Cardiovascular Risk in

the Filipino Community

Formative Research from Daly City

and San Francisco, California

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

National Heart, Lung, and Blood Institute
A collaborative report from the National Heart, Lung, and Blood Institute, 

the Asian & Pacific Islander American Health Forum, 

and West Bay Pilipino Multi-Services, Inc.
i

Table of Contents 

Acknowledgements........................................................................................................................ iii 

I. Forward................................................................................................................................v 

II. Executive Summary.............................................................................................................1

III. Introduction..........................................................................................................................2 

IV. Methodology........................................................................................................................2 

A. Community-Based Partner.............................................................................................2 

B. Data Collection ..............................................................................................................2 

C. Interviewer Training ......................................................................................................3 

D. Translation of Research Instruments .............................................................................3 

E. Data Feedback................................................................................................................3 

V. Demographics ......................................................................................................................4 

VI. Results..................................................................................................................................6 

A. What Does the Heart Symbolize?..................................................................................6 

B. Concept of Health ..........................................................................................................6 

C. Pevention and Causes of Poor Health or Illness ............................................................6 

D. Major Health Concerns..................................................................................................6 

E. Filipino Lifestyle in the United States and in the Philippines .......................................7 

i. Nutrition.............................................................................................................7 

ii. Physical Activity................................................................................................9 

iii. Stress..................................................................................................................9 

iv. Tobacco............................................................................................................10 

v. Alcohol.............................................................................................................11 

F. Personal Health ............................................................................................................12 

i. Perceptions of Obesity .....................................................................................12 

ii. Factors Associated With Cardiovascular Disease............................................12 

iii. Perceptions of High Blood Pressure ................................................................13 

iv. Perceptions of High Blood Cholesterol ...........................................................13 

v. Perceptions of Heart Disease ...........................................................................13 

vi. Alternative Health Care Services.....................................................................14 

G. Engaging in Healthy Behaviors ...................................................................................14 

i. Confidence in Maintaining Heart Healthy Habits ...........................................14 

ii. Motivations and Barriers for Physical Activity ...............................................15 

H. Health Education and Promotion.................................................................................15 

i. Health Information Sources .............................................................................15 

ii. Engaging Community Residents in Heart Health............................................16 

iii. Problems Acquiring Medical Help or Services ...............................................17 

iv. Feedback on NHLBI Publications ...................................................................17 
ii

VII. Discussion..........................................................................................................................17 

A. Assets in the Community.............................................................................................17 

B. Awareness of Health Issues ........................................................................................17 

C. Factors That Increase Risk of Cardiovascular Disease................................................18 

D. Motivations and Barriers for Physical Activity ...........................................................19 

E. Prevention and Intervention Strategies ........................................................................19 

VIII. Limitations of the Study.....................................................................................................21

IX. Conclusion .........................................................................................................................22 

X. Appendices.........................................................................................................................23 

A. Appendix A: Training Materials..................................................................................24 

i. Key Informant Interview Training Protocol ....................................................25 

ii. Key Informant Interview Training Handout....................................................26 

iii. Indepth Interview Training Protocol................................................................30 

iv. Indepth Interview Training Handout ...............................................................31 

B. Appendix B: Interview Guides ....................................................................................37 

i. Focus Group Guide..........................................................................................38 

ii. Key Informant Interview Guide.......................................................................45 

iii. Indepth Interview Guide ..................................................................................52 

C. Appendix C: Interview Guides (Tagalog)...................................................................65 

i. Key Informant Interview Guide.......................................................................66 

ii. Indepth Interview Guide ..................................................................................73 
iii

Acknowledgements 

Advisory Committee 

Magelende McBride, Ph.D., M.S.N., R.N. 

Community Liaison 

Curtiss Takada Rooks, Ph.D. 

Consultant 

Asian and Pacific Islander American Health Forum staff 

Tracy L. Buenavista, B.A. 

Research Assistant 

 

Roselyn N. Calangian 

Project Assistant 

Tessie Guillermo 

Former Executive Director 

 

Betty Hong, M.P.H. 

Former Director, Community Health Development Division 

Susana M. Lowe, Ph.D. 

Project Coordinator 

Shobha Srinivasan, Ph.D. 

Research Director 

Principal Investigator 

Joon Ho Yu 

Tobacco and Cancer Coordinator 

West Bay Pilipino Multi-Services, Inc., staff and volunteers 

Daisy Cruz 

Interviewer 

 

Grace Cruz 

Interviewer 
iv

West Bay Pilipino Multi-Services, Inc., staff and volunteers (continued) 

Cheryl Deocampo 

Interviewer 

 

Pia Galindo 

Interviewer 

Edwin D. Jocson 

Executive Director 

Eric M. Landas 

Interviewer 

Divine Marcelo 

Interviewer 

Sherille Pedron 

Interviewer 

National Heart, Lung, and Blood Institute, Office of Prevention, Education, and Control 

staff 

Matilde Alvarado, M.S.N., R.N. 

Coordinator, Minority Health Education and Outreach Activities 

Robinson Fulwood, Ph.D., M.S.P.H. 

Senior Manager for Public Health Program Development 

Ellen Sommer, M.B.A. 

Public Health Advisor 

Juliana Tu, M.S., C.H.E.S. 

Community Health Specialist 

We would especially like to thank the members of the Filipino community in Daly City and San 

Francisco, California, who generously gave their time, effort, and invaluable insight for this 

report. 
v

I. Forward

The Healthy People 2010 report outlines the current status of the Nation’s health and the 

projected health objectives to be reached by the end of the decade. The two main goals of 

Healthy People 2010 are to increase the quality and years of healthy life and to end disparities in 

the burden of disease. The NHLBI is committed to meeting the goals set forth in Healthy People 

2010, including ending the burden of disease for all racial and ethnic groups. The Institute has 

developed programs and initiatives to address high blood pressure, high blood cholesterol, early 

warning signs of heart attack, asthma, obesity, and sleep disorders. 

With this report on the Filipino community, we are gaining a greater understanding of the AAPI 

subgroups that have been largely overlooked. In fact, Filipinos are rarely studied even though 

they represent the third largest Asian subgroup in the United States, based on the 2000 Census. 

California has the largest number of Filipinos in the Nation and the largest population of 

Filipinos outside of Manila. Cardiovascular disease and stroke cause more than half of Filipino 

deaths. 

Heart disease is the leading cause of death for all Americans, including the Filipino population. 

We now have the opportunity to build partnerships within Filipino communities to focus local 

community action on creating heart disease prevention activities. Through the development and 

implementation of focused, culturally sensitive, and language-appropriate heart health strategies, 

we can help to prevent the development of heart disease risk factors in Filipino communities and 

help address the Healthy People 2010 goal of eliminating racial and ethnic disparities in heart 

disease risk. Together, we can make a difference! 

Claude Lenfant, M.D. 

Director 

National Heart, Lung, and Blood Institute 

National Institutes of Health 
1

II. Executive Summary 

Asian Americans and Pacific Islanders (AAPIs) are the fastest growing racial/ethnic group in the 

United States. They have varying socioeconomic characteristics, levels of acculturation, 

immigration history, and health profiles. The AAPI population is extremely diverse; its 

members have ancestral ties to approximately 50 Asian and Pacific Islander nations. Heart 

disease is the leading cause of death among these groups, but its impact on each group varies. 

For instance, high blood pressure is a major problem among Filipinos and control rates are 

particularly poor. 

The National Heart, Lung, and Blood Institute (NHLBI) worked in partnership with the Asian & 

Pacific Islander American Health Forum (Health Forum) to conduct an assessment of the 

cardiovascular health status of AAPIs nationwide. The first AAPI populations studied were the 

Filipino communities in Daly City and San Francisco, California. These particular communities 

were chosen for their strong family and community support. Other populations to be studied 

include Vietnamese, Cambodians, and Native Hawaiians. 

This report focuses on the Filipino population. Three formative research methods were used to 

study the Filipino communities: (1) focus groups with staff and volunteers from a local 

community service agency, (2) key informant interviews with community leaders, and (3) 

indepth interviews with community residents conducted by trained bilingual (English and 

Tagalog) facilitators. This report provides insights into the Filipino community, its perceptions 

and knowledge of heart disease, and motivations to making lifestyle changes. 

Results from this study indicate that Filipinos in the United States are concerned about their 

overall health. There is highly consistent and convergent evidence that this population is at high 

risk of developing cardiovascular disease. Filipinos, particularly new immigrants, are 

susceptible to stress from work and family issues. Some of their coping strategies include 

unhealthy eating and smoking. Outreach and education interventions for this population must 

address dietary habits, blood pressure and blood cholesterol control, tobacco use, physical 

activity, stress, and socioeconomic concerns. 
2

III. Introduction 

Since 1972, NHLBI has translated and disseminated information to the public to promote public 

health and prevent and control heart, lung, and blood diseases and sleep disorders. To date, the 

NHLBI has supported national cardiovascular initiatives for the African American, American 

Indian/Alaskan Native, and Latino populations. This is its first national effort in support of a 

National AAPI Cardiovascular Initiative. The NHLBI’s main objective is to collaborate with 

AAPI community-based organizers, key informants, and community members to conduct 

cardiovascular health needs assessments in specific ethnic communities. 

In August 2000, NHLBI funded the Asian & Pacific Islander Health Forum (Health Forum) to 

conceptualize and implement a formative research project to gain a greater understanding of the 

attitudes toward and knowledge of health practices related to cardiovascular disease (CVD) 

among selected AAPI communities. This report highlights the main findings from the Filipino 

community. 

The information collected under this project was approved as part of the Office of Management 

and Budget (OMB) blanket clearance project. Blanket clearance number 0937 was approved and 

administered by the National Institutes of Health (NIH) as a means to expedite the collection of 

consumer information to enhance program planning and development activities and to improve 

delivery to and utilization of health information by NIH customers. 

IV. Methodology 

A. Community-Based Partner 

In order to formulate culturally appropriate health messages and tools for specific populations, 

community-based organizations (CBOs) were chosen to conduct cardiovascular health needs 

assessments in AAPI communities. For the Filipino needs assessment study, the Health Forum 

partnered with West Bay Pilipino Multi-Services, Inc. (West Bay), because of its reputation as an 

advocate and a resource for the Filipino community. West Bay agreed to interview community 

members and leaders in both Daly City and San Francisco. West Bay is a consolidation of six 

established community service agencies (youth, employment, legal aid, etc.) that provide 

services in a variety of languages and Filipino dialects. 

B. Data Collection 

The data were collected through three methods: 

1. Focus group 

The focus group participants consisted of nine staff members and volunteers from West Bay. 

The focus group was conducted in English; however, some participants chose to speak in 

Tagalog. The focus group was tape recorded, transcribed, and translated. 
3

2. Key informant interviews 

Four members of nonprofit organizations and the Catholic Church were invited to participate 

in individual interviews as leaders of their communities. Two of the interviews were 

conducted in English and two were in Tagalog. Participants had to have held a formal or 

informal position of leadership in the Filipino community to be a key informant. 

3. Community indepth interviews 

Twenty-six community residents who use West Bay services were chosen to participate in an 

indepth interview about their susceptibility to CVD. Five interviews were conducted in 

Tagalog and 21 were in English. 

C. Interviewer Training 

 

Interviewers were trained during one 4-hour session at West Bay. The training took place 

immediately following the focus group with the staff and the volunteers. This enabled 

interviewers to become familiar with the scope of the project as well as some of the specific 

questions they would be asking community members. See Appendix A for detailed training 

materials. 

D. Translation of Research Instruments 

Step 1: The research instruments were first developed in English. 

Step 2: Two bilingual and bicultural Filipinos, who were well versed in Tagalog and other 

Filipino dialects, were asked to do two translations of the instruments. 

Step 3: The primary investigator, coordinator, and translators met to revise the instruments. 

Step 4: West Bay staff reviewed the instruments to ensure cultural and linguistic appropriateness. 

Step 5: Upon completion of the interviews, the interviewers made recommendations for future 

data collection. 

See Appendix B for the English instruments and Appendix C for the Tagalog instruments.∗

E. Data Feedback 

 

After preliminary results were identified, the coordinator and the bicultural/bilingual research 

assistant met with the interviewers. The purpose was to check if the findings resonated with 

their experiences working with people in the community. The interviewers were also asked to 

elaborate on and clarify some of the data. 

 

∗

 The research instruments were developed explicitly for this assessment by the Health Forum, in conjunction with 

West Bay and several members of the Filipino community in San Francisco. West Bay staff made changes to the 

Tagalog translation just before and during the interviews with community residents. Before using the Tagalog 

instruments, please review and revise them to meet your needs. 
4

V. Demographics 

Study participants varied greatly by age, gender, occupation, socioeconomic status, and health 

care coverage. The following tables and figures describe the community residents. Of all 

participants, 17 were males and 22 were females; the overall age range was 20 – 79 years (table 

1).

Table 1—Number of participants by needs assessment methodology, sex, and age 

Group Male Female Age range 

Focus group 4 5 23 – 45 years old 

Community leaders interview 2 2 37 – 55 years old 

Community residents interview 11 15 20 – 79 years old 

Total 17 22 20 – 79 years old 

Of the 26 participants in the community resident interviews, about 58 percent were females; over 

65 percent were 45 years old or younger (table 2). 

Table 2—Number and percent of community resident participants by age and sex 

Age: Grouped by sample distribution Male Female Total (%) 

20 – 29 years old 5 4 9 (34.6) 

30 – 45 years old 3 5 8 (30.8) 

46 – 60 years old 1 3 4 (15.4) 

61+ years old 2 3 5 (19.2) 

Total 11 (42.3) 15 (57.7) 26 (100.0) 

Of the 26 community residents, 62 percent received 13 or more years of education, and 4 percent 

did not receive an education (figure 1). Not shown in figure 1 is that no gender difference was 

observed in the level of education. Data on household income and size were also collected, also 

not shown in figure 1. The range of annual household income was between $20,001 and $40,000. 

The average household size was 4.2 people. Those with higher incomes had larger household 

sizes, the presence of several adult workers, and people working more than one job. 

Figure 1—Percent of community resident participants by educational attainment 

0 10 20 30 40 50 60 70 80 90 100

13+

1 through 12

0

Years of education received

Percent of community residents
5

Of the 26 community residents interviewed, 91 percent were employed. Most of the residents 

were employed; about 65 percent worked in administrative, service, and sales positions (figure 

2). 

Figure 2—Percent of community resident participants by occupational status 

n=26

65%

17%

9%

9%

Administrative support, service,

industrial, or sales

Professional/managerial or

technical

Homemaker

Unemployed

Of the 26 community residents interviewed, 85 percent were born in the Philippines (figure 3). 

Not shown in this figure are the residents’ native language (85 percent say that a Filipino dialect 

is their native language), language preference, and length of stay in the United States (ranges 

from 2 – 32 years). 

Figure 3—Percent of community resident participants by place of birth 

n=26

85%

15%

Born in the Philippines

Born outside of the

Philippines
6

VI. Results 

The results of the cardiovascular health needs assessment revealed several findings about the 

Filipino culture, beliefs, and personal health behaviors. Community leaders described their 

communities as middle-class families with people of all ages. The two major languages used in 

communication are English and Tagalog. Various Filipino dialects are also used, including 

Bicolano, Bisaya, Pampango, and Ilocano. A community leader stated that Filipino residents are 

actively involved in community activities, especially in the church because religion gives 

meaning to their lives. The church is also a place where people meet others who share the same 

cultural backgrounds and find happiness. One leader described Filipinos as “hospitable to those 

who involve themselves [in the community], committed, generous, and have lots of gifts and 

talents to share.” 

A. What Does the Heart Symbolize? 

When the community residents were asked about the heart and what it symbolizes for them, 

among the things they stated were love, life, strength, commitment, and perseverance. 

B. Concept of Health 

When asked about the concept of health, focus group participants said that being healthy is very 

important and that they know how to maintain good health. They stated that one way of staying 

healthy was to exercise. Community leaders agreed that good health is very important. They 

added that good health is achieved when there is a balance between the mental, emotional, and 

physical states of mind. 

C. Prevention and Causes of Poor Health or Illness 

Community residents were asked to discuss prevention and illness separately, but they did not 

see these as discrete concepts. They listed fatigue, stress, unhealthy eating, smoking, drug abuse, 

lack of concern for one’s health, and lack of exercise as factors related to poor health. 

Community residents understood the importance of prevention and the different preventive 

measures they can take to ensure a healthy heart. Being open minded, listening to their body, 

and getting health advice from trusted family members, friends, physicians, and ministers help 

them to stay healthy. Key community leaders said that illness in the Filipino culture is a sign of 

a weak body, low resistance, and imbalance. 

D. Major Health Concerns 

 

Community leaders named heart disease, high blood pressure, and diabetes as three of the top 

five major health concerns in the Filipino community. The community leaders cited heredity of 
7

heart disease and a high fat, high cholesterol, and high sodium Filipino diet as reasons 

cardiovascular health-related diseases are big concerns. Other health concerns included 

emphysema and breast cancer. 

E. Filipino Lifestyle in the United States and in the Philippines 

i. Nutrition 

There are quite a few differences between the Filipino and American diets. First, the 

Filipino diet contains a lot of salt. Patis (fish sauce) is one of the most common 

ingredients in the Filipino diet. Bagoong (shrimp paste), anchovies and anchovy paste, 

and soy sauce are also popular ingredients. Despite the fact that community residents 

believe that eating less salt is better for their blood pressure and health in general, they 

are not likely to reduce their salt intake. 

Second, traditional Filipino foods include ingredients from a variety of cultures. 

Common Chinese ingredients such as oyster sauce are regularly used. Vinegar, coconut 

milk, lime, tamarind, garlic, ginger, onion, and pepper are also key ingredients. The 

availability of ethnic Filipino ingredients is great. In fact, there is a greater affordability 

and variety in the local United States markets compared with those in the Philippines. 

This allows more frequent use of these ingredients and in greater quantities. 

Third, traditional Filipino dishes such as fried fish, roasted pork, pancit, lumpia, adobo, 

and desserts rich in sugar and starch are eaten frequently. Table 3 lists traditional 

Filipino foods. These native dishes are more often prepared and served at gatherings, 

which occur frequently. One woman expressed the popularity of fried, fatty foods by 

declaring, “I like that crispy, crispy, crispy.” 

