Risk Education for Prevention of Eating Disorders among Korean American Women

For nursing students

Study summary

Eating disorders — anorexia nervosa, bulimia nervosa, and binge-eating disorder — are serious mental illnesses tied to distorted body image and harmful behaviors around food and weight. This Doctor of Nursing Practice (DNP) project, completed by Jessica Hyunjung Oh at the University of Arizona, looked at a group that is often overlooked in eating disorder research: Korean American women. The author noted that research on Korean Americans and eating disorders is limited, even though this population faces cultural pressure around body weight and appearance, alongside broader weight stigma present in Korean culture.

To address this gap, Oh designed and delivered an in-person educational session for a community group of Korean American women attending a Korean church in Phoenix, Arizona. The session used a PowerPoint presentation to teach participants about the three main types of eating disorders, the risk factors involved, and resources available for people struggling with disordered eating. A specific goal was to raise awareness of weight stigma as it affects this cultural group, since unrealistic body weight ideals can shape how women see themselves and how they are treated by others.

Twenty Korean American women took part in the project. Before the session, participants completed a pretest, and after the session they completed a posttest, both designed to measure their knowledge about eating disorders. Everyone also completed the EAT-26 (Eating Attitudes Test), a validated 26-item screening tool that looks at attitudes, feelings, and behaviors connected to disordered eating, and a satisfaction survey about the presentation itself.

The results were notable on two fronts. First, knowledge improved substantially: the number of correct answers on the posttest was double the number on the pretest, suggesting the education session was effective at teaching participants about eating disorders, their risks, and where to find help. Second, and more strikingly, the EAT-26 results showed that all twenty participants screened as being at high risk for an eating disorder at some point in their lives. That finding, involving every single participant, underscores just how prevalent disordered eating risk may be within this community sample, even though it does not by itself mean all twenty women currently have a diagnosed eating disorder. Finally, participants reported being satisfied with the content of the presentation.

Oh concluded that a PowerPoint-based educational session was an effective way to increase Korean American women's knowledge about eating disorders and to help them identify relevant risks and resources. Based on these results, the project recommended that healthcare providers, including nurses, receive training in culturally appropriate care for patients navigating eating disorders, particularly within Asian American communities where these issues can be underrecognized or stigmatized.

For nursing students, this project is a good example of how a DNP quality-improvement or practice-change project can target a specific, under-served population with a low-cost, low-barrier intervention: one educational session delivered in a familiar community setting. It also illustrates how screening tools like the EAT-26 can be used practically, outside of a hospital or clinic, to identify people who may benefit from further evaluation or referral. At the same time, students should notice what this project can and cannot tell us. Twenty participants from one church group in one city is a small, specific sample; the EAT-26 identifies risk based on self-reported attitudes and behaviors, it is not a diagnostic tool, and a single educational session cannot be expected to change entrenched cultural attitudes toward body weight on its own. Read this project as a hopeful pilot demonstrating feasibility and impact within one community, not as proof that this exact approach will generalize to all Korean American women or other Asian American populations. The project's main practical takeaway for practicing nurses is straightforward: ask about eating attitudes and body image even with patients from cultural backgrounds where eating disorders are assumed to be rare, and be ready to offer culturally sensitive education and referral resources when risk is identified — a lesson that applies equally to Canadian nurses caring for Korean-Canadian and other Asian-Canadian patients.

For educators

Teaching and appraisal notes

This DNP scholarly project, completed by Jessica Hyunjung Oh at the University of Arizona (2022), addresses a documented gap in the literature: the scarcity of eating disorder research and intervention specific to Korean American women. The project's stated background rationale is that body image and perceptions of normal body weight are shaped by cultural and societal pressures, and that Korean American women face elevated risk for disordered eating and distorted body image tied to culturally specific ideals of thinness, alongside broader weight stigma documented in Korean and Korean American communities.

The intervention was a single in-person educational session delivered via PowerPoint to a community group of Korean American women recruited through a Korean church in Phoenix, Arizona. This is a classic DNP quality-improvement/practice project design: a targeted educational intervention evaluated with a pretest–posttest structure rather than an experimental or quasi-experimental comparison-group design. Twenty participants completed the full protocol, which included a knowledge pretest and posttest, the EAT-26 (a validated, widely used 26-item self-report screening instrument for disordered eating attitudes and behaviors), and a satisfaction survey.

Two results merit emphasis for classroom discussion. First, the doubling of correct posttest answers relative to pretest is a straightforward, clinically meaningful demonstration that a single culturally tailored session can measurably improve health literacy about eating disorders in an under-served population. Second, and more clinically consequential, all twenty participants screened positive for high lifetime risk of an eating disorder on the EAT-26. This finding, drawn from a convenience sample of church-attending community members rather than a clinical population, is striking and worth unpacking with students: it may reflect a genuinely high-risk population, it may reflect self-selection (women more concerned about body image may have been more likely to attend), or it may reflect known limitations of the EAT-26 as a screening rather than diagnostic tool. Instructors should use this as a teaching moment about the difference between screening-positive and diagnosed prevalence, and about how convenience sampling can inflate or skew apparent risk estimates.

Methodologically, the abstract does not report inferential statistics, effect sizes, or a formal limitations section, and no full peer-reviewed publication accompanies the ProQuest/ERIC dissertation record; some procedural detail (recruitment method beyond the church setting, session length, instrument psychometrics as applied here, follow-up duration) is not available from the metadata reviewed. Students and faculty appraising this project should treat it as a small, single-site, single-session DNP implementation project with strong face validity and a clear practice recommendation (training providers in culturally appropriate care for Asian American patients with eating disorder risk) rather than as generalizable efficacy evidence.

Discussion in seminar could productively center on: how nurses can build culturally responsive screening and education into community outreach; the tension between brief, low-cost interventions and the need for sustained behavior change; and how DNP projects of this scale still generate actionable, publishable practice knowledge even without a comparison group. The project is a useful exemplar for teaching translational, community-based DNP scholarship, and for discussing how underrepresented populations in eating disorder research can be reached through trusted community institutions like faith organizations. For Canadian nursing educators, the transferable lesson is not the specific US church setting but the underlying principle of culturally responsive, community-embedded outreach: Canada's sizeable and diverse Korean-Canadian and broader Asian-Canadian communities are subject to the same mistaken assumption that eating disorders are rare in East Asian populations, and cultural-competence and person-centred-care expectations familiar to Canadian community and primary-care nurses support the same screen-plus-educate-plus-refer approach.