Patient Reported Outcomes of 'Eat, Walk, Sleep': A Cardiometabolic Lifestyle Program for Cambodian Americans Delivered by Community Health Workers

Wagner J, Kong S, Kuoch T, Scully MF, Tan HK, Bermudez-Millan A.

Published inJournal of Health Care for the Poor and Underserved  May 2015.



This study investigated a community health worker-delivered lifestyle intervention for prevention of cardiometabolic disease, called Eat, Walk, Sleep. It was designed for traumatized, low-literacy Cambodian American refugees.


We used a single group, pre-post design to evaluate the effects of the program on self-reported health behaviors. As a control for threats to internal validity, we also measured a nonequivalent dependent variable, i.e., perceived discrimination by health care providers.


Of 140 participants enrolled, 114 completed one-year assessments. In intent-to-treat analysis with correction for multiple comparisons, compared with baseline, participants at one year scored higher on cardiometabolic prevention knowledge, self-rated health, physical activity, medication compliance, and preventive screenings, and they reported improved sleep, a modest shift from white to brown rice, and reduced barriers to care. As expected, perceptions of discrimination by health care providers did not change.


Self-reported behavioral risk factors improved. A randomized, controlled study with objective measures is warranted.


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