Table 3—Traditional Filipino foods 

Traditional dish Description 

Pancit Sautéed vegetables, shredded chicken, shrimp, and rice noodles 

Lumpia (fried egg rolls) Ground beef or pork with mixed vegetables 

Adobo Onions, garlic, pork or chicken, soy sauce, and vinegar 

Dinuguan (chocolate meat) Pork blood, pork, tripe, onions, garlic, and peppers 

Kare-kare Ox tail, peanut butter, bok choy, long green beans, salt, pepper, 

and shrimp paste 

Sinigang Beef, salmon, milk fish, or pork ribs with fresh tamarind or 

tamarind mix, tomatoes, long green beans, onions, taro root, and 

fish sauce 

Lechon Roasted pig 

Crispy pata Deep fried pork leg 

Chicharon Pork rinds served with vinegar and chili 

Fried chicken Chicken deep fried in oil. 

Fried fish Fish deep fried in oil. 
8

Fourth, focus group members discussed the traditional practice of “gift giving” 

(pasalubung) as a barrier to eating healthy. Pasalubung is customary when one person 

visits another, such as dinner gatherings or after returning from a trip. Community 

residents described the gifts as unhealthy for the body. Alcohol, roast pork, adobo, and 

chicharon are common gifts. It is considered rude and disrespectful if the gifts are not 

well received, particularly if an older person offers them. 

Fifth, residents also believe that immigrants seeking comfort food can also lead to poor 

health. Comfort food provides a sense of home and security and helps to alleviate the 

stressors of adapting to life in a new country. 

Lastly, residents talked about the affordability of American foods, which are more 

expensive overseas. Many Filipinos who immigrate to America are poor. Foods that 

they are not able to afford in the Philippines can be bought in the United States at a 

reasonable price. In the United States, Filipinos frequent fast-food chains and take-out 

restaurants that serve high-fat, high-sodium, and high-cholesterol foods, usually reserved 

for wealthy people in the Philippines. Because of this practice, Filipinos in the United 

States consume more unhealthy foods. 

The community residents described home-cooked meals as less salty, less oily, and less 

fatty than restaurant food. Residents tend to use a fresher and larger variety of fruits and 

vegetables and less meat, which gives them the option to choose healthier food 

alternatives. 

Figure 4 shows the kinds of food community residents consumed 2 days prior to the 

study. Generally, the community residents eat a healthy diet with lots of fruits and 

vegetables. However, there were just as many residents who consume foods high in fat 

and cholesterol, such as red meat and snacks (figure 4). 

Figure 4—Percent of community resident participants by type of food reported and 

number of servings 

0 10 20 30 40 50 60 70 80 90 100

Ethnic dishes

Homecooked meals

Vegetables

Fruits

Dairy

Red meat

Chicken

Fish

Vegetable protein

Snacks

Food type

Percent of community residents

3+ servings

1 serving
9

ii. Physical Activity 

Overall, community residents believe that physical activity is important (figure 5). 

However, they preferred walking rather than vigorous exercise. Community leaders 

added that Filipinos often do physical labor at work and are also active at home. Doing 

laundry, cleaning the house, and gardening are some of the chores that allow Filipinos to 

stay active in their daily life. These activities should be recognized as heart healthy 

practices. It can be misleading to look at physical activities in the Filipino community as 

those typically recognized in Western culture, such as aerobics, use of exercise machines 

in gyms, etc. Furthermore, it is important to pay attention to the kinds of community 

activities that Filipinos engage in that provide aerobic activity, such as dancing. 

As with dietary regulations, adherence to exercise was considered “a matter of priorities,” 

as one man in the focus group explained. Working for wages to support the family and 

doing daily chores around the house are given greater priority over physical activity. 

However, as figure 5 shows, all forms of physical activity are important to the Filipino 

lifestyle. Eighty-one percent of the community residents exercised at least once in the 

last month, while only 38 percent regularly participate in organized community activities 

(figure 5).

Figure 5—Percent of community resident participants engaging in physical activity by 

attitudes and behavior 

0 10 20 30 40 50 60 70 80 90 100

Very important

Somewhat important

Participate in organized activities

Exercised once last month

Attitudes and behavior

Percent of community residents

iii. Stress 

Fifty-four percent of the community residents said that they lead somewhat to very 

stressful lives. Common stressors include: 

 Work 

 School 

 Caring for the family and children 

 Money 
10

Filipinos relieve stress by talking with friends and family, exercising, praying, listening 

to music, shopping, watching television, and smoking. 

iv. Tobacco 

Community residents identified various effects of smoking, which included damage to 

the liver and lungs, cancer, and high blood pressure. “Looking cool and sophisticated” 

are some of the motivating factors that drive Filipinos to smoke. Smoking was also 

mentioned as part of the natural process of growing up, which may explain why residents 

are concerned about the number of children who smoke. 

A majority of the community residents (n=21) have been exposed to smoke from family, 

friends, coworkers, clients, and strangers. Figure 6 shows the percent of community 

resident participants exposed to tobacco smoke.

Figure 6—Percent of community resident participants exposed to environmental tobacco 

smoke by source of exposure 

Sources of exposure

Family Friends Coworkers Clients Strangers

70

60

50

40

30

20

10

0

Percent of community residents

Of the 26 community residents, only 9 reported that they used tobacco products. Within 

this group of 9: 

 The average number of years smoked was 13 years (SD=7.2 years). 

 Five smoked less than four cigarettes a day. 

 Four smoked regularly. 

 Six generally smoked outside the home. 

 Seven believe smoking has negative consequences on health. 

All formative research participants said that the Filipino community views smoking as 

normal and socially acceptable. Both the Filipino community in the United States and in 

the Philippines consider smoking a highly social activity. 
11

Community residents indicated smoking as a stress reliever; however, when the same 

respondents were asked how they coped with stress, only a few mentioned smoking. This 

dichotomy may be explained by the difference in community beliefs versus individual 

behaviors. It is also possible that smoking and drinking alcohol, however socially 

acceptable in practice, are less desirable to report in a personal interview. 

What influences Filipinos to smoke? Many of the common socialization factors, 

according to the community interviews are: 

1. Environment (e.g., social gatherings, family, friends, coworkers) 

2. Social pressure (e.g., peer pressure, the perception that smoking is considered macho 

for men, and an increasing perception that smoking is stylish for women) 

3. Individual (e.g., depression, stress, and the desire to experiment) 

4. Media (television, commercials, movies, and magazines) 

A death or illness of family members who smoked and quitting cold turkey were 

mentioned as the strongest motivator and the most successful method, respectively, for 

quitting smoking. 

v. Alcohol 

Of the 26 community participants 46 percent (n=14) reported that they drink alcohol. 

Figure 7 shows the types of alcohol people generally drink. 

Figure 7—Percent of community resident participants who drank alcohol by type of 

alcohol 

0

10

20

30

40

50

60

70

Percent of community residents

Beer Hard liquor Wine Wine cooler

Type of alcohol
12

F. Personal Health 

i. Perceptions of Obesity 

Community leaders and residents agree that obesity is a reflection of one’s economic 

status. One community leader said, “Obesity is visual evidence of good economic status. 

Being fat means being healthy and being able to financially care for your children.” On 

the other hand, there is a more modern viewpoint that obesity in adults can also be 

considered unhealthy and unattractive because an obese person can be perceived as lazy 

or unmotivated. 

Community leaders and residents also say that it is culturally acceptable for Filipino 

children to be overweight. However, overweight and obesity acquired during childhood 

or adolescence may persist into adulthood and increase the risk for cardiovascular-related 

diseases later in life. Therefore, when children reach adolescence, it is important to teach 

them how to be at a healthy weight. 

While community residents understand the social ramifications of obesity, the problem 

persists because of overeating, unbalanced and irregular meals, lack of exercise, and selfesteem issues. Being selective about what one eats is not necessarily a priority because in 

the Filipino culture one must be thankful for the blessings one receives. Food is 

considered a gift from God. 

ii. Factors Associated With Cardiovascular Disease 

The community residents were asked about their personal history and family history of 

CVD. Twenty-three percent responded that they are on a special, physician-ordered diet; 

19 percent have high blood cholesterol; 35 percent have high blood pressure; 12 percent 

have diabetes; and 39 percent responded that they have at least one family member with 

heart disease (figure 8). The community residents did not report prior strokes and heart 

attacks. 
13

Figure 8—Percent of community resident participants with various CVD-related factors 

0 10 20 30 40 50 60 70 80 90 100

Family with heart

disease

Has diabetes

Has hypertension

Has high cholesterol

On a special diet

Factors of CVD

Percent of community residents

iii. Perceptions of High Blood Pressure 

When community residents were asked about high blood pressure, stress was given as the 

number one cause. Other causes named were eating fatty foods, drinking too much, and 

heredity. Factors such as not monitoring food consumption and little knowledge about 

controlling blood pressure were listed as common barriers to lowering hypertension. 

iv. Perceptions of High Blood Cholesterol 

The community residents were aware of one factor associated with increasing ones’ risk 

of developing high blood cholesterol—diet. Community leaders expressed concern that 

Filipinos do not take greater care in controlling their diet, particularly eating too much 

high fat food, to decrease their risk of CVD. Interestingly, the community residents 

incorrectly believed that a high sodium and high protein diet would also put them at risk 

of developing high blood cholesterol. 

v. Perceptions of Heart Disease 

Formative research participants shared similar views on the causes of heart disease. 

Genes, physical inactivity, high sodium and high fat diet, stress, financial problems, and 

tobacco and alcohol abuse were all named. Those who had a family history of heart 

disease indicated that a combination of stress, bad eating habits, genetics, lack of 

exercise, and fatigue contributed to the development of heart disease. The participants 
14

did not mention other key risk factors for heart disease like high blood pressure, high 

blood cholesterol, and overweight and obesity. 

Community residents said that motivation to adopt a healthy lifestyle is prompted by a 

loved one’s illness. Until someone reaches the point of illness, there is no motivation to 

shift to a healthier lifestyle. Residents said that they would be more conscious about 

what they are eating if someone they loved had heart disease. 

 

vi. Alternative Health Care Services 

In the United States, Filipinos typically choose to use a combination of Eastern and 

Western medicines to overcome general health ailments. Their choice of remedies 

include prayer, going to neighborhood health centers, self-medication with herbal 

medicine, seeking advice from trusted individuals, visiting traditional healers, and 

visiting physicians. Filipinos use a lot of herbal medicine and household items, in 

addition to over-the-counter medications, to self-treat minor illnesses. Home remedies 

involving coconut oil, tea, ginger and mint leaves, vinegar and coffee, garlic, and white 

flour oil are common. 

Getting medical advice for illnesses varies from person to person. More than half of the 

community residents said they would go to a doctor. Members of the focus group said 

that they and other Filipinos they know only go to a doctor when the illness is really 

severe, as a last resort. Others seek out family members, friends, pharmacists, 

community health specialists, acupuncturists, hilots (massage therapists), or albolarios 

(faith healers). More than half prefer the advice of a hilot or albolario because of their 

holistic approach to healing. 

G. Engaging in Healthy Behaviors 

i. Confidence in Maintaining Heart Healthy Habits 

The community residents were asked to state how confident they were in maintaining 

good heart health. Figure 9 shows the percentage of community residents who could 

maintain healthy heart habits. Eighty-seven percent of the residents said they were 

confident that they could eat five fruits and vegetables each day. However, 

approximately 92 percent of the residents were only somewhat confident that they could 

maintain a healthy weight, exercise at least 30 minutes/day, eat a lowfat and low-salt diet, 

lower their blood cholesterol, and control their blood pressure. 
15

Figure 9—Percent of community residents who engage in personal health habits to improve 

cardiovascular health 

0 10 20 30 40 50 60 70 80 90 100

Maintain a healthy weight

Exercise 30 min/day or more

Eat low fat and low salt

Eat 5 a day

Lower cholesterol

Control BP

Personal habits

Percent of community residents

ii. Motivations and Barriers for Physical Activity 

Community residents believe that motivation for being physically active comes from 

concern for their overall health. Other motivators included weight loss, being strong, and 

feeling energetic. Some residents named external influences, such as significant others 

and setting a good example for their children, as their motivators. 

Barriers to increasing physical activity include lack of time, boredom with regular 

activities, difficulty in changing dietary habits, lack of motivation, and difficulty in 

managing stress. Residents believe that limited access to health insurance and health 

information and inadequate health care are their biggest barriers to increasing physical 

activity. 

H. Health Education and Promotion 

i. Health Information Sources

Figure 10 shows the most popular sources residents use for health information. At least 

80 percent of the community residents reported that they get most of their health 

information from friends and family, health care providers/doctor’s office, or from 

television. The least reported sources were from radio, Filipino newspapers and 

magazines, and English newspapers (figure 10). However, 83 percent of community 

residents felt that educational materials should be available in the native Filipino 

language. 
16

Figure 10—Percent of community resident participants who report where they get their 

health information by information source 

0 10 20 30 40 50 60 70 80 90

Television

Community outreach programs

English newspapers

Filipino newspapers and magazines

Radio

Doctor's office

Health care providers

Friends and family

Information sources

Percent of community residents

ii. Engaging Community Residents in Heart Health 

Table 4 lists the community activities residents used the most to actively participate in 

their own heart health. Residents also utilize health education information, including 

articles, brochures and pamphlets, magazines, public service announcements (PSAs), and 

health care providers, as a supplement to the community activities. 

Table 4— Community Activities to Engage Residents in Heart Health 

 Exercise classes and machines at local fitness facilities 

 Free blood pressure check-ups at a nonprofit organization 

 Health lectures at community health centers 

Older community residents also say that senior clinics in San Francisco are a good place 

to seek treatment. Senior clinics provide comprehensive services, including health 

education lectures, home visits, exercise activities, stress management, recreation, 

shopping trips, an advice nurse, meetings with doctors on health, nutritional cooking 

lessons, brochures, and health fairs. 

Younger community residents said that there are far fewer services available to them, or 

that they are not aware that services for younger people exist. 
17

iii. Problems Acquiring Medical Help or Services 

Nine community residents said that they seldom had or did not have problems acquiring 

medical services. Those who did cite problems indicated that long waits in getting an 

appointment was a major issue. Transportation represented a barrier to accessing 

services for some, while others reported a lack of time. Financial problems, as well as 

problems with insurance coverage for certain service, were also mentioned. 

iv. Feedback on NHLBI Publications 

It is important to develop educational publications based on the nativity of the target 

audience, either the Filipino immigrant population or the American-born population. The 

older generation of residents prefers health materials in Tagalog, Visaya, or other Filipino 

dialects. Community residents said they prefer health presentations in Tagalog and 

pamphlets in Taglish (combination of Tagalog and English) or bilingual English and 

Tagalog (side by side). Focus group participants said that American-born Filipinos get 

more health information through school, whereas immigrants do not tend to receive much 

health information at all. 

VII. Discussion 

Findings from this cardiovascular health needs assessment will aid the development of future 

prevention and intervention programs in the Filipino community. To highlight the major issues 

that were discussed, this section is divided into five areas: (1) assets in the community, (2) 

awareness of health issues, (3) health risk factors, (4) motivators, and (5) prevention and 

intervention strategies. 

A. Assets in the Community 

The culture of the Filipino communities in Daly City and San Francisco is one that fosters 

interpersonal support and togetherness. There is a strong emphasis on community participation 

and involvement. The Filipino family plays a major role in the life of the individual. Although 

Filipinos may sometimes find themselves isolated in terms of access to health resources, there is 

a wealth of community and family resources. 

B. Awareness of Health Issues 

The community is aware that CVD is a major threat to the health of Filipinos. Definitions of 

prevention for CVDs include adages such as prevention is better than cure, drink eight glasses of 

water, and exercise. However, the predominant view is that prevention is not traditionally 

practiced in the culture; rather, the emphasis is to “live life.” 
18

Community residents are aware that a poor diet and lack of exercise contribute to poor health, 

and that open mindedness helps prevent illness. They recognize stress and other psychological 

issues as contributors to the onset of illness. Community residents are also aware that smoking, 

drinking alcohol, and genetic predisposition contribute to a variety of health problems, including 

heart disease. 

C. Factors That Increase Risk of Cardiovascular Disease 

When asked about the risk factors for CVD, community residents successfully identified several 

of them. However, it will take more than knowledge to get the residents to change their 

behavior. Below are a number of factors that put the Filipino population in the United States at 

great risk for heart disease. 

 Smoking 

Smoking is a big problem among the Filipino youth. It is recognized as a socially acceptable 

behavior, especially for men and increasingly for women. Although the community is aware that 

smoking is bad for one’s health, it is also recognized as a social norm. 

 Dietary habits 

Many traditional Filipino dishes are high in fat and sodium. Foods from other cultures that are 

high fat and high sodium, such as Vietnamese food and American fast food, put Filipino 

consumers at risk for heart disease. Cultural practices such as gift giving (pasalubung) 

contribute to unhealthy eating. 

 Stress 

Stress leads to a variety of unhealthy behaviors, all of which interact with one another to impact 

cardiovascular health. To cope with the strain of immigration and daily life, some people turn to 

consuming Filipino comfort foods, which are fatty and high in sodium. Some reported smoking 

to relieve stress. 

 Socioeconomic status 

Socioeconomic needs in the Filipino community often take precedence over personal health, 

resulting in lower consciousness about health and less time devoted to health maintenance and 

improvement. Consequently, Filipinos react to acute health crises instead of focusing on 

prevention. 

 Lack of time 

A lack of time is the most frequently reported barrier to being physically active. Illness and 

fatigue also contribute to problems in staying active. Relatively few community residents make 

the connection between regular exercise and personal health benefits. 
19

D. Motivations and Barriers for Physical Activity 

A disease in the family or the immediate threat of illness in the family can be an effective 

motivator for behavior change. The community residents believe that the necessity to care for 

one’s family leads individuals to be more cognizant about caring for their own physical health. 

Some feel that they maintain a healthy lifestyle to set a good example for their children. 

The community residents identify health and health concerns as the prime motives for being 

physically active. External motivators for some are apparent, such as the insistence of their 

partners and significant others. Some people exercise “by force,” while others exercise to be 

strong. 

Even though the residents have external motivators to change their behavior, barriers to 

increasing physical activity still exist. Lack of time, lack of variety in activities, and limited 

access to health care and information were most frequently cited as barriers to change. 

E. Prevention and Intervention Strategies 

A number of recommendations for prevention and intervention programs in the Filipino 

community are based on the results of this project. Suggestions are derived from discussions 

with community residents on a variety of lifestyle issues. 

 Develop programs centered on the family. 

The Filipinos live in a close-knit community where the support of family and friends is 

essential for a healthy life. Intervention programs, particularly those that address physical 

activity, nutrition, and smoking cessation, should be based on a transgenerational model 

where the old are teaching the young, and vice versa. 

 Increase smoking cessation programs.

