Heart healthy integrative nutritional counseling (H2INC): Creating a Chinese medicine + western medicine patient education curriculum for Chinese Americans

Patient Educ Couns. 2018 Dec;101(12):2202-2208. doi: 10.1016/j.pec.2018.08.011. Epub 2018 Aug 9.


Objectives: Current cardiovascular disease (CVD) nutrition guidelines do not take into account Chinese medicine (CM) principles. We created a heart healthy integrative nutritional counseling (H2INC) curriculum consistent with CM principles and current nutrition guidelines.

Methods: We conducted three phases of semi-structured interviews with key stakeholders (CM and biomedical providers and Chinese American (CAs) patients with CVD) followed by iterative development of H2INC. First, we interviewed licensed CM providers (n = 9) and laypeople with CM foods expertise (n = 1). Second, we interviewed biomedical providers (n = 11) and licensed CM providers (n = 3). Third, we conducted four focus groups with CAs (n = 20) with CVD.

Results: Stakeholders emphasized different principles for creating H2INC. Phase one emphasized alignment of CM diagnoses to biomedical CVD conditions. Phase two overlaid CM concepts like the nature of foods and constitution (hot/neutral/cool) with heart healthy nutrition recommendations such as MyPlate, and avoiding excess salt, fat, and sugars. Phase three demonstrated patient acceptability.

Conclusion: By integrating CM foods principles with biomedical nutrition, this integrative approach yields culturally relevant health education for an underserved population.

Practice implications: Integrative nutritional counseling shows promise for CAs and could support biomedical providers with little knowledge about patients' use of CM for CVD.

Keywords: Cardiovascular disease; Cardiovascular health; Chinese Americans; Chinese medicine; Dietary guidelines; Health education; Integrative medicine; Nutrition; Prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian Americans*
  • Counseling*
  • Curriculum
  • Female
  • Health Education / methods*
  • Humans
  • Integrative Medicine
  • Interviews as Topic
  • Male
  • Medicine, Chinese Traditional*
  • Nutrition Policy*
  • Patient Education as Topic / methods*
  • Qualitative Research