Skip to main content
SpringerLink
Log in

Incorporating Cultural Perspectives into Diabetes Self-Management Programs for East Asian Immigrants: A Mixed-Study Review

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

It is important to understand East Asian immigrants (EAIs)’ unique perspectives in managing diabetes in order to provide culturally-competent care. However, it is not known whether EAIs’ perspectives are addressed in diabetes self-management interventions developed for EAIs. Therefore, a mixed-study review was conducted to identify EAIs’ perspective from qualitative research (n = 9 studies) and to evaluate the components of EAI diabetes self-management interventions (n = 7). Themes from the qualitative synthesis demonstrated that EAIs have unique cultural values and traditional health beliefs while struggling with multi-contextual barriers due to immigration. The evaluation of EAI diabetes self-management interventions revealed that there was a lack of consensus on cultural strategies for EAIs’ across the interventions. Addressing language barriers was the only factor consistently integrated in the cultural components of intervention by employing bilingual interventionists. EAIs’ perspectives and experiences need to be incorporated in the future diabetes self-management interventions to better provide culturally-competent care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ramachandran A, Ma RCW, Snehalatha C. Diabetes in Asia. Lancet. 2010;375(9712):408–18.

    Article  PubMed  Google Scholar 

  2. United Nations Statistics Division. Composition of macro geographical (continental) regions, geographical sub-regions, and selected economic and other groupings. 2013. Retrieved from http://unstats.un.org/unsd/methods/m49/m49regin.htm.

  3. U.S. Bureau of the Census. The Asian population: 2010. Washington, DC: U.S. Department of Commerce; 2012.

    Google Scholar 

  4. Wang EJ, Wong EC, Dixit AA, Fortmann SP, Linde RB, Palaniappan LP. Type 2 diabetes: identifying high risk Asian American subgroups in a clinical population. Diabetes Res Clin Pract. 2011;93(2):248–54.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Cha E, Yang K, Lee J, Min J, Kim KH, Dunbar SB, et al. Understanding cultural issues in the diabetes self-management behaviors of Korean immigrants. Diabetes Educ. 2012;38(6):835–44.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nam S, Song H-J, Park S-Y, Song Y. Challenges of diabetes management in immigrant Korean Americans. Diabetes Educ. 2013;39(2):213–21.

    Article  PubMed  Google Scholar 

  7. Shinagawa LH, Kim DY. A portrait of Chinese Americans. College Park: OCA and University of Maryland Asian Aemricans Studies Program; 2008.

    Google Scholar 

  8. U.S. Bureau of the Census. Language use in the United States. Washington, DC: U.S. Department of Commerce; 2013.

    Google Scholar 

  9. Ho EY, Chesla CA, Chun KM. Health communication with Chinese Americans about type 2 diabetes. Diabetes Educ. 2012;38(1):67–76.

    Article  PubMed  Google Scholar 

  10. Ngo-Metzger Q, Fund C. Cultural competency and quality of care: obtaining the patient’s perspective. New York: Commonwealth Fund; 2006.

    Google Scholar 

  11. Ma GX. Between two worlds: the use of traditional and Western health services by Chinese immigrants. J Community Health. 1999;24(6):421–37.

    Article  CAS  PubMed  Google Scholar 

  12. Choi S, Rankin S. Glucose control in korean immigrants with type 2 diabetes. West J Nurs Res. 2009;31(3):347–63.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Harden A, Thomas J. Methodological issues in combining diverse study types in systematic reviews. Int J Soc Res Methodol. 2005;8(3):257–71.

    Article  Google Scholar 

  14. Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.

    Google Scholar 

  15. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.

    Article  PubMed  Google Scholar 

  16. Pluye P, Gagnon MP, Griffiths F, Johnson-Lafleur J. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews. Int J Nurs Stud. 2009;46(4):529–46.

    Article  PubMed  Google Scholar 

  17. Tseng J, Halperin L, Ritholz MD, Hsu WC. Perceptions and management of psychosocial factors affecting type 2 diabetes mellitus in Chinese Americans. J Diabetes Complicat. 2013;27(4):383–90.