Smoking is a big problem in the Filipino community, particularly among the youth. In a 

comparison of smoking patterns among Asian American youth in California, Filipinos were 

most likely to have smoked than any other Asian American subgroup. More intervention 

programs should target children and young adults about the dangers of smoking. Ultimately, 

programs should move community residents to change this social norm. 

 

 Teach dietary monitoring.

Most Filipinos know that they should eat five fruits and five vegetables a day, but keeping 

track of it can be difficult. Recording daily meals in a food journal can help. Seeing exactly 

what one eats and how much is a good start towards healthy eating. 

 Provide alternative food choices.

Most of the traditional Filipino dishes are high in fat and sodium. A bilingual Filipino 

cookbook with easy-to-prepare recipes offers healthy alternatives. Adaptations to the 

traditional dishes can include using less salty and less fatty ingredients. 
20

 Teach coping strategies.

Stress leads to decreased motivation for physical activity and results in maladaptive coping 

strategies, such as unhealthy eating habits and smoking. Programs should build upon 

existing social relationships. Examples of this include bringing community members 

together to focus on stress management, family support, career development, housing and 

immigration, smoking cessation, physical activity, and healthy cooking. 

 Use fear. 

Interventions are needed to motivate people to change before they or a loved one experience 

a crisis. The Filipino community has a cognitive understanding of the major health risks. 

However, health problems tend to remain in the abstract until an illness strikes close to home. 

Community residents feel that stronger messages are needed to move people to action. The 

use of scare tactics can help grab the audience’s attention and reinforce health messages. 

Testimonies of Filipino celebrities have been successful because they serve as role models 

for the community. Filipinos would pay heed to these personal accounts, which would 

encourage them to make changes in their own lifestyles. 

 Improve the quality and access of health information.

The key leaders believe that wider distribution of health materials in Filipino languages and 

new methods to present health information are needed. The leaders offered several 

suggestions, which are listed below: 

 Ensure that communities receive accurate health information. Interviews with 

community residents indicate that more people in the community go to friends and 

family for health information than to any other source. 

 Literature should be low-literate, culturally competent, and presented in a comedic 

style. 

 Literature can be distributed as a CD-ROM, or in another electronic format. 

 Health fairs and community-based organizations (CBOs) that offer free medical 

services are popular venues for residents to obtain health information. Free or lowcost public transportation to these venues should be considered. 

 Nurses at community health centers or bilingual health care providers in the 

community should be trained to educate the residents about heart health. 

 Improve access to exercise facilities.

Community residents believe that free and low-cost gyms in the community and at the 

workplace help to increase physical activity levels. Gyms provide a safe and supportive 

environment for people of all ages to exercise. Programs in partnership with a local clubs or 

organizations may encourage more young people to stay physically active and steer them 

away from drugs and gang violence. 
21

VIII. Limitations of the Study 

It is both important and useful to discuss the limitations in conducting the Filipino portion of this 

multiethnic study on cardiovascular health in Asian American and Pacific Islander communities. 

Changes in personnel significantly delayed the project. The project was slated to begin July 

2000 but did not move forward until September 2000, when new Health Forum staff were hired. 

Time lag and changes in personnel at one of the community-based organizations (CBOs) made it 

difficult to pursue a partnership with two groups. Thus, the approach was modified to include 

one CBO instead of two in the project collaboration. This modification may have affected the 

extent to which Daly City was represented in the sample. 

True partnerships with CBOs in conducting community-based research require considerable time 

and training on the part of the researchers and the community. Tight deadlines and timelines are 

not conducive to building important partnerships that enhance the process of research and 

community capacity building. CBOs that provide direct services to their communities are hard 

pressed for time and resources. Conducting any kind of partnered research has to recognize 

these issues and compensate the CBOs and community participants adequately (i.e., in terms of 

recognizing their priorities, time, human resources, and monetary constraints). 

 

Various delays resulted in expedited work to move the project forward. Development of the 

interview and focus group protocols could have benefited from greater participation with our 

CBO partners, particularly in piloting the procedures and reviewing translated materials for their 

cultural and linguistic appropriateness. As a result, the protocols could have been more concise 

and the translations needed to be improved. 

Extremely positive feedback was received about the focus group conducted at West Bay. 

Participants appreciated the opportunity to discuss cardiovascular health in the Filipino 

community and would like to see more community gatherings. They all recognized the major 

significance of addressing cardiovascular health and disease in the Filipino community. They 

were very pointed in their feedback that they hoped this focus group was not a one-time effort. 

They said they would feel extremely disappointed if there was no follow-through to further 

examine the issues or provide solutions and support to the community. 

Some of the focus group questions were repetitive and modifications were made as the 

discussion progressed. It is therefore necessary for the next round of data collection to edit the 

focus group materials. 

During the data feedback meeting, interviewers were invited to critique the interview materials 

and processes. They concurred that the interview protocols, particularly the indepth interview 

with community members, were exceedingly long, tedious, and repetitive. They made specific 

comments in regard to collecting information on eating behaviors—the 3-day diet was a good 

process for participants, but the weeklong diet was difficult to recall. They also critiqued the 

tobacco section, stating that there needed to be greater consistency on whether the questions 

addressed smoking behavior or general tobacco use. Furthermore, the formatting of the tobacco 

questions was confusing. 
22

In addition, the interviewers found the question on health-seeking behaviors to be repetitive and 

too detailed. This led to participants providing the same information on several questions. 

It is important to be cognizant of this study’s limited geographic area and relatively small sample 

size. Results should not be generalized to the larger Filipino community in California and in the 

United States. Epidemiological studies and qualitative research to further assess cardiovascular 

risk are warranted. Mixed-methods research, especially studies conducted in partnership with 

CBOs, would enhance the capacity to develop more informed and effective CVD intervention 

and prevention programs. 

IX. Conclusion 

Heart disease is the leading cause of death for Filipinos, representing about 32 percent of all 

Filipino deaths. One of the major risk factors that is quite prevalent among Filipinos, and 

increases their risk of heart disease, is high blood pressure. About 25 percent of Filipinos living 

in the United States suffer from high blood pressure; their rates are almost comparable to African 

American rates in the United States. In addition, Filipinos have high rates of cigarette smoking. 

Thus, community-based programs to improve nutrition-related behaviors such as eating low salt 

and low sodium foods, increase screening, referral, and followup for high blood pressure control, 

and provide smoking cessation programs may help reverse the increasing prevalence of heart 

disease in this population. By studying this community, we are gaining a greater understanding 

of the heart health problems that plague this small but important subgroup of AAPIs in the 

United States, and how to prevent them. Many are immigrants who have traveled a great 

distance from the Philippines. They bring with them their cultural values and hopes for a better 

life. This hope, for a happy and healthy life, can inspire minority health advocates to help 

improve the overall well-being of Filipinos nationwide. 
23

X. Appendices 
24

APPENDIX A: Training Materials 
25

Key Informant Interview Training Protocol 

1. Go over the purpose of the program and the scope of the study. 

2. Discuss the target population. 

3. Talk about the questionnaire. 

4. Talk about using a conversational interview style. 

5. Talk about tape recording the interview. 

6. Stress the importance of neat handwritten notes. 

7. Talk about the cultural and linguistic appropriateness of the interview protocol. 

8. Take a break. 

9. Practice role-playing the interview, following my example. Go over the following steps. 

a. Make an appointment. 

b. Create a timeline. 

c. Finding a location for the interview. 

d. Arranging travel. 

e. Confirming with the interviewee the day before. 

f. Signing the permission form. 

g. Conducting the interview. 

h. Looking at NHLBI materials. 

10. Find a partner with whom to practice. 

11. Discuss any further modifications or issues. 

12. Schedule a followup training if needed. 
26

Key Informant Interview Training Handout 

Purpose 

To collect information about community health needs, knowledge, attitudes, behaviors, and 

cultural beliefs and practices about having a healthy heart and preventing heart disease from four 

Asian American and Pacific Islander groups. These ethnic groups include Filipino, Vietnamese, 

Cambodian, and Native Hawaiian. The information obtained through active community 

participation will be used to guide the development of culturally and linguistically appropriate 

resources to increase the community’s awareness of heart disease and encourage heart healthy 

behaviors. 

 Personal and demographic information 

 Health education 

 Community health services 

It is very important to write your notes neatly so that we can read them later. Please write your 

notes in English, or translate them afterwards into English. 

Who Should Be Invited to Participate in a Key Informant Interview? 

Some of you will be doing key informant interviews. Each community-based organization 

(CBO) should interview two key informants. Key informants should be people who are seen as 

leaders in the Filipino community. They may hold a position of leadership (e.g., a director of a 

program, political leader, active teacher) or they may be leaders through their efforts outside of a 

formal job (i.e., a person who is active in the community but isn’t necessarily paid to do their 

community work). 

Cultural and Language Appropriateness 

When we designed the interview protocol, we knew that each interviewer would have his or her 

own style and also his or her own suggestions about how useful the questions are and whether 

they are culturally appropriate. We will go over the questionnaire (in English and in the native 

language), section by section and discuss it. If we agree upon modifications, we can hand mark 

them on the forms. I will make multiple copies of ones with modifications. You will use these 

revised questionnaires when you do your interviews. 

Pre-Interview 

It is important to call the interviewees right away to schedule interviews. Tell them they have 

been identified as a leader in the community, and that you would like to interview them to learn 

more about heart health and the Filipino community. Inform them that the program is sponsored 
27

by the National Heart, Lung, and Blood Institute and is partnered with the Asian & Pacific 

Islander American Health Forum and your CBO. They will receive $20 as a token of 

appreciation for doing the interview. Let them know that the interview should last about 1 hour 

and 15 minutes. Tell them that their names will not be used, but the information they provide 

will help develop health promotion programs for Filipinos. Let them know that you would like 

to tape record the interview to ensure that we capture everything they discuss in the interview. 

Tell them when you are available, and see if they can interview during one of those times. 

Please schedule for 1.5 hours of their time, and let them know where the interview will be (e.g., 

at your CBO or at their office, if you are willing to travel). Make sure you have some time 

before and after the scheduled interview time, in case the person comes late or if the interview 

runs long. 

Confirm appointments: Call them the day before or the day of the interview to confirm they can 

still do the interview. It really helps to do this, so that they know when they are coming. If there 

is a problem, you can reschedule. 

At the Interview 

Thank them for coming to the interview. Tell them you will be interviewing them about health 

issues, but first you would like them to look at the permission form, and sign it. Briefly describe 

the permission form. They can look at it as you talk. Give them time to read it themselves, and 

to ask you questions if they have any. If they agree, then they need to initial and sign the form, 

and you will also sign. You will keep one copy, and they will keep the other copy. 

Tape recording: The questions in this interview are designed to gather a lot of information from 

each person. We want to hear their opinions, their experiences, and their ideas for their 

community. Because of this, we would like to you to tape-record the interview. You will need 

to ask permission from the person. If they say no, then we will rely solely on your notes. If they 

say yes, then you can have them initial the line on the form that gives their permission to tape 

record, and you can begin tape recording. 

Note-taking: It is very important for you to take neat notes while you are interviewing the key 

informants. It is especially critical if they do not agree to be tape recorded. 

Advice about the Interview Process

Open-ended questions: Open-ended questions are questions that don’t have a yes/no or 

black/white/brown answer. An example of an open-ended question would be if I asked you, 

“What kind of fruits do you like?” The person can answer however they like, such as, “I like 

papaya, mango, and bananas.” They can also answer, “I don’t like fruit at all.” 

On the other hand, closed questions are useful when you are asking a lot of people the same 

questions. You want to give them choices, so that you can analyze what a large group of people 

said about something. For example, if I ask you, “Do you like apples or bananas better?” I have 

only given you two choices that are predetermined. You can say either apples or bananas. This 
28

is an example of a closed question. In the indepth interview questionnaire, there are many 

multiple-choice questions (questions that have a set number of answers are also closed questions) 

such as, “How stressful is your life?” Possible responses could be: (a) not stressful, (b) a little 

stressful, (c) somewhat stressful, and (d) very stressful. If I asked this question to a group of 

soldiers stationed in Virginia, where there is no current military conflict, I could add up their 

answers and have a pretty good sense of how stressful their lives were. Then I could ask a group 

of soldiers stationed in the Middle East, where there is conflict, and I would be able to compare 

their answers with those of the soldiers in Virginia. We could guess that where there is military 

conflict, there might be more stress. Multiple-choice questions are helpful when asking general 

questions for larger groups of people. 

You can still make comparisons when you ask open-ended questions, but the type of information 

you gather with open-ended questions tells you more information about a certain subject. For 

example, I could ask the soldiers, “What causes you stress in your job?” Their answers would 

give me more depth (more information about one subject). But, it would be harder to ask a 

group of 300 soldiers in each place to tell me what causes their stress, and then to put together all 

of their answers in a simple fashion. We would have to take into consideration complex answers 

like, “missing home because they just had their first child; a particular supervisor doesn’t like 

them; the food is bad; they have allergies to a certain plant in the region.” These kinds of 

answers are very rich in telling us about their experiences, but it would be hard to say that most 

soldiers are stressed because of one reason. 

In summary, open-ended questions and closed questions have different purposes. During the key 

informant interview, you will ask mostly open-ended questions, because we are interested in 

detailed information about certain subjects from a few people. During the indepth interview, we 

are looking for detailed information about some subjects, but also simple categories of 

information on other subjects for comparison with larger numbers of people. So, for the openended questions you will take notes, and for the closed questions you will circle a choice. 

Use examples: Sometimes it can be helpful to use examples. The problem with giving examples 

right away is that once people hear the examples you read, they tend to pick one of those choices. 

If you don’t give them those examples, they are likely to answer their own way. For instance, if 

I ask you, “Whom do you generally go to when you feel sick? For example, the doctor or your 

mom.” The person may respond by saying the doctor when, in fact, they may actually tend to 

look up their illness in a book. But, because you gave them an example, they picked one of 

them. Psychologically, this is called “leading” (leading someone to a certain answer by 

persuasion). 

Examples are also helpful when the question is unclear to vague. For instance, I may ask, “What 

are some cultural practices to treat illness that you were raised with?” The person may wonder 

what you mean by cultural practices. You could clarify by saying, “For example, in the Chinese 

culture, some people see an herbalist. Are there things that people do in the Filipino culture to 

treat illness that are different from the American culture?” By giving an example, I can show the 

person what type of question I am asking, because somehow the question wasn’t clear. Again, 

use examples with caution because they can psychologically lead people to pick the examples 

you gave. 
29

Completing the Interview 

After asking the key informant if they have anything else they would like to add (take notes if 

they do have things to add), thank the person for their help and for their time. Give them the $20 

dollar stipend. Remind them that if they have any questions, they can call the number on the 

permission form, and someone will try to answer their questions. 
30

Indepth Interview Training Protocol 

1. Go over the purpose of the program and the scope of the study. 

2. Discuss the target population. 

3. Talk about the questionnaire. 

4. Talk about using a conversational interview style. 

5. Discuss reading most questions directly. Food questions accompany the calendar, which 

is filled in after the interview is over. 

6. Stress the importance of neat handwritten notes. 

7. Talk about the cultural and linguistic appropriateness of the questionnaires. 

8. Take a break. 

9. Practice role-playing the interview, following my example. Go over the following steps. 

a. Make an appointment 

b. Create a timeline. 

c. Find a location for the interview. 

d. Arrange for travel to the interview site. 

e. Confirm with the interviewee the day before the interview. 

f. Sign the permission form. 

g. Conduct the interview. 

h. Look at NHLBI materials. 

10. Give instructions on filling out the food questions. 

11. Find a partner with whom to practice. 

12. Discuss any further modifications or issues. 

13. Schedule a followup training if needed. 
31

Indepth Interview Training Handout 

Purpose 

To collect information about community health needs, knowledge, attitudes, behaviors, cultural 

beliefs and practices about having a healthy heart and preventing heart disease from four Asian 

American and Pacific Islander groups. These ethnic groups include Filipino, Vietnamese, 

Cambodian, and Native Hawaiian. The information obtained through active community 

participation will be used to guide the development of culturally and linguistically appropriate 

resources to increase the community's awareness of heart disease and encourage heart healthy 

behaviors. 

Who Should Be Invited to Participate in the Indepth Interviews? 

 Adults, aged 18 – 50 years 

 Females and males (equal numbers) 

 Immigrant and second-generation Filipino Americans (equal numbers) 

 High school education or less 

 Low-income individuals (divided equally between people with an annual household income 

of $5,000 to $15,000 and people with an annual household income of $15,001 to $35,000) 

Interview 10 people who fit the above criteria. The reason we ask for equal numbers of men and 

women and equal numbers in the education and income area is to get a variety of people and 

experiences. It may be difficult, however, to find participants that match all the criteria. 

The Indepth Interview 

This is called an indepth interview because you will be gathering detailed information about an 

individual’s life including: 

 Physical activity 

 Eating behaviors 

 Tobacco and alcohol use 

 Health history 

 Personal and demographic information 

 Health education 

 Community health services 

Please remember that you are having a real conversation with the person. Imagine you are really 

curious about a friend and you decide to find out as much as possible from him or her. It will be 

more fun for both you and the person being interviewed if you talk about the issues with genuine 

interest. 
32

You can read most of the questions out loud and circle or write down their response. The one 

section that is different is the food section. 

It is very important to write your notes neatly so that we can read them later. Please write your 

notes in English, or translate them afterward into English. 

Cultural and Language Appropriateness 

When we designed the questionnaire, we knew that the interviewers would have their own styles 

and also their own suggestions about how useful the questions are and whether they are 

culturally appropriate. We will go over the questionnaire (in English and in the native language) 

section by section and discuss it. If we agree upon modifications, we can hand-mark them on the 

forms. I’ll make multiple copies those ones with modifications. You will use these revised 

questionnaires when you do your interviews. 

Pre-Interview 

It is important to call people right away to schedule interviews. You can tell them that you 

would like to interview them to learn more about Filipino health and that they will receive $15 at 

the end of the interview. You can let them know that the interview should last about 1 hour and 

15 minutes. Tell them that their names will not be used, but the information they provide will 

help develop health promotion programs for Filipinos. 

Tell them when you are available, and see if they can interview during one of those times. 

Please schedule for 1.5 hours of their time, and let them know where the interview will be (e.g., 

at your CBO or at their house, if you are willing to travel). Make sure you have some time 

before and after the scheduled interview time, in case the person comes late or if the interview 

runs long. 

Confirm appointments: Call them the day before or the day of the interview to confirm they can 

still do the interview. It really helps to do this, so that they know when they are coming. If there 

is a problem, you can reschedule. 

