(P02-018-25) Trauma History Predicts Outcomes of a Healthy Eating Intervention Among Cambodian American Refugees With High Risk for Diabetes: A Retrospective Cohort Study

Objectives: Rates of type 2 diabetes for Cambodian Americans are double the U.S. national average. In a retrospective cohort study, we explored trauma and dietary changes among Cambodian Americans who received the Eat, Walk, Sleep (EWS) intervention for diabetes prevention/delay.

Methods: Participants were n=135 Cambodian Americans with depression and high risk for developing type 2 diabetes who received EWS for 12 months. Trauma indicators included experiences under the Pol Pot regime (age of exposure, duration of exposure, duration in refugee camp, history of starvation) and current symptoms of post-traumatic stress and baksbat, a culture-bound syndrome of distress. Dietary behaviors at baseline, 12-months and 15-months included self-reported brown rice, white rice, sweetened drinks, sodium and fat.

Results: Most participants were women (76.3%), with 7 years of education who were 55.3 ± 8.9 years old. They were on average 16 years old in 1979 at the end of Pol Pot. Participants had spent 3.2 ± 1.1 years under the Khmer Rouge, 3.1 ± 5.9 years in a refugee camp, and most evidenced starvation (64.9%) during Pol Pot. Over half (54%) had elevated depressive symptoms and about one-third were taking antidepressant medication. Models showed that longer exposure to Pol Pot was associated with greater increase (improvement) in brown rice and greater effort to reduce fat. Higher baksbat was associated with greater effort to reduce fat.

Conclusions: EWS was beneficial for those with certain trauma characteristics. Similar interventions may help other traumatized communities.

Funding Sources: Funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)