Chinese-Americans Can Face Barriers in Self-Managing Type 2 Diabetes
Published June 2010
Chinese-Americans with type 2 diabetes seem willing to take charge of their health but may face cultural barriers to self-management, says UC College of Nursing researcher Yin Xu, PhD.
"Chinese-Americans are really eager to learn, but they feel like they don’t have the resources,” says Xu, a UC assistant professor, who will present her preliminary research findings at the 2010 State of the Science Congress on Nursing Research in September.
Xu, who is Chinese-American, received a $10,000 grant from the Midwest Nursing Research Society in 2009 to study perceptions of diabetes self-management among Chinese-Americans with type 2 diabetes and their family members.
Type 2 diabetes is the most common form of diabetes and is more common in African-Americans, Latinos, Native Americans and Asian-Americans, native Hawaiians and other Pacific Islanders, as well as the aged population.
In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy.
What Xu found, through focus groups and individual interviews with 32 Chinese-Americans, was:
• There is a knowledge gap to understanding the condition. Most Chinese-Americans in the study indicated that they had never received any formal diabetes self-management education program.
• Chinese-Americans have limited access to culturally and linguistically appropriate educational materials. Food lists, for example, are geared toward foods commonly prepared in Western culture.
• Chinese-Americans have a strong belief in using food therapy as a first line of defense. From a traditional Chinese medicine perspective, any medications have toxicity effects to some extent. Chinese food therapy is a practice of healing using natural foods instead of medications. For example, one participant read in a Chinese newspaper regarding the effects of mung bean soup on reducing blood pressure, and then she started to cook mung bean soup every day.
• This ethnic group has a very positive outlook toward managing diabetes and emphasizes that it is important not to worry about the condition.
Some of the participants in their 70s and 80s thought that their ages were considered advanced compared to the past in China.
They were satisfied that they could live such a long life, and felt that it was unnecessary to be too concerned about living longer and they shouldn’t be too tough on themselves.
"Since type 2 diabetes is related to lifestyle and individuals’ cultural values and beliefs influence their eating and lifestyle behaviors, it’s important to understand perspectives of Chinese-Americans regarding diabetes self-management and factors that facilitate or hinder their self-management practices (to effectively design interventions),” says Xu.
One intervention, she says, would be to provide Chinese-Americans with materials relevant to foods they commonly consume.
Dietary strategies and assessments reflect Chinese dietary patterns, common Chinese foods, Chinese food preparation techniques and Chinese-style utensils to estimate serving size; however, the information does not usually show up on the diet recommendation to people with diabetes.
Says Xu: "No one, regardless of ethnicity, really does a perfect job of managing their diabetes because it requires a lot of discipline. But with Chinese-Americans, they may face more challenges in managing their diseases because of language and cultural barriers.”
Xu says she will be applying to the American Diabetes Association this summer for a grant to continue her research.