At the Interview 

Thank them for coming to the interview. Tell them you will be interviewing them about health 

issues, but first you would like them to look at the permission form and sign it. Briefly describe 

the permission form. They can look at it as you talk. Give them time to read it themselves, and 

to ask you questions if they have any. If they agree, then they need to initial and sign the form, 

and you will also sign. You will keep one copy, and they will keep the other copy. 
33

Conducting the Indepth Interview 

It will be helpful to sit with the interviewee at a table or desk. Sit facing the interviewee, but be 

flexible to move so that he or she can see the form. He or she may, at times, want to see the 

questions themselves to jog his or her memory for answers. 

Section A—Physical Activity: These are simple questions. Be aware that many people are 

physically active, but they don’t think of it as physical activity because it’s not “exercise” or 

“sports.” For example, for many people, their paid work involves physical activity (e.g., 

custodians and janitors walk a lot; construction workers exert a lot of energy building; caretakers 

of young children chase children all day; housekeepers pick up and do physical cleaning). 

Similarly, people can also be active for nonpaid work (e.g., taking care of one’s own small 

children; doing lots of laundry; gardening; cooking and cleaning). Please make sure you ask 

about these kinds of activities in addition to the activities many people think of, such as 

basketball, swimming, Tai Chi, etc. 

Section B—Eating Behaviors: There are instructions for Section B on the form. We will go 

through those together. Basically, you are given two calendar sheets. On the first one, you will 

fill out information about what the interviewee ate the day of the interview (today), and the last 2 

days (yesterday and the day before). In your Section B instructions (page 53), you will see 

questions you can read aloud, and also a list of the types of foods to ask about. These are 

prompts, which are to help you and the person remember different categories of food as they tell 

you what they ate. 

We are very interested in the ethnic foods they eat, particularly from the Filipino culture. We are 

also interested in who generally cooks the food they eat (e.g., do they eat out most of the time, 

does the mom in the household do most of the cooking, etc.). After you take note of the foods 

they ate over the last 2 days (2-day data), then you can use the second calendar sheet to discuss a 

typical week for them. We are interested in asking them about a typical week because what they 

ate in the last 2 days may be unusual for them (e.g., perhaps they have been sick so they ate less 

than usual, or work has been busy so they have eaten a lot of fast food). Remember to use your 

prompts to cover “who cooks,” what types of ethnic foods, and categories of food such as fruits, 

fish, grains, etc. After you finish discussing a typical week (“typical week data”), return to page 

54 and resume asking questions B1 to B3. 

At the end of the whole interview, you will go to page 61, and fill out the answers to the food 

questions based on the “2-day data.” Please note we are not asking about alcoholic beverages on 

these charts. That is the next section. 

Section C—Tobacco and Alcohol Use: This section includes detailed questions about the 

person’s current behaviors and past history of using tobacco and drinking alcohol. Sometimes 

people are sensitive about talking about these areas. Try to reassure the interviewee that there 

are no right or wrong answers, and you are not judging them. Sometimes their pattern of using 

tobacco or drinking may not fit the categories we put on the form. If it does not, please write 

notes about quantity (how much), and also type of product (e.g.. whiskey, beer, red wine, white 

wine). This information is useful because different drinks have different levels of alcohol. 
34

Several questions ask about how the Filipino culture views tobacco and also about what tends to 

influence people to smoke. Please try to engage the interviewee in talking about his or her own 

views as well as whether those views come from their cultural heritage. Have ideas about 

tobacco changed in the Philippines since they came to the United States? Here is an opportunity 

to find out more about cultural norms (how certain cultures tend to do things). 

Section D—Health History: In this section, you will ask the interviewee about his or her 

personal and family history of heart problems. You will see many questions that are meant to 

find out how he or she views different health issues, like “what makes people sick?” and “how 

people can prevent or avoid getting sick?” You will ask about cultural perspectives on these 

topics. Similarly, it is important to find out what kind of health and medical services they use. 

As you know, people have many ways of treating illness besides going to a Western doctor or 

hospital. You will help us find out what those ways are, so we can better understand how people 

think about and treat their health. In this interview, we really want to find out how important 

people’s traditions and cultural practices can be in making decisions about their health. 

Section E—Personal Information: These questions are very straightforward. If none of the 

categories fit their answer, then just write down their answer on the form beside the categories. 

Section F—Health Education: Since this program is being sponsored by the National Heart, 

Lung, and Blood Institute (NHLBI), we would like you to ask questions about what kind of 

health education information they receive, and where and how often they get it. Their answers 

will help the NHLBI figure out where they should give out health education materials, and 

whether there should be translations into different languages. 

Section G—Community Health Services: Here we are interested in the person’s opinion and 

ideas about useful health information programs. The NHLBI would like to get ideas from 

community members about types of programs that people would like to see and where they 

would like to see them. Treat the person like the expert on what he or she would like to see 

happen, and how health professionals can effectively reach people in the community. 

The last questions involve showing the person some sample pamphlets that the NHLBI 

published. Ask them if they would like pamphlets like these to be developed for Filipinos, and 

what suggestions they would have for making useful education materials (e.g., translated into 

Tagalog, what types of pictures, cookbooks vs. factual information about heart health, etc.). 

Advice About the Interview Process 

Open-ended questions: Open-ended questions are questions that don’t have a yes/no or 

black/white/brown answer. An example of an open-ended question would be if I asked you, 

“What kind of fruits do you like?” The person can answer however they like, such as, “I like 

papaya, mango, and bananas.” They can also answer, “I don’t like fruit at all.” 

On the other hand, closed questions are useful when you are asking a lot of people the same 

questions. You want to give them choices, so that you can analyze what a large group of people 
35

said about something. For example, if I ask you, “Do you like apples or bananas better?” I have 

only given you two choices that are predetermined. You can say either apples or bananas. This 

is an example of a closed question. In the indepth interview questionnaire, there are many 

multiple-choice questions (questions that have a set number of answers are also closed questions) 

such as, “How stressful is your life?” Possible responses could be: (a) not stressful, (b) a little 

stressful, (c) somewhat stressful, and (d) very stressful. If I asked this question to a group of 

soldiers stationed in Virginia, where there is no current military conflict, I could add up their 

answers and have a pretty good sense of how stressful their lives were. Then I could ask a group 

of soldiers stationed in the Middle East, where there is conflict, and I would be able to compare 

their answers with those of the soldiers in Virginia. We could guess that where there is military 

conflict, there might be more stress. Multiple-choice questions are helpful when asking general 

questions for larger groups of people. 

You can still make comparisons when you ask open-ended questions, but the type of information 

you gather with open-ended questions tells you more information about a certain subject. For 

example, I could ask the soldiers, “What causes you stress in your job?” Their answers would 

give me more depth (more information about one subject). But, it would be harder to ask a 

group of 300 soldiers in each place to tell me what causes their stress, and then to put together all 

of their answers in a simple fashion. We would have to take into consideration complex answers 

like, “missing home because they just had their first child; a particular supervisor doesn’t like 

them; the food is bad; they have allergies to a certain plant in the region.” These kinds of 

answers are very rich in telling us about their experiences, but it would be hard to say that most 

soldiers are stressed because of one reason. 

In summary, open-ended questions and closed questions have different purposes. During the key 

informant interview, you will ask mostly open-ended questions, because we are interested in 

detailed information about certain subjects from a few people. During the indepth interview, we 

are looking for detailed information about some subjects, but also simple categories of 

information on other subjects for comparison with larger numbers of people. So, for the openended questions you will take notes, and for the closed questions you will circle a choice. 

Use examples: Sometimes it can be helpful to use examples. The problem with giving examples 

right away is that once people hear the examples you read, they tend to pick one of those choices. 

If you don’t give them those examples, they are likely to answer their own way. For instance, if 

I ask you, “Whom do you generally go to when you feel sick? For example, the doctor or your 

mom.” The person may respond by saying the doctor when, in fact, they may actually tend to 

look up their illness in a book. But, because you gave them an example, they picked one of 

them. Psychologically, this is called “leading” (leading someone to a certain answer by 

persuasion). 

Examples are also helpful when the question is unclear to vague. For instance, I may ask, “What 

are some cultural practices to treat illness that you were raised with?” The person may wonder 

what you mean by cultural practices. You could clarify by saying, “For example, in the Chinese 

culture, some people see an herbalist. Are there things that people do in the Filipino culture that 

people do to treat illness that are different from the American culture?” By giving an example, I 

can show the person what type of question I am asking, because somehow the question was not 
36

clear. Again, use examples with caution because they can psychologically lead people to pick 

the examples you gave. 

Completing the Interview 

After asking the interviewees if they have anything else they would like to add (take notes if they 

do have things to add), thank them for their help and for their time. Give them the $15 dollar 

stipend. Remind them that if they have any questions, they can call the number on the 

permission form and someone will try to answer their questions. 
37

APPENDIX B: Interview Guides 
38

Focus Group Guide 

Today’s Date: 

Time: 

Focus Group Location: 

Address: 

Community Organization Sponsor(s): 

Focus Group Facilitator: 

Focus Group Recorder: 

Sign-in Sheet 

Name Age Sex Ethnicity ZIP code Organization 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 
39

I. Introduction 

 Greetings and thank you for coming. This focus group is to assist us in understanding our 

community’s ideas, attitudes, and practices about heart health, general wellness, and 

preventive health. This includes the various health and community resources available to 

you and other community residents. 

 This community assessment is being conducted in conjunction with the [insert name of local 

organization(s)] and the Asian & Pacific Islander American Health Forum. This project is 

funded by the National Heart, Lung, and Blood Institute in an effort to develop effective 

messages and programs to promote heart health in the [insert name] community. Your 

participation is very important because YOU know your own community best. There are no 

right or wrong answers to any of the questions. Feel free to express your ideas, opinions, or 

experiences. 

 As you may have noticed, there is a tape recorder in the middle of the table. We hope that 

having a tape recorder will not make you feel uncomfortable. We want to make sure we 

capture all your ideas and that we do not miss any of the valuable information the group may 

offer. The tape recorder ensures this. There will also be a recorder who will be writing your 

response on the flip chart to make sure that we capture what you are saying correctly. 

 Please be assured that your individual comments here today are confidential in the sense that 

we will not identify by name anyone’s statements. We would like you to sign a permission 

form to ensure your confidentiality and to affirm your voluntary participation in this 

discussion. 

 Let’s go through the permission form. [Pass out permission form to participants and go over 

entire form.] 

 Before beginning, does anyone have any questions or comments? 

II. Attitudes About Heart Disease 

Let’s start our discussion. 

A. Cultural Meaning of Prevention 

1. What does good health mean to you? Are there any folktales, sayings, or symbols 

about health in general in your culture? 

2. What does the word “prevention” mean in your culture? 

3. What does being ill or sick mean to you? Are there any folktales, sayings, or symbols 

about illness or disease in general in your culture? 
40

B. Community Health Concerns 

What do you feel are the top health problems (or diseases/sicknesses) in the [insert name] 

community? (e.g., diabetes, cancer) [Use flipchart to list responses. Then ask the group 

to rank the top five health concerns they have identified.] 

C. Heart Disease 

Now let’s talk more about heart disease (i.e., heart attack, high blood pressure, stroke, or 

stress) and factors that increase a person’s chances of getting heart disease. 

1. If heart disease was mentioned and ranked, ask: Why did you rank heart disease 

where you did? How concerned are people in the [insert name] community about 

heart disease compared to what you’ve just listed? [If heart disease was not 

ranked, then ask: How about heart disease? Compared to the problems you 

mentioned and ranked, how important is heart disease in your community?]

2. How do people in the community think they develop heart disease? [Probe: What 

are the causes of heart disease?]

3. Do you know someone who has heart disease? 

4. What are some of the things people can do to prevent heart disease? 

5. In Filipino culture, how do people take care of the heart? What does the heart 

symbolize in Filipino culture? Are there any folktales or sayings about the heart 

health in your culture? 

I am going to ask you some questions about three different topics: high blood pressure, 

blood cholesterol, and obesity. I will ask you the same questions for each topic. Please 

do not feel like you have to be an expert on these things. I am asking to get a sense of 

what you think. 

D. High Blood Pressure 

1. What do people think high blood pressure is? [Probe for words used to describe or 

refer to high blood pressure, such as stress.] 

2. How does high blood pressure affect your health? 

3. What should people do if they have high blood pressure? 

4. What keeps people from controlling their high blood pressure? 

5. What would help people control their high blood pressure? 

6. How realistic is it for people in the community to keep their blood pressure under 

control? 
41

E. Cholesterol 

1. What does cholesterol mean in [insert name] culture? Where does cholesterol come 

from? 

2. How does cholesterol affect your health? 

3. What can people do to lower their blood cholesterol? 

4. What keeps them from lowering their cholesterol? 

5. What would help people lower their cholesterol? 

6. How realistic is it for people in the community to lower their cholesterol? 

F. Overweight and Obesity 

1. What does being overweight mean in our culture? Are there any perceived 

 differences for men and women? Do you think people in the Filipino culture view 

 weight differently depending on the age of a person? [Probe if it is okay for an 

 older woman to be overweight, vs. a young woman.] 

2. How does being overweight weight affect your health? 

3. Do you know anyone who is overweight? 

4. What keeps people from losing weight? 

5. What would help people lose weight? 

6. How realistic is it for people in the community to maintain a healthy weight? 

G. Tobacco Smoking 

1. How does the Filipino community view tobacco smoking? How does tobacco 

smoking affect your health? In what way? 

2. How realistic is it for people in the community to quit smoking? 

H. Diet 

1. What kinds of food do you like to eat? What kinds of food do you like to prepare for 

you and your family at home? 

2. Do you cook anything different for special celebrations? 

3. How often do you eat out? What types of food do you eat when you eat out? 

4. Do you think that the kinds of food you eat can affect your heart? How? 

5. What makes it hard for people to eat foods low in salt? 

6. What would help people to eat food low in salt? 

7. How realistic is it for people in the community to eat foods low in salt? 
42

I. Physical Activity and Exercise Patterns 

1. When you look around the [insert name] community here in [insert name of city or 

town], how physically active are the people in the community? 

2. What types of physical activities or exercise do people do for fun? What types of 

physical activities or exercise do people do on their own (e.g., morning walks, 

running)? What types of physical activities or exercise do people do as a group (e.g., 

join sports leagues, take exercise classes, work in a community garden, or take 

morning walks with friends)? 

3. What types of physical activities or exercise do people do at home (e.g., gardening, 

lawn mowing, cleaning)? What types of physical activities or exercise do people do 

at work (e.g., walking clubs)? 

4. What types of physical activities or exercise do people in your community tend to 

prefer? 

5. Why do you think people are not active? 

6. What would help people become more active? 

7. Use a flip chart to list the reasons that makes it difficult for people to be physically 

active and ways to solve or overcome those difficulties. 

8. How realistic is it for people in the community to exercise 30 minutes on most days 

of the week? 

III. Health Care Options, Access, and Services 

1. When people in the community get sick, what do people tend to do? 

2. Who do they go to “see” first? [Probe for use of self-treatment, such as taking herbs, 

over the counter medicine.]

3. What do people expect from the person they first go see? 

4. Do people in the community go for “regular” health checkups? If so, where do people in 

the community go for “regular” health checkups? [Probe: What other things do people 

do regularly or routinely to maintain their health and well-being, e.g., talk to clergy, do 

acupuncture?]

5. What health care services are available in the community or neighborhoods? [Probe: 

Are there other health care services people use in the community? Probe for use of nonWestern health care services, e.g., traditional healers, herbalists.]

6. What are some of the reasons that make it difficult for people in the community to 

receive health care services? [Use flip chart to record responses. Probe for language, 

transportation, race/culture, insurance, trust.]

7. Using the flip chart as reference, ask: What would encourage people to use existing 

health care services in the community? 

8. What kinds of heart health education programs and activities do you think could be 

developed in the community that would reduce the risk for heart disease? What should 

these programs include? [Probe: What kinds of activities or programs would encourage 

people to do things that would lower their blood pressure? What kinds of activities of 
43

program would encourage people to exercise more? To eat food with less fat? To eat 

food with less salt? To maintain a healthy weight?]

IV. Sources of Health Information and Languages 

1. Where do people in your community get information about health? [Use the flip chart to 

make a list of sources of health information. If not mentioned, ask if they use the Internet 

to find information about health.] 

2. How useful or effective are these materials in educating the [insert name] community 

about heart health issues? 

3. Would people receive the information on issues not related to health from the same 

sources (e.g., community issues such as census participation, immigration, and 

community events)? 

4. We would like to ask you about any information you receive on heart health or 

prevention of heart disease, such as brochures, television ads, radio ads, etc. 

5. What information format is most appealing to the [insert name] community (e.g., 

brochures, television ads, radio ads, videotapes, audiotapes, interviews, etc.)? 

6. What languages or dialects do most people in the Filipino community in [insert name of 

city or town] speak? Which ones do you think are the best languages or dialects for 

getting information to community residents? 

7. Who should deliver health messages to the community? [Probe for credible 

spokespeople in the community.]

8. What activities do people in your community participate in local ethnic group 

organizations? What about churches? What about ethnic celebrations or events? 

Followup: Which organizations? Which churches? Which ethnic celebrations or 

events? 

Followup: Why do you think people like to participate that organization? Why 

do you think people like to participate in that church (or those churches)? Why 

do you think people like to participate in that celebration or event? 

V. Reactions to Selected Health Education Materials 

Now we would like to get your reactions to a few health education materials. Your input will 

help us develop [insert desired word]-specific materials. We want your impressions of these 

materials. We are not asking you to read the material at this time. 

Show the materials and give them a few seconds to look at it. Then ask the group, what do you 

like the best and why? What do you like the least and why? 
44

VI. Closing 

 We are now finished with the discussion. Before we leave, does anyone have other 

responses or comments about the information discussed today? 

 Once again, I want to reassure you that everything you said here is today is strictly 

confidential and anonymous. Your names will not be connected to the information given 

today. 

 Thank you for coming. The information that you have provided is very important. You have 

been very helpful to us. 
45

Key Informant Interview Guide 

Today’s Date: 

Time: 

Interview Location: 

Address: 

Community Organization Sponsor(s): 

Interviewer: 
46

I. Introduction 

 Thank you for coming. Because you have been identified as a leader in the [insert name] 

community, we hope you will assist us in understanding your community’s ideas, attitudes 

and practices about heart health, wellness, and preventive health. This includes the various 

health and community resources available to you and other community residents. 

 

 This community assessment is being conducted in conjunction with the [insert name] 

community organization and the Asian & Pacific Islander American Health Forum. This 

project is funded by the National Heart, Lung, and Blood Institute in an effort to develop 

effective messages and programs to promote wellness and heart health in the Filipino 

community. Your participation is very important because YOU have an in depth knowledge 

and insight into your community. 