    Article  PubMed  Google Scholar 

  18. Washington G, Wang-Letzkus MF. Self-care practices, health beliefs, and attitudes of older diabetic Chinese Americans. J Health Hum Serv Adm. 2009;32(3):305–23.

    PubMed  Google Scholar 

  19. Chesla CA, Chun KM, Kwan CM. Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans. Diabetes Care. 2009;32(10):1812–6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Chun KM, Chesla CA. Cultural issues in disease management for Chinese Americans with type 2 diabetes. Psychol Health. 2004;19(6):767–85.

    Article  Google Scholar 

  21. Wang Y, Chuang L, Bateman WB. Focus group study assessing self-management skills of Chinese Americans with type 2 diabetes mellitus. J Immigr Minor Health. 2012;14(5):869–74.

    Article  PubMed  Google Scholar 

  22. Chesla CA, Chun KM. Accommodating type 2 diabetes in the Chinese American family. Qual Health Res. 2005;15(2):240–55.

    Article  PubMed  Google Scholar 

  23. Chun KM, Chesla CA, Kwan CM. “So We Adapt Step by Step”: acculturation experiences affecting diabetes management and perceived health for Chinese American immigrants. Soc Sci Med. 2011;72(2):256–64.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Pistulka GM, Winch PJ, Park H, Han H-R, Kim MT. Maintaining an outward image a Korean immigrant’s life with type 2 diabetes mellitus and hypertension. Qual Health Res. 2012;22(6):825–34.

    Article  PubMed  Google Scholar 

  25. Chesla CA, Chun KM, Kwan CM, Mullan JT, Kwong Y, Hsu L, et al. Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research. Res Nurs Health. 2013;36(4):359–72.

    Article  PubMed  Google Scholar 

  26. Choi SE, Rush EB. Effect of a short-duration, culturally tailored, community-based diabetes self-management intervention for Korean immigrants: a pilot study. Diabetes Educ. 2012;38(3):377–85.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Ivey SL, Tseng W, Kurtovich E, Weir RC, Liu J, Song H, et al. Evaluating a culturally and linguistically competent health coach intervention for Chinese–American patients with diabetes. Diabetes Spectr. 2012;25(2):93–102.

    Article  Google Scholar 

  28. Kim MT, Han H-R, Song H-J, Lee J-E, Kim J, Ryu JP, et al. A community-based, culturally tailored behavioral intervention for Korean Americans with type 2 diabetes. Diabetes Educ. 2009;35(6):986–94.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Sun AC, Tsoh JY, Saw A, Chan JL, Cheng JW. Effectiveness of a culturally tailored diabetes self-management program for Chinese Americans. Diabetes Educ. 2012;38(5):685–94.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wang C-Y, Chan SMA. Culturally tailored diabetes education program for Chinese Americans: a pilot study. Nurs Res. 2005;54(5):347–53.

    Article  PubMed  Google Scholar 

  31. Islam NS, Zanowiak JM, Wyatt LC, Chun K, Lee L, Kwon SC, et al. A randomized-controlled, pilot intervention on diabetes prevention and healthy lifestyles in the New York City Korean community. J Community Health. 2013;38(6):1030–41.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Abraido-Lanza AF, Chao MT, Florez KR. Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Soc Sci Med. 2005;61(6):1243–55.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Nursing, Yale University, 400 West Campus Drive, Orange, CT, 06477, USA

    Chorong Park, Soohyun Nam & Robin Whittemore

Authors
  1. Chorong Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Soohyun Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robin Whittemore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chorong Park.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, C., Nam, S. & Whittemore, R. Incorporating Cultural Perspectives into Diabetes Self-Management Programs for East Asian Immigrants: A Mixed-Study Review. J Immigrant Minority Health 18, 454–467 (2016). https://doi.org/10.1007/s10903-015-0181-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-015-0181-5

Keywords

Search

Navigation