomes BP , stroke and IHD mortality . Results From 2003 to 2011 , there was a decrease in mortality from stroke by 42 % ( p<0.001 ) and IHD by 40 % ( p<0.001 ) . In parallel , there was a fall in BP of 3.0±0.33/1.4±0.20 mm Hg ( p<0.001/p<0.001 ) , a decrease of 0.4±0.02 mmol/L ( p<0.001 ) in cholesterol , a reduction in smoking prevalence from 19 % to 14 % ( p<0.001 ) , an increase in fruit and vegetable consumption ( 0.2±0.05 portion/day , p<0.001 ) and an increase in body mass index ( BMI ; 0.5±0.09 kg/m2 , p<0.001 ) . Salt intake , as measured by 24 h urinary sodium , decreased by 1.4 g/day ( p<0.01 ) . It is likely that all of these factors ( with the exception of BMI ) , along with improvements in the treatments of BP , cholesterol and cardiovascular disease , contributed to the falls in stroke and IHD mortality . In individuals who were not on antihypertensive medication , there was a fall in BP of 2.7±0.34/1.1±0.23 mm Hg ( p<0.001/p<0.001 ) after adjusting for age , sex , ethnic group , education , household income , alcohol consumption , fruit and vegetable intake and BMI . Although salt intake was not measured in these participants , the fact that the average salt intake in a r and om sample of the population fell by 15 % during the same period suggests that the falls in BP would be largely attributable to the reduction in salt intake rather than antihypertensive medications . Conclusions The reduction in salt intake is likely to be an important contributor to the falls in BP from 2003 to 2011 in Engl and . As a result , it would have contributed substantially to the decreases in stroke and IHD mortality OBJECTIVE We estimated the prevalence and incidence of diabetes among specific subgroups of Asians and Pacific Isl and ers ( APIs ) in a multiethnic U.S. population with uniform access to care . RESEARCH DESIGN AND METHODS This prospect i ve cohort analysis included 2,123,548 adult members of Kaiser Permanente Northern California , including 1,704,363 with known race/ethnicity ( white , 56.9 % ; Latino , 14.9 % ; African American , 8.0 % ; Filipino , 4.9 % ; Chinese , 4.0 % ; multiracial , 2.8 % ; Japanese , 0.9 % ; Native American , 0.6 % ; Pacific Isl and er , 0.5 % ; South Asian , 0.4 % ; and Southeast Asian , Korean , and Vietnamese , 0.1 % each ) . We calculated age-st and ardized ( to the 2010 U.S. population ) and sex-adjusted diabetes prevalence at baseline and incidence ( during the 2010 calendar year ) . Poisson models were used to estimate relative risks . RESULTS There were 210,632 subjects with prevalent diabetes as of 1 January 2010 and 15,357 incident cases of diabetes identified during 2010 . The crude diabetes prevalence was 9.9 % and the incidence was 8.0 cases per 1,000 person-years and , after st and ardizing by age and sex to the 2010 U.S. Census , 8.9 % and 7.7 cases per 1,000 person-years . There was considerable variation among the seven largest API subgroups . Pacific Isl and ers , South Asians , and Filipinos had the highest prevalence ( 18.3 , 15.9 , and 16.1 % , respectively ) and the highest incidence ( 19.9 , 17.2 , and 14.7 cases per 1,000 person-years , respectively ) of diabetes among all racial/ethnic groups , including minorities traditionally considered high risk ( e.g. , African Americans , Latinos , and Native Americans ) . CONCLUSIONS High rates of diabetes among Pacific Isl and ers , South Asians , and Filipinos are obscured by much lower rates among the large population of Chinese and several smaller Asian subgroups BACKGROUND National health in the United States is influenced by the dietary norms brought into the country by an increasing number of immigrants . OBJECTIVES This cross-sectional study aim ed to document dietary changes and disease prevalence in relation to the length of residence in the United States for Korean Americans in Michigan . DESIGN Of 1,860  question naires mailed out , 637 ( 34.3 % ) were returned with respondent-reported information , including demographics , weight and height , chronic diseases , and dietary patterns . SUBJECTS/ SETTING Included in the final analyses were 497 first-generation Korean-American immigrants ( 263 men , 234 women , aged 30 to 87 years ) . STATISTICAL ANALYSES PERFORMED Analysis of covariance with the Tukey test and logistic regression models provided sex-specific analysis of dietary changes and disease patterns . All statistical analyses were adjusted for age . RESULTS Chronic diseases reported most frequently by men and women , respectively , were hypertension , digestive diseases , arthritis , and diabetes . Length of residence in the United States ( < or=15 years , 16 to 25 years , or > or=26 years ) was inversely associated with the prevalence of digestive diseases in men ( P=0.017 ) and women ( P=0.001 ) , and positively with respiratory diseases in men and thyroid disease in women ( P<0.05 ) . Length of residence in the United States was inversely associated with intake of rice/rice dishes in both men ( servings per week , P<0.001 ) and women ( P=0.012 ) . The prevalence of digestive diseases associated inversely with length of residence and positively with servings of rice/rice dishes consumed for Korean-American men . The age-adjusted odds ratio for digestive diseases was highest among men who had the shortest length of residence in the United States ( < or=15 years ) and greater consumption of rice/rice dishes ( > 2 servings per day ) ( odds ratio 12.10 ; P=0.03 ) . CONCLUSIONS Dietary changes of Korean-American immigrants in the United States over time were associated with changes in their chronic disease patterns . These findings may help food and nutrition professionals who work with minority immigrants because they identify factors that affect changes in dietary patterns and work toward preventing diet-related diseases . Prospect i ve studies could address underlying mechanisms of the observed diet-disease relationship with subsequent generations of Korean Americans , as well as various ethnic minority immigrants in the United States 
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Moreover , they were less likely to receive counseling about their diseases from healthcare providers and modify their lifestyle ( eg , reduce their diet sodium intake , control their weight ) to manage their diseases than were other ethnic population s. Individual- , interpersonal- , community- , and societal-level influences contributed to the high prevalence of cardiovascular risk factors .