 Please be assured that your individual comments here today are confidential in the sense that 

we will not identify by name your statements. We would like you to sign a permission form 

to ensure your confidentiality and to affirm your voluntary participation in this discussion. 

 Let’s go through the permission form. [Give copy of permission form and go through the 

entire form.] 

 Before beginning, do you have any questions or comments? 

II. Respondent Demographic Information 

Age: 

Sex: 

Ethnicity: 

Birth country: 

Native language: 

Citizenship, which country? 

Years in the United States? 

What is your role in the community (both formal and informal)? 

With what organizations or institutions are you affiliated? 

III. Community Context and Sources of Information 

1. To begin, can you describe the [insert name] community in [insert name]? 

 

[Probe: Are most of the [insert name] in this community long-term residents?] 

[Probe: Would you consider it a youthful or an elderly community?] 
47

2. What languages or dialects do most people in the community speak, and which ones do you 

think are the most effective for getting information to community residents? 

3. How active are most people in the community in local ethnic group organizations, churches, 

and ethnic celebrations or events? 

Followup: Which organizations, churches, and ethnic celebrations or events do people 

like to go to? 

Followup: Why do you think people like to go to those organizations, churches, or ethnic 

celebration or events? 

4. How do people in your community get information about health? [Check all sources that 

participants identify.]

 Family, especially those family members in the health care professions 

 Friends, especially those friends in the health care professions 

 Ethnic radio 

 Local English radio 

 Ethnic newspaper (English and Asian language) 

 Local English newspaper 

 Ethnic television 

 Local English television 

 Community organization newsletter 

 Flyers—community outreach materials 

 Brochures and educational materials in (Western) doctor’s offices, HMO, or other 

health care provider 

 Information from “cultural or traditional” healers (e.g., acupuncturist) 

5. What information format is most appealing to the [insert name] community (e.g., brochures, 

television ads, radio ads, videotapes, audiotapes)? 

6. What can you tell us about the network of ethnic community organizations and services in 

[insert name of city or town]? Are they well-integrated? Are there overlaps in services or 

efforts by the community organizations? 

7. What do you see as the greatest assets of [insert name of city or town]? What do you see as 

some of the important needs? 

IV. Attitudes About Heart Disease, Community Health, and Wellness 

A. Cultural Meaning of Prevention 

1. What does good health mean to you? Are there any folktales, sayings, or symbols about 

health in general in your culture? 

2. What does the word “prevention” mean in your culture? 

3. What does being ill or sick mean to you? Are there any folktales, sayings or symbols 

about illness or disease in general in your culture? 
48

B. Community Health Concerns 

1. What do you feel are the greatest threats to health and wellness in your community? 

2. What do you feel are the top five health problems (or diseases/sicknesses) in the 

community (e.g., diabetes, cancer)? For whom? 

C. Heart Disease

Now let’s talk about heart disease (i.e. heart attack, high blood pressure, stroke, or stress) and 

the factors that increase a person’s chances of getting heart disease. 

1. If mentioned and ranked ask, “Why did you rank heart disease where you did?” If not, 

then ask, “How about heart disease? Compared to the problems you mentioned and rank, 

how important is heart disease in your community?” 

2. What is the top concern related to cardiovascular health or heart disease? 

3. How do people in the community think are the causes of heart disease? 

4. Do you know someone who has heart disease? 

5. What are some of the things people can do to prevent heart disease? 

6. In [insert name] culture, what do people do to take care of their heart? What does the 

heart symbolize in [insert name] culture? Are there any folktales or sayings about the 

heart health in your culture? 

I am going to ask you some questions about three different topics: high blood pressure, 

cholesterol, and obesity. There will be the same questions for each topic. Please do not feel like 

you have to be an expert on these things. I am asking just to get a sense of what you think with 

regard to the community. 

D. High Blood Pressure 

1. What do people think high blood pressure is? [Probe for words used to describe or refer 

to high blood pressure, such as stress.] 

2. How does high blood pressure affect health? 

3. What keeps people from controlling their high blood pressure? 

4. What would help people control their high blood pressure? 

5. How realistic is it for people in the community to keep their blood pressure under 

control? 

E. Cholesterol 

1. What does cholesterol mean in our culture? Where does cholesterol comes from? 

2. How does cholesterol affect health? 

3. What can people do to lower their blood cholesterol? 

4. What keeps from lowering their cholesterol? 
49

5. What would help people lower their cholesterol? 

6. How realistic is it for people in the community to lower their cholesterol? 

F. Overweight and Obesity 

1. What does being overweight mean in our culture? Are there any perceived differences 

for men and women? Do you think people in the Filipino culture view weight differently 

depending on the age of a person? [Probe: Is it okay for an older woman to be 

overweight, vs. a younger woman?]

2. How does being overweight weight affect health? 

3. Do you know anyone who is overweight? 

4. What keeps people from losing weight? 

5. What would help people lose weight? 

6. How realistic is it for people in the community to maintain a healthy weight? 

G. Smoking 

1. How does the Filipino community view tobacco smoking? How does tobacco smoking 

affect your health? In what way? 

2. How realistic is it for people in the community to quit smoking? 

H. Diet 

1. What kinds of food do Filipinos most often eat for special holidays, family gatherings, or 

celebrations? 

2. Do people in the [insert name] community tend to eat differently or similar to the way 

they ate in the Philippines? Please explain. Are the styles of eating in the United States 

more or less healthy than the old ways? In what way? 

I. Physical Activity and Exercise Patterns

1. When you look around the Filipino community here in [insert name of city or town], how 

physically active are the people in the community? 

2. What types of physical activities or exercise do people do for fun? What types of physical 

activities or exercise do people do on their own (e.g., morning walks, running)? What 

types of physical activities or exercise do people do as a group (e.g., join sports leagues, 

take exercise classes, work in a community garden, or take morning walks with friends)? 

3. What types of physical activities or exercise do people do at home (e.g., gardening, lawn 

mowing, cleaning)? What types of physical activities or exercise do people do at work 

(e.g., walking clubs)? 

a. Why do you think some people are not active? 

b. What would help people become more active? 
50

4. How realistic is it for people in the community to exercise 30 minutes on most days of 

the week? 

V. Health Care Options, Access, and Services 

1. When people in the community get sick what do people tend to do? 

2. Who do they go to “see” first? [Probe for use of self-treatment, such as taking herbs, overthe-counter medicine, medicine from the (insert name) culture.]

3. What do people expect from the person they first go see? 

4. Do people in the community go for “regular” health checkups? If so, where do people in the 

community go for “regular” health checkups? 

5. What other things people do regularly or routinely to maintain their health and well-being? 

(e.g., clergy, acupuncture, etc.) 

6. What health care services are available in your community or neighborhood? 

7. Are there other health care services people use in the community? [Probe for use of nonWestern health care services, e.g., traditional healers, herbalists, etc.]

8. What proportion of the community uses “Western” medicine and health care services? What 

are the alternative health care services you see people use? 

9. Who or what types of organizations are seen as having credibility in providing health care 

education and/or services? 

10. What are some of the factors that make it difficult for folks in the [insert name] community 

to receive health care services (e.g., language, transportation, race/culture, insurance, trust)? 

11. What would encourage people to use existing health care services in the community? 

12. If not addressed, ask: Do most folks in your community have “health insurance?” If not, 

why do you think that is (e.g., cost, not important, not available)? 

13. For heart disease in particular, what kinds of activities do you think could be developed in 

the community that would reduce the risk for heart disease? What are the elements it should 

have? [Probe: What kinds of activities or programs would encourage people to do things 

that would lower their blood pressure? What kinds of activities or programs would 

encourage people to exercise more? To eat foods with less fat? To eat foods with less salt? 

To maintain a healthy weight?]

VI. Heart Health Prevention and Intervention Materials 

Now we would like to get your reactions to the a few health education materials. Your input will 

help us develop specific materials for your community. We want your impressions of these 

materials. We are not asking you to read the materials at this time. 

What do you like the best and why? What do you like the least and why? 
51

VII. Closing 

 We are now finished with the discussion. Before we leave, do you have other responses or 

comments about the information discussed today? 

 Once again, I want to reassure you that everything you said here is today is strictly 

confidential and anonymous. Your name will not be connected to the information given 

today. 

 Thank you for coming. The information that you have provided is very important. You have 

been very helpful to us. 
52

Indepth Interview Guide 

Six areas are explored: 

Section A: Physical Activity 

Section B: Eating Behaviors 

Section C: Tobacco and Alcohol Use and Exposure 

Section D: Health History 

Section E: Personal and Demographic Information 

Section F: Health Education 

Section G: Community Health Services 

Note: This will be administered by a trained interviewer in an interactive discussion. 

Each community-based organization will identify and interview ten participants. 

Date: 

Time: 

Location: 

Interviewer: 

Respondent Demographic Information 

Age: 

Sex: 

Ethnicity: 

Birth country: 

Native language: 

Nationality: 

Years in the United States: 

Number of adults in the household (including self): 

Number of children in the household: 
53

Section A: Physical Activity 

A1. How important is getting daily physical activity for you? 

1. Not important 

2. Somewhat important 

3. Very important 

9. N/A 

A2. During the last month, did you participate in any physical activities such as walking, 

hiking, basketball, volleyball, swimming, gardening, etc.? 

0. No 

1. Yes (If yes, answer the next 5 questions) 

A2a. Please tell me the type(s) of physical activities that you did. 

A2b. Of these physical activities you just told me about, which is the one you do the most? 

A2c. Which is/are your favorite activities? 

A2d. Are any of your activities in leagues, classes (recreation or school), or some other formal 

 clubs? 

A2e. Which of these activities are with friends, relatives, etc.? 

A2f. Are you physically active at home or at work (e.g., carrying laundry, walking up stairs, 

 physical labor for work like walking, lifting, building)? 

A3. What motivates you or would motivate you to be physically active? 

A4. What makes it hard for you to be physically active? 

A5. How are physical or recreational activities viewed within the [insert name] culture? Are 

these activities different or similar from [insert name of country] to here in the United 

States? 

Section B: Eating Behaviors 

Interviewer Instructions: 

Please pull out calendar sheets (will be supplied). Explain that you will be going over the 

calendar with them to ask them some questions about diet and other behaviors. Sit side-by-side, 

if possible. 

You may wish to state: “Now I’m going to ask you some questions about the foods you eat. I 

find it’s easiest to talk about it if we look at a calendar together, and just talk about the typical 

foods you generally have. Is that okay? Thanks. First I’m going to ask you what you ate the 

last few days, including today. It may seem a little strange, but it will give us a clear 

understanding of your diet for a few days. Please tell me how typical the last 2 days were in 

terms of your regular eating habits.” 

Interviewer will ask the interviewee what they ate today, yesterday (morning, mid-day, evening, 

night), and the last 2 days, including today. As the interviewer writes down the foods on the 

calendar, they check with the participant as to the accuracy of the information. After the 2 days 
54

on the calendar are filled out, the interviewer asks general questions, marking down information 

on the following topics with as much specificity as the interviewee can give. Use the two 

calendar sheets we’ll give you. 

Ask: Who cooks the food you generally eat? 

 [Insert name] ethnic foods (what kind) 

 Grains (types, frequency) 

 Red meat (look for type of preparation—deep fried, pan-fried, steamed—how fatty?) 

 Chicken (look for type of preparation—deep fried, pan-fried, steamed—how fatty?) 

 Fish (look for type of preparation—deep fried, pan-fried, steamed—how fatty?) 

 Soy products (look for type of preparation—deep fried, pan-fried, steamed—how 

fatty?) 

 Dairy (milk, eggs—how prepared? how fatty, how lean?) 

 Vegetables (type and preparation) 

 Fruit (type) 

 Sweets (candies, cakes, other) 

Interviewer states: “Try to answer for a typical week.” 

Interviewer can use lines or arrows to indicate a certain food throughout the week. This will be 

elaborated upon in training. Note that the interviewer will fill in the answers to food questions 

at end of the interview with or without the participant, depending on the time. This is based on 

the 2-day data. 

After filling in the information from above onto the calendar sheets, ask: 

B1. How important is it to have a lowfat diet? 

1. Not important 

2. Somewhat important 

3. Very important 

9. N/A 

B2. Can you name some of the traditional ingredients you put in your food? Name them in 

your native language. If you could not buy these traditional ingredients, what types of 

“American” ingredients would you use as a substitute? 

B3. How has living in the United States affected how you eat? Is it more or less healthy? 

Please be specific. 

Section C: Tobacco and Alcohol Use 

C1. Do you smoke cigarettes, cigars, or pipes or chew tobacco? Please specify. 

0. No 

1. Yes (If yes, answer the next 4 questions) 

9. N/A 
55

C2. If you smoke, how long have you been smoking? 

C3. If you smoke, how often do you smoke? 

0. Rarely, on special social occasions (How many cigarettes/cigars at an event?) 

1. Occasionally, about once a month (How many cigarettes/cigars on each 

occasion?) 

2. Regularly, several times a week 

3. Daily 

9. N/A 

C4. On average, about how many cigarettes do you smoke each day? 

1. 1 – 4 cigarettes 

2. 5 – 8 cigarettes 

3. 9 – 12 cigarettes (about half a pack) 

4. 12 – 16 cigarettes 

5. 17 – 20 cigarettes (about a pack) 

6. 20 – 40 cigarettes 

7. 40+ cigarettes (2 packs) 

9. N/A 

C5. When you are at home, where do you primarily smoke? 

 1. Inside the house 

 2. Outside the house 

 3. Other 

 9. N/A 

C6. Did you ever smoke? 

0. No 

1. Yes 

9. N/A 

C7. If yes, how long ago did you stop smoking? What method/methods did you use to quit 

smoking? (If they have smoked off and on, please describe pattern of quitting and starting 

again.)

C8. How long did you smoke? How much did you smoke daily when you used to smoke? 

C9. Who exposes you to tobacco smoke? (Check all that apply.) 

 Family 

 Friends 

 Coworker/students 

 Clients/customers 

 Strangers 

 Others (specify) 

C10. How do you think tobacco affects your health? 

C11. How do you feel tobacco smoking is viewed in the [insert name] community here in 

[insert name of city or town]? 

C12. How is using tobacco viewed in the [insert country of origin]? Do those attitudes affect 

how you or others in the [insert name] community think about tobacco or smoking? 

C13. What do you think influences [insert ethnicity] men or women, and kids to use tobacco? 

(e.g., certain situations like social gatherings, magazine ads, movies, and cultural norms) 
56

C14. Do you drink alcohol? 

0. No (If No, then skip to section D) 

1. Yes 

9. N/A 

C15. How often do you drink alcohol? 

0. Never 

1. Rarely, special social occasions (What kind of occasions?) 

2. Occasionally, about once a month 

3. Once per week 

4. Regularly, several times a week 

5. Daily 

9. N/A 

C16. When you drink alcohol, what do you tend to drink? How much? 

Section D: Health History 

D1. How tall are you? 

D2. How much do you weigh? 

D3. Do any of your family members have heart disease? 

0. No 

1. Yes 

9. N/A 

D4. Has a doctor ever told you that you have any of the following? (Check all that apply.) 

 Diabetes 

 Hypertension (high blood pressure) 

 High cholesterol (How many times?)

 Heart attack 

 Stroke 

IF YES TO D3 OR D4, THEN ANSWER THE NEXT 4 QUESTIONS: 

D5. Do you have heart disease? How did you or your family member find out about having 

heart disease? 

D6. How do you think you/your family member developed or got heart disease? 

D7. What do you do to on a daily basis to take care of your heart? Has this resulted in any 

changes in your family? [Probe for cultural methods of taking care of the heart.]

D8a – f. 

Confident Somewhat 

confident 

Not 

confident 

How confident are you that you can control your high 

blood pressure? 

 

How confident are you that you can lower your 

cholesterol? 

 

How confident are you that you can eat five servings of 

fruits and vegetables? 

 
57

Confident Somewhat 

confident 

Not 

confident 

How confident are you that you eat food low is saturated 

fat and salt? 

 

How confident are you that you can exercise 30 minutes 

on most days of the week? 

 

How confident are you that you can maintain a healthy 

weight? 

 

D9. What does the heart symbolize in your culture? 

D10. Are you on a special diet (low fat or low salt) ordered by a doctor? Do you follow it? Why 

or why not? 

0. No 

 1. Yes 

 9. N/A 

D11. Can you share some [insert name] cultural perspectives on the following topics? Any 

differences for men or women? 

 Causes of bad health or illness 

 Prevention of illness 

 Overweight (chubbiness) and obesity 

 High blood pressure 

 High blood cholesterol 

 Physical activity 

D12. How do you view “Western medications”? [Probe for cultural attitudes regarding use of 

“Western medications.”]

D13. Do you try to treat yourself when you are sick? 

0. No 

1. Yes (If yes, move on to D14) 

9. N/A 

D14. What do you use to treat yourself when you are sick? (Ask about herbal medications, 

whether they take medications from friends.) 

D15. Do you use traditional healers (e.g., acupuncturist, herbalist)? 

D16. Who do you generally go to (if anyone) when you get sick? When (and for what) would 

you go to a Western doctor? 

D17. Do you go to someone regularly for health check-ups? [Followup: Whom do you go for 

regular health check-ups?] 

D18. Are there are any other things that you do on a regular basis to maintain your health and 

well-being? (e.g., massage, clergy, acupuncturist). Why or why not? 

D19. How stressful is your life? 

1. Not stressful 

2. Somewhat stressful 

3. Very stressful 

9. N/A 

D20. What causes you stress? 

D21. What are of some of things you do to relieve stress?

D22. How important is it for you to do stress relieving activities? 

1. Not important 
58

2. Somewhat important 

3. Very important 

9. N/A 

Section E: Personal information 

E1. How long have you lived in your current community (number of years)? 

E2. How many years of education do you and your spouse/partner have? 

 Self Spouse 

0. None  

1. 1 – 8 years  

2. 9 – 12 years  

3. Tech/prof  

4. Community college  

5. 4-year college  

6. Post-bachelor’s degree  

9. N/A  

E3. What kind of work do you do? 

1. Professional/Managerial 

2. Technical 

3. Sales 

4. Administrative support (e.g., clerical, secretarial) 

5. Service 

6. Industrial 

7. Homemaker 

8. Unemployed 

9. Own a business 

10. Other (specify) 

E3a. How many hours do you spend working for pay? 

E3b. How many jobs do you have for pay? 

E4. What was your annual household income last year? (All wage earners in the household) 

1. < $5,000 

2. < $10,000 

3. < $20,000 

4. < $40,000 

5. < $60,000 

6. < $80,000 

7. < $100,000 

8. < $120,000 

9. > $120,000+ 

99. N/A 

E5. Who in your household speaks [insert ethnic language]? (Check all that apply.) 

