Family Involvement in Asian American Health Interventions: A Scoping Review and Conceptual Model

Abstract

Family members play a crucial role in the health of Asian American communities, and their involvement in health interventions can be pivotal in optimizing impact and implementation. To explore how family members can be effectively involved in Asian American health interventions and develop a conceptual framework of methods of involvement at the stages of intervention development, process, and evaluation, this scoping review documented the role of Asian American family members in interventions (across any health objective). Of the 7175 studies identified through database and manual searches, we included 48 studies in the final analysis. Many studies focused on Chinese (54%) or Vietnamese (21%) populations, were conducted in California (44%), and involved spouses (35%) or parents/children (39%). We observed involvement across 3 stages: (1) intervention development (formative research, review process, material development), (2) intervention process (recruitment, receiving the intervention together, receiving a parallel intervention, enlisting support to achieve goals, voluntary intervention support, agent of family-wide change, and participation gatekeepers), and (3) intervention evaluation (received evaluation together, indirect impact evaluation, and feedback during intervention). Impact of family member involvement was both positive (as sources of encouragement, insight, accountability, comfort, and passion) and negative (sources of hindrance, backlash, stigma, obligation, and negative influence). Suggestions for future research interventions include (1) exploring family involvement in South Asian or young adult interventions, (2) diversifying types of family members involved (eg, extended family), and (3) diversifying methods of involvement (eg, family members as implementation agents).

Keywords: Asian American; family; intervention; parents; spouses.

Figure 1.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of search strategy and final sample of studies included in a scoping review of Asian American health interventions involving family members as of 2021.

Figure 2.

Conceptual model of methods and impact of family involvement in Asian American health interventions involving family members as of 2021. Solid-filled arrowed lines indicate involvement of a family member, whereas dotted arrowed lines describe when participants themselves may also play a role within a particular type of family member intervention involvement. An arrow going through a family member symbolizes their strong agency or responsibility in the type of involvement (eg, as a changemaker, recruiter, or gatekeeper), whereas an arrow in close proximity to the family member symbolizes a more secondary, optional, or voluntary type of involvement (eg, as support).