 Children (preteens) 

 Youth (teens) 
59

 Adults 18 – 30 

 Adults 30 – 45 

 Adults 45 – 60 

 Elders 61+ 

E6. Who in your household speaks English? (Check all that apply. Mark N/A if not 

applicable.) 

 Children (preteens) 

 Youth (teens) 

 Adults 18 – 30 

 Adults 30 – 45 

 Adults 45 – 60 

 Elders 61+ 

 N/A 

E7. Are you or anyone in your household involved in or a member of an ethnic 

organization/association? 

0. No 

1. Yes 

9. N/A 

E12. Do you have health insurance? If yes, with whom? 

0. No 

1. Yes 

9. N/A 

Section F: Health Education 

F1. When you need medical advice or information, which do you usually ask (or go to)? 

F2. Where do you get health information? 

F3. How important is it to have regular community health fairs in your neighborhood? 

1. Not important 

2. Somewhat important 

3. Very important 

9. N/A 

F4. Have you ever attended a community health fair? [Probe for how often people in the 

community attend such fairs.]

0. No 

1. Yes 

9. N/A 

F5. How important is it to have brochures, pamphlets, videos, and audiotapes in your native 

language? 

1. Not important 

2. Somewhat important 

3. Very important 

9. N/A 
60

F6. How important is it to have health education programs in your native language? 

1. Not important 

2. Somewhat important 

3. Very important 

9. N/A 

F7. How often do you read or learn about health education information: 

0. Rarely 

1. When something is wrong with a friend or relative 

2. When something is wrong with me 

3. For general knowledge and awareness 

9. N/A 

Section G: Community Health Services 

G1. Has your doctor/medical plan recommended that you have any of the following? (Check 

all that apply.) 

 Cholesterol check 

 Blood pressure check 

 Blood sugar test 

 Electrocardiogram, etc. 

 Other 

G2. What are some of the problems you have in getting medical help or health services? 

G3. Now, I’d like to ask you about the services in the [insert name] community. What kinds of 

services are available for people to live healthier lives [insert name] community? 

G4. Which of them are used most often? Why? 

G5. What kind of community services would help you maintain a healthy diet? To be 

physically active and exercise regularly? 

G7. What do you think is the best way to provide information and education about heart health 

to people in your community? 

G8. Do you receive health information from the following? 

 Most 

Often 

Sometimes Rarely Never 

1 Friends and/or family 

2 Providers 

3 Radio 

4 TV 

5 Local English paper 

6 Native-language newspaper or 

magazines 

 

7 Flyers, community outreach materials 

8 Brochures, educational materials in 

doctor’s office, etc. 

 
61

G9. We’re almost through with the interview. Is there anything else you would like to add? 

G10. We’d like to ask you to look at these pamphlets and tell us if you think it would be useful to 

have something like it in your native language. (Show pamphlets and write comments in 

the space below.) 

Interviewer: Please don’t forget to fill in the food questions at the end of this interview. 

AFTER the interview is completed, the interviewer circles the answer on the codes below. 

B4. About how many times was [insert ethnicity] food a large part of any of the meals you ate 

in the past 2 days? 

0. None 

1. 1 – 2 meals 

2. 3 – 4 meals 

3. 5 – 6 meals 

4. 7+ 

9. N/A 

B5. About how many times was red meat a large part of any of the meals you ate in the past 2 

days? 

0. None 

1. 1 – 2 meals 

2. 3 – 4 meals 

3. 5 – 6 meals 

4. 7+ meals 

9. N/A 

B6. Generally speaking was the red meat... 

1. Extra lean 

2. Lean 

3. “Regular” 

9. N/A 

B7. About how many times was chicken large part of any of the meals you ate in the past 2 

days? 

 0. None 

1. 1 – 2 meals 

2. 3 – 4 meals 

3. 5 – 6 meals 

4. 7+ meals 

9. N/A 

B8. Generally speaking was the chicken... 

1. Skinless 

2. With skin 

9. N/A 
62

B9. About how many times was fish a large part of any of the meals you ate in the past 2 days? 

0. None 

1. 1 – 2 meals 

2. 3 – 4 meals 

3. 5 – 6 meals 

4. 7+ meals 

9. N/A 

B10. About how many times was a vegetable protein (tofu, beans, soy product) a large part of 

any of the meals you ate in the past 2 days? 

0. None 

1. 1 – 2 meals 

2. 3 – 4 meals 

3. 5 – 6 meals 

4. 7+ meals 

9. N/A 

B11. About how many times were dairy products a large part of any of the meals you ate in the 

past 2 days? 

0. None 

1. 1 – 2 meals 

2. 3 – 4 meals 

3. 5 – 6 meals 

4. 7+ meals 

9. N/A 

B12. Generally speaking, are the dairy products you use... 

1. Fat free (i.e., skim milk) 

2. Low fat (i.e., 2% fat milk) 

3. Full fat (i.e., whole milk) 

9. N/A 

B13. About how many times were eggs a large part of any of the meals you ate in the past 2 

days? 

0. None 

1. 1 – 2 meals 

2. 3 – 4 meals 

3. 5 – 6 meals 

4. 7+ meals 

9. N/A 

B14. About how many servings of vegetables did you eat as a part of your meals in the past 2 

days? 

0. None 

1. 1 – 2 servings 

2. 3 – 4 servings 

3. 5 – 6 servings 

4. 7+ servings 

9. N/A 
63

B15. Generally speaking were the vegetables... 

1. Dried 

2. Canned/jar 

3. Fresh 

9. N/A 

B16. What types of vegetables do you eat (e.g., green beans, carrots, beets)? 

B17. About how many servings of fruit did you eat in the past 2 days? 

1. 1 – 2 servings 

2. 3 – 4 servings 

3. 5 – 6 servings 

4. 7+ servings 

9. N/A 

B18. Generally speaking was the fruit... 

1. Dried 

2. Canned/jar 

3. Fresh 

9. N/A 

B19. What type of fruits do you eat (e.g., bananas, apples)? 

B20. Generally speaking who prepares the foods you eat? 

1. Self 

2. Other, in the same household 

3. Other, not restaurant 

4. Restaurant 

5. N/A 

B21. Generally speaking, when you eat red meat, chicken, fish, and vegetables, are they prepared 

as part of [insert ethnicity] food meal? 

0. No 

1. Yes 

2. N/A 

B22. What are your favorite snack foods (e.g., candy, chips, cookies, cake, fruit)? 

B23. About how many snacks do they eat each day? 

0. None 

1. 1 – 2 snacks 

2. 3 – 4 snacks 

3. 5+ snacks 

 9. N/A 
64

Meal calendar 

Two Days Before Today Day Before 

Breakfast Breakfast Breakfast 

Lunch Lunch Lunch 

Dinner Dinner Dinner 

Snacks Snacks Snacks 

Prompts: Who prepared the food (yourself, microwave, restaurant [McDonalds, Denny’s, Mr. 

Chau’s, Black Angus])? How was it prepared (e.g., skinless, lean, fatty, fried, baked, dried, 

canned)? Are these types of foods eaten often (e.g., two eggs and three pieces of bacon every 

day)? 

Checklist: drinks, dairy, protein (red meat, chicken, fish, vegetable protein [tofu, beans, soy 

products]), vegetables, fruit, ethnic food, snacks 

Weekly meal calendar

Sunday Monday Tuesday Wednesday Thursday Friday Saturday 

Breakfast Breakfast Breakfast Breakfast Breakfast Breakfast Breakfast 

Lunch Lunch Lunch Lunch Lunch Lunch Lunch 

Dinner Dinner Dinner Dinner Dinner Dinner Dinner 

Snacks Snacks Snacks Snacks Snacks Snacks Snacks 

Prompts: Who prepared the food (yourself, microwave, restaurant [McDonalds, Denny’s, Mr. 

Chau’s, Black Angus]? How was it prepared (e.g., skinless, lean, fatty, fried, baked, dried, 

canned)? Are these types of foods eaten often (e.g., two eggs and three pieces of bacon every 

day)? 

Checklist: drinks, dairy, protein [red meat, chicken, fish, vegetable protein (tofu, beans, soy 

products)], vegetables, fruit, ethnic food, snacks 
65

APPENDIX C: Interview Guides (Tagalog) 
66

Key Informant Interview Guide 

Petsa ngayon: 

Oras: 

Lugar ng pakikipanayam: 

Direksiyon: 

Taga-pakinayam: 
67

I. Pangunahing salita 

 Maraming salamat sa iyong pag-parito. Sapagkat ikaw ay kinikilalang puno sa komunidad 

ng_________, inaasahan namin na matutulungan mo kami sa pag-unawa ng mga paniniwala, 

pag-tingin at mga ugaliin tungkol sa kalusugan ng puso, kabutihan nito at pag-iwas sa sakit 

sa iyong komunidad. Ka-ugnay rin dito ang ibat-ibang serbisyong pang-kalusugan at pangkomunidad na magagamit mo at ng ibang mga nakatira sa komunidad.. 

 Itong pag-susuring pang-komunidad ay isinasagawa sa pamamagitan ng Samahang pangkomunidad ng ________ at ng Asian & Pacific Islander American Health Forum. Ang 

proyektong ito ay pinopondohan ng National Heart, Lung, and Blood Institute upang 

magparating ng mabisang mensahe at mga programa sa pagpapa-unlad ng kabutihan at 

kalusugan ng puso sa mga komunidad ng mga Filipino. Ang iyong pag-lahok ay mahalaga 

dahil sa IYONG malalim na kaalaman at kabatiran tungkol sa iyong komunidad. 

 Umasa ka na ang iyong natatanging mga komentaryo sa araw na ito ay lihim at hindi 

ipakikilala ang iyong pangalan sa mga katagang ibibigay mo. Upang matiyak ang iyong dipagpapakilala at patibayin ang iyong kusang-loob na paglahok sa talakaying ito, mangyari 

lamang na paki-lagdaan mo ang Pahintulot na iyong ibinibigay. 

 Ating basahin ang pahina ng Pahintulot (Ibigay ang kopya ng Pahintulot at isa-isang basahin 

ang nakasulat doon). 

 Bago tayo magsimula, mayroon ka bang gustong itanong o ikomentaryo? 

II. Kaalamang demograpico ng kapanayam 

Edad: 

Kasarian: 

Katutubong lahi: 

Lupang sinilang-an: 

Katutubong wika: 

Pambansang pagkamamama-yan saan? 

Ilang taon sa United States: 

Ano ang papel mo sa komunidad (pormal o hindi)? 

Anong samahan/institusyon ang iyong kina-aaniban? 

III. Pag-unawa sa komunidad at pinanggagalingan ng kaalaman 

1. Una, maaari mo bang ilarawan ang iyong komunidad sa __________? 

[Suriin: Karamihan ba ng mga _________sa komunidad na ito ay matagal ng 

naninirahan doon?] 
68

[Suriin: Maituturing mo bang isang komunidad ng mga kabataan o di kaya ng mga 

nakatatanda ang iyong komunidad?] 

2. Ano-anong mga salita o diyalekto ang ginagamit ng karamihan sa iyong komunidad, at ano 

sa palagay mo ang pinaka-mabisa sa mga ito sa pag-bibigay ng kaalaman sa mga naninirahan 

doon? 

3. Gaano ka-sigla ang karamihan sa mga naninirahan sa iyong komunidad na sumapi sa mga 

samahang katutubo, sa mga simbahan, at sa paglahok sa mga katutubong pagdiriwang at 

pistahan? 

Itanong: Anong samahan, simbahan o katutubong pagdiriwang/pistahan ang gustong 

puntahan ng mga tao? 

Itanong: Ano ang dahilan at itong mga samahan, simbahan at katutubong 

pagdiriwang/pistahan na mga ito and kanilang pinupuntahan? 

4. Sa paanong paraan nakatatanggap ng kaalaman ang mga naninirahan sa iyong komunidad 

tungkol sa kalusugan? [Markahan sa mga sumusunod ang binanggit na pinanggagalinga ng 

kaalaman.]

 Pamilya, lalo na iyong mga nagtatrabaho sa mga propesyong bantay-kalusugan 

 Mga kaibigan, lalo na iyong mga nagtatrabaho sa mga propesyong bantay- kalusugan 

 Radyong katutubo 

 Radyong Ingles (lokal) 

 Pahayagang katutubo (sa salitang Ingles o salitang Asian) 

 Pahayagang Ingles (lokal) 

 Telebisyong katutubo 

 Telebisyong Ingles (lokal) 

 Pahayagan ng Samahang pang-komunidad 

 Mga “flyers” (programang maka-tao ng komunidad) 

 Mga “brochures” at mga materyales na pangkaalaman sa mga klinika ng mga 

modernong doctor, “HMO” o iba pang serbisyong bantay-kalusugan 

 Kaalaman mula sa mga katutubong/tradisyonal na manggagamot (halimbawa: nagaacupuncture) 

5. Anong porma ng kaalaman ang mas naka-aakit sa komunidad ng _________ (halimbawa: 

mga “brochures,” anunsiyo sa TV, anunsiyo sa radyo, video, o tape, atbp.)? 

6. Ano ang iyong masasabi tungkol sa sistema ng mga samahan at serbisyong katutubo sa 

siyudad/bayan ng __________? Maayos ba ang takbo nito? Mayroon bang mga nagkakapatong-patong na mga pamamalakad sa mga serbisyo at mga pagsisikap ng mga samahan sa 

komunidad? 

7. Ano sa tingin mo ang pinaka-malaking kayamanan ng siudad/bayan ng _________? Ano 

naman ang ilan sa mga mahalagang pangangailangan? 

IV. Pagtingin sa sakit puso, kalusugang pang-komunidad at kagalingan

A. Kahulugang pang-kultura ng “prevention” o “pag-iwas” 
69

1. Ano ang kahulugan ng mabuting kalusugan para sa iyo? Mayroon bang mga kwentongbayan, mga kasabihan o mga simbolo tungkol sa kalusugan sa iyong kultura? 

2. Ano ang kahulugan ng katagang “prevention” o “pag-iwas” sa iyong kultura? 

3. Ano ang kahulugan sa iyo ng pag-kakasakit o may karandaman? Mayroon bang mga 

kwentong-bayan, kasabihan o mga simbolo tungkol sa pag-kakasakit o may karandaman 

sa iyong kultura? 

B. Mga pagka-bahala tungkol sa kalusugang pang-komunidad 

1. Ano sa palagay mo ang pinaka-matinding banta laban sa kalusugan o kabutihan sa iyong 

komunidad? 

2. Ano sa palagay mo ang limang pinaka-matinding problema (o mga sakit/karamdaman) sa 

iyong komunidad (halimbawa: diabetes, canser, atbp.)? Para kanino? 

C. Sakit sa puso 

Pag-usapan natin ngayon ang sakit sa puso (katulad ng atake sa puso, alta presyon, atake 

serebral o “stress”/bigat ng kalooban) at ang mga dahilan na nagdadagdag ng pagkakataong 

magkaroon ng sakit na ito ang isang tao. 

1. Kung binanggit at iniranggo, itanong, “Bakit mo iniranggo ang sakit sa puso katulad ng 

ginawa mo? Kung hindi binanggit, itanong, “Ano ang masasabi mo tungkol sa sakit sa 

puso?” Kung ipaparis mo sa ibang mga sakit na binanggit at iniranggo mo, gaano kahalaga ang sakit sa puso sa iyong komunidad? 

2. Ano ang pinaka-matinding problemang kaugnay ng sakit sa puso? 

3. Ano ang mga paniniwala ng mga tao sa iyong komunidad tungkol sa mga ka-dahilanan 

ng sakit sa puso? 

4. May kilala ka bang may sakit sa puso? 

5. Ano ang mga bagay na maaaring gawin ng mga tao upang maiwasan ang pag-kakasakit 

sa puso? 

6. Sa kultura ng __________, ano ang ginagawa ng mga tao upang ingatan ang kanilang 

puso? Ano ang isinasagisag ng puso sa kultura ng __________? Mayroon bang mga 

kwentong-bayan o mga kasabihan tungkol sa kalusugan ng puso sa iyong kultura? 

D. Alta presyon 

1. Ano ang paniniwala ng mga tao tungkol sa alta presyon? [Suriin: ang ibang mga kataga 

na naglalarawan ng alta presyon, katulad ng “stress”/bigat ng kalooban.]

2. Ano ang epekto ng alta presyon sa kalusugan ng katawan? 

3. Ano ang dahilan kung kaya’t hindi ma-pigil ng mga tao ang kanilang alta presyon? 

4. Ano ang maka-tutulong sa pag-pigil ng mga tao sa kanilang alta presyon? 

5. Gaanong maka-totohanan ang nasa ng mga tao sa komunidad sa pag-pigil ng kanilang 

alta presyon? 
70

E. Kolesterol 

1. Ano ang kahulugan ng kolesterol sa ating kultura? Saan nag-sisimula ang kolesterol? 

2. Ano ang epekto ng kolesterol sa ating kalusugan? 

3. Ano ang magagawa ng mga tao sa pagpapa-baba ng kanilang kolesterol? 

4. Ano ang naka-sasagabal sa pagpapa-baba ng kolesterol? 

5. Ano ang maka-tutulong sa mga tao sa pagpapa-baba ng kanilang kolesterol? 

6. Gaanong maka-totohanan ang nasa ng mga tao sa komunidad sa pagpapa-baba ng 

kanilang kolesterol? 

F. Sobrang timbang/sobrang taba 

1. Ano ang kahulugan ng sobrang timbang sa ating kultura? Mayroon bang pag-kakaiba 

kung sa lalake man o kaya sa babae? Sa iyong palagay ba ang tingin nila sa kulturang 

Filipino tungkol sa pagkaka-iba sa timbang ng tao ay depende sa edad? [Suriin: Kung 

tama lamang na may sobrang timbang ang isang nakatatandang babae kung ipaparis sa 

isang batang babae?]

2. Ano ang epekto ng sobrang timbang sa kalusugan natin? 

3. May kilala ka bang sobra ang timbang? 

4. Ano ang naka-sasagabal sa mga tao sa pag-babawas ng timbang 

5. Ano ang maka-tutulong sa mga tao sa pag-babawas ng kanilang timbang? 

6. Gaanong maka-totohanan ang nasa ng mga tao sa komunidad na magpanatili ng malusog 

na timbang? 

G. Pag-hithit ng tabako 

1. Ano ang tingin ng mga Filipino sa pag-hithit ng tabako? Ano ang epekto ng pag-hithit ng 

tabako sa ating kalusugan? Paano? 

2. Gaanong maka-totohanan ang nasa ng mga tao sa komunidad sa pag-sugpo ng pag-hithit? 

H. Pagkain 

1. Anong klase ng pagkain ang kadalasang kinakain ng mga Filipino sa mga pistahang 

espesyal, salo-salong pam-pamilya o mga pagdiriwang? 

2. Magkaiba ba o magkapareho ang pagkain ng mga tao sa komunidad ng ___________ 

kung itutulad nuong sila ay nasa Pilipinas pa? Paki-paliwanag lamang. Mas malusog ba 

ang uri ng pagkain sa U.S. kung ipaparis sa dati? Sa anong paraan? 
71

V. Kilos ng katawan/ehersisyo 

1. Kung titingnan mo ang mga Filipino sa komunidad ng siudad/bayan ng ___________, gaano 

ka-sigla ang kanilang pagkilos? 

2. Anong klaseng pagkilos o ehersisyo ang nagsisilbing katuwaan ng mga tao (halimbawa: 

pag-lalaro, liga ng mga palaro, atbp.)? Anong klaseng pagkilos o ehersisyo ang ginagawa 

nilang mag-isa (halimbawa: paglalakad sa umaga, pag-takbo)? Anong klaseng pagkilos o 

ehersisyo ang ginagawa nilang sama-sama sa grupo (halimbawa: pormal na liga ng 

palakasan, mga klaseng pang-ehersisyo, paghahalamang pang-komunidad, o magkakasamang naglalakad kung umaga). 

3. Anong klaseng pagkilos o ehersisyo ang ginagawa ng mga tao sa kani-kanilang mga bahay 

(halimbawa: pag-hahalaman, pag-tatabas ng damo sa lawn, pag-lilinis ng bahay)? Anong 

klaseng pagkilos o ehersisyo ang ginagawa ng mga tao sa kani-kanilang trabaho 

(halimbawa: mga klub ng mang-lalakad)? 

4. Anong klaseng pag-kilos o ehersisyo ang mas gusto ng mga tao sa iyong komunidad? 

5. Sa iyong palagay, bakit kaya mabagal kumilos ang mga tao? 

6. Ano kaya ang maka-tutulong upang sumigla ang pagkilos ng mga tao? (Gumamit ng “flip 

chart” o pisara at isulat ang mga kadahilanan kung bakit problema ng mga tao ang pagkilos 

ng masigla at ang mga paraan upang malunasan ito.) 

7. Gaanong maka-totohanan ang nasa ng mga tao sa komunidad na mag-ehersisyo ng 30 

minutos sa karamihan ng araw sa loob ng isang linggo? 

VI. Mga opsiyon, daan, serbisiyo ng bantay-kalusugan 

1. Ano ang gingawa ng mga tao sa komunidad kung sila’y nagkaka-sakit? 

2. Sino ang una nilang pinupuntahan? [Suriin ang sariling pag-gamot, tulad ng pag-gamit ng 

damong-gamot, ang pag-gamit ng di-niresetang gamot, ang pag-gamit ng gamot ng 

katutubong kultura ng _________.]

3. Ano ang inaasahan nila na magagawa ng taong una nilang pinuntahan? 

4. Nagpapa-tingin ba ng regular ang mga tao sa komunidad para sa kanilang kalusugan? Kung 

ganoon, saan sila pumupunta para sa regular na pagpapa-tingin ng kanilang kalusugan? 

5. Ano pang ibang paraan ang karaniwang gingawa ng mga tao upang manatili ang kanilang 

mabuting kalusugan at kabutihan (halimbawa: konsulta sa pari, “acupuncture,” atbp.)? 

6. Anong mga serbisiyong bantay-kalusugan ang magagamit sa iyong komunidad o 

kapaligiran? 

7. Mayoon bang iba pang mga serbisyong bantay-kalusugan na ginagamit ang mga tao sa 

komunidad [Suriin: ang pag-gamit ng katutubong serbisyong bantay-kalusugan, 

halimbawa: mga tradisyonal na manggagamot, albularyo, atbp.]?

8. Anong bahagi ng komunidad ang gumagamit ng mga modernong gamot at serbisyong 

bantay-kalusugan? Anong mga iba pang klase ng serbisyong bantay-kalusugan ang nakikita 

mong pinagpi-pilian ng mga tao? 

9. Sino o anong uri ng kapisanan ang kapani-paniwala sa pag-bibigay ng karunungan tungkol sa 

bantay-kalusugan at mga serbisyo? 
72

10. Ano ang mga bagay na nagpapa-hirap sa pag-bibigay ng pag-aalaga at serbisiyong bantaykalusugan sa mga tao sa komunidad ng __________ (halimbawa: wika, sasakyan, 

lahi/kultura, seguro, pagtitiwala)? 

11. Paanong mahihikayat ang mga tao na gumamit ng mga nakalaang mga pag-alaga/mga 

serbisiyong bantay-kalusugan sa komunidad? 

12. Kung hindi tiniyak, itanong: Mayroon bang “health insurance” o “seguro” ang karamihan sa 

mga tao sa iyong komunidad? Kung hindi, bakit mo inaakala na ganito ito (halimbawa: 

magastos, hindi mahalaga, hindi makukuha)? 

13. Tanging para sa sakit sa puso, ano sa iyong palagay ang mga kilusan na maaaring paunlarin 

upang mabawasan ang peligro ng sakit sa puso sa komunidad? Anong mga sangkap ang 

nararapat na magkaroon ang mga ito? [Suriin: Ano-anong mga kilusan o programa ang 

magpapa-himok sa mga tao na gumawa ng mga paraan upang mapababa ang kanilang alta 

presyon? Anong mga kilusan o programa ang magpapa-himok sa mga tao na mag-ehersisyo 

ng mas madalas? Upang kumain ng pagkain na kaunti ang taba? Upang kumain ng pagkain 

na kaunti ang asin? Upang magpa-natili ng malusog na timbang?]

VII. Mga kagamitang pang-pamamagitan an at pang-iwas sa sakit ng puso

Ngayon gusto naming maalaman ang iyong sagot tungkol sa ilang kagamitang pang-karunungan 

tungkol sa kalusugan. Ang iyong ibabahagi ay makatutulong sa aming pag-gawa ng mga 

natatanging kagamitan para sa iyong komunidad. Ibig naming marinig and iyong ina-akala 

tungkol sa mga kagamitang ito. Hindi namin hinihingi na basahin mo ang mga ito sa ngayon. 

Ano ang labis na gusto mo, at bakit? Ano ang labis na hindi mo gusto, at bakit? 

VIII. Pag-wawakas 

 Tapos na tayo sa ating pag-uusap. Bago tayo mag-hiwahiwalay, mayroon ka bang ibang 

masasabi o komentaryo tungkol sa mga pinag-usapan natin ngayon? 

 Inu-ulit ko, maka-aasa ka na lahat ng iyong i-binahagi sa amin sa araw na ito ay mahigpit na 

lihim at hindi magpapa-kilala sa iyo. Ang iyong pangalan ay hindi iuugnay sa kaalamang 

ibinigay ngayong araw na ito. 

 Maraming salamat sa iyong pag-parito. Ang kaalamang ibinigay mo ay napaka-halaga. 

Malaking tulong ang ibinigay mo sa amin. 
73

Indepth Interview Guide 

Anim na bahagi ang sisiyasatin: 

Bahaging A: Gawaing Pang-aliwan 

Bahaging B: Ugaling Pangkain 

Bahaging C: Mga Paggamit at Pagkatampak Sa Tabako At Alkohol (Alak) 

Bahaging D: Kasaysayang Pang Kalusugan 

Bahaging E: Pansarili at Pang-demograpiko Impormasiyon 

Bahaging F: Karunungang Pangkalusugan 

Bahaging G: Mga Serbisyong Pangkalusugan Sa Komunidad 

Tandaan: Ito ay dapat pangasiwaan ng isang sanay na tagapag-panayam sa isang 

dalawahang pagtalakay. Bawa’t samahang pang-komunidad ay kikilalanin at 

kapapanayamin ang sa sampung kalahok. 

Petsa: 

Oras Ng Pag-simula: 

Lugar/Siudad: 

Taga-pakinayam: 

Kaalamang demograpico ng tumutugon 

Edad: 

Kasa-rian: 

Katutu-bong lahi: 

Lupang tinubu-an: 

Katutu-bong wika: 

Pambansang pagkamamama-yan saan? 

Ilang taon sa United States: 

Bilang ng mga may sapat na gulang sa tirahan kasama ang sarili: 

Bilang ng mga menor de edad sa tirahan: 
74

Bahaging A: Gaiwaing pang-aliwan 

A1. Gaano ang kahalaga ng gawaing pangkatauhan sa araw-araw para sa iyo? 

1. Hindi mahalaga 

2. Medyo mahalaga 

3. Napakahalaga 

9. Walang kasagutan 

A2. Nuong nakaraang buwan, lumahok ka ba sa mga kilos pangkatawan katulad ng 

paglalakad, basketbol, balibol, paglangoy, paghahalaman, atbp.? 

0. Hindi 

1. Oo (Kung Oo, sagutin ang mga sumusunod pitong katanungan.) 

A2a. Sabihin mo ang uri ng mga gawaing pangkatawan na iyong nilahukan? 

A2b. Alin sa mga gawaing pangkatawan ang mas malimitmong lahukan? 

A2c. Alin namong mga gawin ang iyon paborito o gustong-gusto? 

A2d. Ang iyong pagkilos ba ay bilang kasapi sa mga liga, mga klase (ng aliwan o sa paaralan) 

o sa mga ibang pormal na klub? 

A2e. Alin sa mga gawaing iyong binanggit, ang mga kasama mo ay kaibigan, kamag-anak at 

iba pa? 

A2f. Ano ang mga gawain mong pang katawan sa bahay? (Halimbawa: pag-dala ng labada, 

pag-akyat sa hagdanan) 

A2g. Ano naman sa trabaho (pag-kilos sa trabaho tulad ng pag-lalakad, pag-bubuhat, paggawa)? 

A3. Anong bagay ay nakaka pasigla sa iyo o nakaka pagsigla upang bumilis ang kilos ng 

iyong pang katawan? 

A4. Ano naman ang nagpapahirap sa iyo upang maging masigla ang iyong? 

A5. Ano naman ang palagay ng iyong mga kababayan sa mga gawaing pang katawan at pangaliwan? Ito ba ay iba o katulad ng sa Pilipinas hambing dito sa Amerika? 

Bahaging B: Ugaling pangkain 

Patalastas para sa taga-pakinayam: Mangyari lamang na ipakita ang mga pilyego ng 

kalendaryo (ito ay itutustus). Ipaliwanag na magkasama ninyong titingnan ang kalendaryo 

habang ikaw ay magtatanong ng tungkol sa pagkain at ibang mga gawi nila. Maaari mong 

sabihin: 

“Ngayon ay tatanungin kita tungkol sa mga pagkain na kinakain mo. Pinakamadali para sa akin 

ng pag-usapan natin ito habang tumitingin tayong dalawa sa kalendaryo at mag-usap lamang 

tungkol sa mga kaugaliang pagkain na pang karaniwang kinakain mo. Okey ba sa iyo? 

Salamat.” 

(Tabihan sa upuan ang kalahok kung maaari). 
75

“Una, ang tanong ko ay ano-ano ang kinain mo nitong mga huling araw, kasama yong ngayon? 

Maaring may kaunting hawa, pero makatutulong ng malaki sa ikalilinaw ng aming pag-unawa ng 

inyong gana sa pagkain nitong mga huling araw. Subalit ang itatanong ko lamang ay may 

kinalaman sa mga bagay na inyong parating kinakain.” 

(Itatanong ng taga-pakinayam kung ano ang kinain ngayon, kahapon (umaga, tanghali, 

hapon at gabi), at nuong nakaraang tatlong araw, kasama na rin ang araw ngayon. 

Habang isinusulat ng taga-pakinayam ang mga pagkain sa kalendaryo, kanyang 

titiyakin sa kalahok na tamang-tamang ang kaalamang ibinigay.) 

(Pagkatapos na maitala ang tatlong araw, magtatanong ang taga-pakinayam ng mga 

karaniwang tanong habang tinitiyak na mabuti ang kaalamang ibinibigay ng kalahok 

tungkol sa mga sumusunod na paksa. Gamitin ang dalawang pilyego ng kalendaryo na 

ibibigay sa inyo): 

 Sino ang nagluluto ng pagkain na karaniwang kinakain nila 

 Pagkaing katutubong Pilipino (anong klase) 

 Butil (uri, limit) 

 Karne (paanong pagluto - pinirito sa maraming mantika, pinirito sa kakaunting 

mantika, siningaw, atbp. - gaano ito kataba?) 

 Manok (paanong pagluto - pinirito sa maraming mantika, pinirito sa kakaunting 

mantika, siningaw, atbp. - gaano ito kataba?) 

 Isda (paanong pagluto - pinirito sa maraming mantika, pinirito sa kakaunting mantika, 

siningaw, atbp. - gaano ito kataba?) 

 Mga produktong Soy (paanong pagluto - pinirito sa maraming mantika, pinirito sa 

kakaunting mantika, siningaw, atbp. - gaano ito kataba?) 

 Produktong pagatasan (gatas, itlog - paanong pagluto - gaano ito kataba o di-taba?) 

 Gulay (klase at paanong pagluto) 

 Prutas (klase) 

 Pang Matamis (kendi, cake, atbp.) 

Sasabihin ng taga-pakinayam: “Mangyari lang na sagutin ang tungkol sa loob ng isang 

pangkaraniwang linggo” 

(Maaaring gumamit ng mga guhit/palaso upang maipahiwatig ang isang uri ng pagkain sa 

buong linggo - ito ay idedetalye pag dating sa pag-aaral. Tandaan na itatala ng tagapakinayam ang mga sagot sa mga katanungan tungkol sa pagkain sa katapusan ng pakikipanayam kasabay man o hindi ang kalahok, depende sa takdang oras. Ito ay batay sa tatlong 

araw na mga datos.) 

Pagkatapos na maitala ang nasabing impormasyon sa mga pilyego ng kalendaryo, 

ipagpatuloy ang deretsong pagtatanong ng mga sumunod: 

B1. Gaano kahalaga ang magkaroon ng mga pagkaing mababa sa taba? 

1. Hindi mahalaga 

2. Bahagyang mahalaga 
76

3. Napaka-halaga 

9. Walang kasagutan 

B2. Maaaring bang banggitin mo ang mga kinaugaliang sangkap na inihahalo mo sa iyong 

pagkain? Sabihin mo nga ito sa iyong sariling wika? Kung hindi mo mabili ang mga ito, 

anong uri ng sangkap na “Americano” ang gagamitin mong kapalit? 

B3. Gaano nagbago ang iyong pagkain simula ng tumira ka sa U.S.? Ito ba ay mas malusog o 

hindi? Paki-tiyakin lang ng mabuti. 

Bahaging C: Mga paggamit at pagkatampak sa tabako at alcohol (alak) 

C1. Nagasisigarilyo o nagatabako ka ba? Humihithit o ngumonguya. Paki-tiyakin ang sagot. 

0. Hindi 

1. O o - Kung Oo, sagutin ang susunod na apat (4) na tanong. 

9. Walang kasagutan 

C2. Kung ganoon, gaano katagal ka ng humihithit? 

C3. Kung humihithit ka, gaano kadalas ang iyong pag-hithit? 

0. Pambihira - pang-sosyalang espesyal lamang - Kung pambihira, ilang 

 sigarilyo/tabako sa bawat pagkakataon: 

1. Paminsan-minsan, mga isang beses sa loob ng isang buwan - mga ilang 

 sigarilyo/tabako sa bawat pagkakataon: 

2. Pirmihan, mga ilang beses sa loob ng isang linggo 

3. Araw-araw 

9. Walang kasagutan 

C4. Sa pangkaraniwan, mga ilang sigarilyo ang hinihithit mo araw-araw 

1. 1 – 4 sa sigarilyo 

2. 5 – 8 sigarilyo 

3. 9 – 12 sigarilyo (mga kalahating kaha) 

4. 12 – 16 na sigarilyo 

5. 17 – 20 sigarilyo (mga isang kaha) 

6. 20 – 40 sigarilyo 

7. Mahigit sa 40 sigarilyo (dalawang kaha) 

9. Walang kasagutan 

C5. Saan ka malimit na humihithit sa iyong pamamahay? 

1. Sa loob ng bahay 

2. Sa labas ng bahay 

3. Sa ibang puwesto 

9. Walang kasagutan 

C6. Simula’t sapol, nakahithit ka na ba ng sigarilyo? 

0. Hindi 

1. O o 

9. Walang kasagutan 

C7. Kung Oo ang sagot, kailan ka huminoto ng pagsisigarilyo __________? Anong paraan o 

pamamaraan at na ihinto mo ang iyong pagsisigarilyo? (Kung hinto-balik sa pag 
77

sisigarilyo, paki-paliwanag ang limit at tagal ng paghinto at pagsisimulang muli ng 

paghithit.) 

C8. Gaano katagal ka nang humihithit ng sigarilyo ___________? Ilan o gaano kalimit kang 

humihithit sa araw-araw noong nagsisigarilyo ka pa? 

C9. Sino ang pinanggagalingan ng usok ng tabakong nalalanghap mo? (Markahan lahat ng 

nararapat.) 

 Pamilya 

 Mga kaibigan 

 Ka-trabaho/ka-eskwela 

 Mga kliyente/suki 

 Mga taon di-kilala 

 Mga iba 

C10. Ano sa palagay mo ang epekto ng tabako sa iyong kalusugan? 

C11. Ano sa damdam mo ang palagay ng inyong kabaayan sa ___________ tungkol sa 

pasisigarilyo? 

C12. Ano naman ang palagay sa pagtatabako ng mga tao sa Pilipinas? Yaon bang kanilang 

paniniwala sa paggamit ng tabako o paninigarilyo ay may epekto sa inyo at iyong mga 

kabayan dito sa ____________? 

C13. Ano sa iyong paniwala ang nakakaakit sa mga lalake o babae at mga bata upang humithit 

ng tabako? (Halimbawa: mga pag-titipontipong sosyal, mgaanunsio sa magasin, mga 

sinehan, mga pamantayang kultural, atbp.) 

C14. Umiinom ka ba ng alak/alkohol? 

0. Hindi - Kung hindi, tumalon sa Bahaging D 

1. O o 

9. Walang kasagutan 

C15. Gaano ka kalimit uminom ng alak (alkohol)? 

0. Hindi kailanman 

1. Pambihira - mga espesiyal na okasyong sosyal - anong uri ng okasyon? 

2. Paminsan-minsan, mga isang beses sa loob ng isang buwan 

3. Isang beses sa loob ng isang linggo 

4. Pirmihan, mga ilang beses sa loob ng isang linggo 

5. Araw-araw 

9. Walang kasagutan 

C16. Kung uminom ka ng alak, anong alak? Gaano Karami? 

Bahaging D: Kasaysayan pang kalusugan 

D1. Gaano ka kataas? 

D2. Ano ang timbang mo? 

D3. Mayroon bang may sakit sa puso sa iyong pamilya? 

0. Wala 

1. O o 

9. Walang kasagutan 
78

D4. May manggagamot bang sinabihan ka na mayroon ka ng sumusunod na mga sakit 

(Markahan lahat ng nararapat)? 

 Diabetes 

 Hypertension (alta presyon) 

 Mataas ang kolesterol (Ilang beses________?) 

 Atake sa puso 

 Stroke (atake serebral) 

KUNG OO ANG SAGOT SA D3 AT D4, MANGYARING SAGUTIN ANG MGA 

SUMUSUNOD NA APAT NA KATANUNGAN: 

D5. Mayroon ka bang sakit sa puso? Paano nabatid ng iyong pamilya na may sakit ka sa 

puso? 

D6. Papaano sa akala mo nakuha mo/ng miembro ng pamilya mo ang sakit sa puso? 

D7. Ano ang pang-araw araw mong isinasagawa upong mapangalagaan ang iyong puso? 

Nagkaroon ba ng pagbabago ang iyong sinabing gawain sa iyong mag-anak? (Alamin 

ang pamamaraang pangkultura pansarili sa pangangalaga ng puso). 

D8. Mayroon kabang sapat na kalooban o kakayahan na: 

Salahat 

ng oras 

Paminsanminsan Pambihira Hindi 

kailanman 

Mapabab ang presyong ng iyong dugo 

Mapapababa ang iyong kolesterol 

Kumain ng limang pagsilbing prutas at gulay 

Kumaing ng pagkaing mababa sa taba at asin 

Mag-ehersisyo ng 30 minutos sa karamihan ng 

mga araw sa loob ng isang linggo 

 

Mapanatili mo ang isang malusog na timbang 

D9. Ano ng simbulo ng puso sa inyong kultura? 

D10. Ikaw ba ay nasa espesyal na pag-didiyeta (kaunting taba o kaunting asin) na inutos ng 

doktor? Sinusunod mo ba ito? Bakit o bakit hindi? 

0. Hindi 

1. Oo 

9. Walang kasagutan 

D11. Mababahagian mo ba kami ng mga paninging kultural tungkol sa ilang mga sumusunod 

na paksa? May mga pagkakaiba kaya kung sa lalake o sa babae? 

 Mga kadahilanan ng masamang kalusugan o pagkakasakit 

 Pag-iwas sa sakit 

 Sobrang timbang (mabintog) napakataba? 

 Alta presyon 

 Mataas ang kolesterol 

 Kilos pang-katawan 

D12. Ano ang tingin mo sa mga “modernong gamot” [Suriin ang mga paninging kultural 

tungkol sa pag-gamit ng mga “modernong gamut.”]
79

D13. Sinusubukan mo bang gamutin ang iyong sarili kapag may sakit ka? 

0. Hindi 

1. Oo 

9. Walang kasagutan 

D14. Kung Oo, ano ang ginagamit mo? (Alamin kong gumagamit ng gamot galing sa mga 

dahon ougat ng halaman at kung ang gamot ay galing/bigay ng mga kaibigan.) 

D15. Gumagamit ka ba ng mga luman paraan ng gamotan tulad ng hilot o albolaryo? 

D16. Saan ka pangkaraniwang pumupunta (kung mayroon man) kung ikaw ay nagkakasakit? 

Kailan (at para ano) ka pupunta sa isang modernong doktor? 

D17. Mayroon ka bang palagian pinupuntahan na tumitingin sa iyong kalusgan, sino naman 

ang palagay mong pinupuntahan upang subaybayan ang iyong kalusugan? 

D18. Mayroon bang ibang bagay na palagian mong ginagawa upang mapanatili mo ang iyong 

kalusugan at mabuting katauhan (Tulad ng masahe, pari, hilot at iba pa)? Bakit o bakit 

hindi? 

D19. Gaano katindi ang pasanin mo sa iyong buhay? 

1. Hindi matindi 

2. Medyo matindi 

3. Napaka-tindi 

9. Walang kasagutan 

D20. Ano ang pinanggagalingan ng tindi ng pasanin mo sa iyong buhay? 

D21. Ano ang mga ilang ginagawa mo upang paginhawahin ang tindi ng pasanin mo sa buhay? 

D22. Gaano kahalaga sa iyo ang mga gawaing pampaginhawa ng tindi ng pasanin sa buhay? 

1. Hindi mahalaga 

2. Medyo mahalaga 

3. Napaka-halaga 

9. Walang kasagutan 

Bahaging E: Pansarili at pang-demograpiko impormasiyon 

E1. Gaano katagal ka ng naninirahan sa iyong kasalukuyang komunidad? (Bilang ng taon) 

E2. Ilang taong nag-aral, ikaw at ang iyong asawa o kapareha? 

 Sarili Asawa

0. Wala  

1. 1 – 8 taon  

2. 9 – 12 taon  

3. Teknika/propesyonal  

4. Pang-kumunidad  

5. 4-na taon kurso  

6. Dalubhasa (Masters)  

9. Walang kasagutan  

E3. Anong uri ang trabaho mo? 

1. Propesyonal/tagapagpaganap 

2. Teknikal 

3. Tagapagbili 
80

4. Katulong ssa pangangasiwa (Halimbawa, klerikal, sekretarya) 

5. Serbisyo 

6. Pang-industriya (pabrika) 

7. Maybahay 

8. Walang trabaho 

9. Sariling negosyo (kalakalan) 

10. Iba (banggitin) 

E3a. Ilang oras ang ginugugol mo sa trabahong may bayad? 

E3b. Ilan ang trabaho mong may bayad? 

E4. Magkano ang kinita ng iyong sambahayan nuong nakaraang taon? (Lahat ng kumita sa 

iyong sambahayan) 

1. <$5,000 

2. <$10,000 

3. <$20,000 

4. <$40,000 

5. <$60,000 

6. <$80,000 

7. <$100,000 

8. <$120,000 

9. Mahigit sa $120,000 

99. Walang kasagutan 

E5a-f. Sino-sino sa iyong kasambahay ang nagsasalita ng iiyong wikang Pilipino? 

 Mga bata (bago mag-teenager) 

 Kabataan (teenager) 

 Mga nasa gulang 18 – 30 

 Mga nasa gulang 30 – 45 

 Mga nasa gulang 45 – 60 

 Mga nakatatanda mahigit sa 61 

E6a-f. Sino sa inyong kasambahay ang nagsasalita ng ingles (Markahan lahat ng nararapat)? 

 Mga bata (bago mag-teenager) 

 Kabataan (teenager) 

 Mga nasa gulang 18 – 30 

 Mga nasa gulang 30 – 45 

 Mga nasa gulang 45 – 60 

 Mga nakatatanda mahigit sa 61 

E7. Ikaw ba o sino man sa sambahayan mo ay kasangkot o miembro ng isang katutubong 

samahan/kapisanan? 

0. Hindi 

1. Oo 

9. Walang kasagutan 

E8. Mayroon ka bang segurong pang-kalusugan? Kung mayroon, kanino? 

0. Hindi 

1. Oo 

9. Walang kasagutan 
81

Bahaging F: Karunungang pangkalusugan 

F1. Kung nanganga-ilangan ka ng payo o impormasiyon tungkkol sa pang-lunas gamot, 

kanino ka malimit magtanong or pumupunta? 

F2. Saan ka kumukuha impormasiyong pang kalusugan? 

F3. Gaano ka-halaga ang magkaroon ng palagian peryang pangkalusugan sa iyong 

kumunidad? 

1. Hindi mahalaga 

2. Medyo mahalaga 

3. Napaka-halaga 

9. Walang kasagutan 

F4. Nakadalo ka na ba ng peryang kumunidad pangkalusugan (alamin kung ilang tao ang 

dumalo sa peryang nabanggit)? 

0. Hindi 

1. Oo 

9. Walang kasagutan 

F5. Gaano ka-halaga ang magkaroon ng mga “brochure,” polyeto, bidyo, tape sa sariling 

wika? 

1. Hindi mahalaga 

2. Medyo mahalaga 

3. Napaka-halaga 

9. Walang kasagutan 

F6. Gaano ka-halaga ang magkaroon ng programa ng karunungang pang-kalusugan sa 

sariling wika? 

1. Hindi mahalaga 

2. Medyo mahalaga 

3. Napakahalaga 

9. Walang kasagutan 

F7. Gaano kalimit kang bumabasa o nagaaral ng mga impormasiyon tungkol sa kalusugan? 

0. Pambihira 

1. Kung mayroong diperensya ang isang kaibigan o kamag-anak 

2. Kung ako’y may diperensya 

3. Para sa panlahat na kaalaman at kabatiran 

9. Walang kasagutan 

Bahaging G: Mga serbisyong pangkalusugan sa komunidad 

G1. Pinayuhan ka na ba ng iyong doktor/planong pang-gamot (medical plan) na ikaw ay 

magpa? (Markahan ang nararapat) 

 Eksamen ng kolesterol 

 Eksamen ng presyon ng dugo 

 Eksamen ng asukal sa dugo 

 Electrocardiogram, atbp. 

 Iba pa 
82

G2. Anong mga suliranin mayroon ka sa pagkuha ng tulong panggamot o lingkod/serbisyong 

pangkalusugan? 

G3. Ngayon, gustong kong itanong sa iyo ang tungkol sa mga serbisyo sa komunidad ng mga 

Pilipino. Ano-anong klase ng serbisyo ang magagamit ng mga tao sa komunidad mga 

Pilipino upang sila’y mamuhay ng mas malusog? 

G4. Ano sa mga ito ang pinaka-madalas na gamitin? Bakit? 

G5. Anong klase ng mga serbisyong pang-komunidad ang makatutulong sa pagpapanatili ng 

malusog na pagkain? Para naman maging masigla ang pangangatawan at magehersisyong palagi? 

G7. Ano sa iyong akala ang pinaka-mabuting paraan sa pag-bibigay ng kaalaman at 

karunungan tungkol sa kalusugan ng puso sa mga tao sa iyong komunidad? 

G8. Tumatanggap ka ba ng impormaciyon pang-kalusugan sa mga sumusunod: 

 Kadalasan Paminsanminsan 

Pambihira Hindi 

Kailanman 

1 Kaibigan/Pamilya 

2 Tagabigay-alagang kalusungan 

3 Radyo 

4 TV 

5 Diaryong Lokal sa Ingles 

6 Mga Pahayagan/Magasin sa 

sariling wika 

 

7 Mga “flyers” - pogramang 

maka-taong pang-komunidad 

8 Babasahin pang kaalaman 

impormasiyon sa opisina ng 

doctor at ibapa 

G9. Malapit na tayong mag-wakas ng ating pakikipanayam. Mayroon ka pa bang ibang 

gustong idagdag? 

G10. Maaari bang paki-tingnan mo ang mga polyetong ito at sabihin mo sa amin kung sa iyong 

palagay ay makakatulong kung ito ay nasa sariling wika mo. (Ipakita ang mga polyeto at 

isulat ang mga komentaryo sa dakong ibaba dito). 

Taga-pakinayam: Mangyari lamang na huwag kalilimutang punuin ang sagot sa mga tanong 

tungkol sa pagkain sa katupusan ng pakiki-panayam. 

Sa pagtatapos ng pakiki-panayam, bibilugan ng taga-panayam ang kasagutan sa sumusunod 

na mga codigo. 

B4. Mga ilang beses nuong nakaraang linggo nangyari na ang malaking bahagi sa mga 

pagkaing kinain mo ay katutubong pagkain ng __________? 

0. Wala 

1. 1 –2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 
83

4. Mahigit sa 7 pagkain 

9. Walang kasagutan 

B5. Mga ilang beses nuong nakaraang linggo nangyari na ang malaking bahagi ng mga 

pagkaing kinain nila ay karne? 

0. Wala 

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit sa 7 pagkain 

9. Walang kasagutan 

B6. Sa karaniwang usapan, ang karne ba ay __________? 

1. Labis na di-mataba 

2. Di-mataba 

3. “Regular” 

9. Walang kasagutan 

B7. Mga ilang beses nuong nakaraang linggo nangyari na ang malaking bahagi ng mga 

pagkaing kinain nila ay manok? 

0. Wala 

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit sa 7 pagkain 

9. Walang kasagutan 

B8. Sa karaniwang usapan, ang manok ba ay __________? 

1. Walang balat 

2. May balat 

9. Walang kasagutan 

B9. Mga ilang beses nuong nakaraang linggo nangyari na ang malaking bahagi ng mga 

pagkaing kinain nila ay isda? 

0. Wala 

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit na 7 pagkain 

9. Walang kasagutan 

B10. Mga ilang beses nuong nakaraang linggo nangyari na ang malaking bahagi ng mga 

pagkaing kinain nila ay ma-protinang gulay (tofu, bins, mga produktong Soy)? 

0. Wala 

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit na 7 pagkain 

9. Walang kasagutan 

B11. Mga ilang beses nuong nakaraang linggo nangyari na ang malaking bahagi ng mga 

pagkaing kinain nila ay mga produktong pagatasan? 

0. Wala 
84

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit na 7 pagkain 

9. Walang kasagutan 

B12. Sa karaniwang usapan, ang mga produktong gatas, keso, atbp., na ginagamit ba nila ay. 

1. Walang taba (halimbawa: “skim milk”) 

2. Kakaunting taba (halimbawa: “2% fat milk”) 

3. Todo ang taba (halimbawa: “whole milk”) 

9. Walang kasagutan 

B13. Mga ilang beses nuong nakaraang linggo nangyari na ang malaking bahagi ng mga 

pagkaing kinain nila ay itlog? 

0. Wala 

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit na 7 pagkain 

9. Walang kasagutan 

B14. Mga ilang pag-silbi ng gulay na bahagi ng kanilang pagkain ang kinain nila nuong 

nakaraang linggo? 

0. Wala 

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit na 7 pagkain 

9. Walang kasagutan 

B15. Sa karaniwang usapan, ang mga gulay ba ay _________? 

1. Tuyo 

2. De-lata/sa garapon 

3. Sariwa 

9. Walang kasagutan 

B16. Ano-anong mga klase ng gulay ang kanilang kinakain (halimbawa: bins, karot, 

remolatsas, atbp.)? 

B17. Mga ilang pag-silbi ng prutas ang kanilang kinain nuong nakaraang linggo? 

0. Wala 

1. 1 – 2 pagkain 

2. 3 – 4 na pagkain 

3. 5 – 6 na pagkain 

4. Mahigit na 7 pagkain 

9. Walang kasagutan 

B18. Sa karaniwang usapan, ang prutas ba ay _____? 

1. Tuyo 

2. De-lata/sa garapon 

3. Sariwa 

9. Walang kasagutan 
85

B19. Ano-anong klase ng prutas ang kinakain nila (halimbawa: saging, mansanas, atbp.)? 

B20. Sa karaniwang usapan, sino ang naghahanda ng mga pagkain na kinakain nila? 

1. Sarili 

2. Iba, sa mismong sambahayan 

3. Iba, hindi restauran 

4. Sa restauran 

5. Walang kasagutan 

B21. Sa karaniwang usapan, ang pag-kain ba nila ng karne, manok, isda at gulay ay inihanda 

bilang bahagi ng katutubong pagkain? 

0. Hindi 

1. Oo 

2. Walang kasagutan 

B22. Anong mga pagkaing kakanin ang paborito nila (halimbawa: kendi, “chips,” kukis, 

“cake,” prutas)? 

B23. Mga ilang merienda ang kinakain nila sa isang araw? 

0. Wala 

1. 1 – 2 merienda 

2. 3 – 4 merienda 

3. Mahigit sa 5 merienda 

 9. Walang kasagutan 

 

Isang karaniwang 

Kamakalawa Kahapon Ngayon 

Almusal Almusal Almusal 

Pananghalian Pananghalian Pananghalian 

Hapunan Hapunan Hapunan 

Merienda Merienda Merienda 

Ididikta: Sino ang naghanda ng pagkain (ang sarili, microwave, restaurant [McDonalds, 

Denny’s, Mr. Chau’s, Black Angus)? Paano ang paghanda (halimbawa: binalatan, di-mataba, 

mataba, prito, ihurno, tuyo, delata)? Madalas bang kainin ang mga klase ng pagkaing ito 

(halimbawa: 2 itlog at 3 piraso ng tusino araw-araw)? 

Paalalang listahan: inumin, produktong pagatasan, protina (karne, manok, isda, maproteinang 

gulay [tofu, bins, produktong soy]), gulay, prutas, pagkaing katutubo, kakanin 
86

Isang karaniwang linggo 

Linggo Lunes Martes Miercoles Huwebes Biernes Sabado 

Almusal Almusal Almusal Almusal Almusal Almusal Almusal 

Pananghalian Pananghalian Pananghalian Pananghalian Pananghalian Pananghalian Pananghalian 

Hapunan Hapunan Hapunan Hapunan Hapunan Hapunan Hapunan 

Merienda Merienda Merienda Merienda Merienda Merienda Merienda 

Ididikta: Sino ang naghandang pagkain (ang sarili, microwave, restaurant [McDonalds, Denny’s, 

Mr. Chau’s, Black Angus])? Paano ang paghanda (halimbawa: binalatan, di-mataba, mataba, 

prito, ihurno, tuyo, delata)? Madalas bang kainin ang mga klase ng pagkaing iito (halimbawa: 2 

itlog at 3 piraso ng tusino araw-araw)? 

Paalalang listahan: inumin, produktong pagatasan, protina (karne, manok, isda, maproteinang 

gulay [tofu, bins, produktong soy]), gulay, prutas, pagkaing katutubo, kakanin
The NHLBI Health Information Center is a service of the National Heart, Lung, and Blood 

Institute (NHLBI) of the National Institutes of Health. The NHLBI Health Information Center 

provides information to health professionals, patients, and the public about the treatment, 

diagnosis, and prevention of heart, lung, and blood diseases. For more information, contact: 

NHLBI Health Information Center 

P.O. Box 30105 

Bethesda, MD 20824-0105 

Phone: 301-592-8573 

Fax: 301-592-8563 

TTY: 240-629-3255 

Web: http://www.nhlbi.nih.gov 
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

National Institutes of Health 

National Heart, Lung, and Blood Institute 

March 2003