A Culturally Tailored Diabetes Self-Management Education Program With Mobile Health Integration for Chinese Americans...

Area of Science:

• Public Health
• Health Disparities
• Digital Health

Background:

• Limited research exists on culturally adapted, evidence-based Diabetes Self-Management Education (DSME) programs for Chinese Americans (CAs) with type 2 diabetes.
• Existing DSME programs often lack cultural tailoring, hindering effectiveness in diverse populations.
• Addressing health disparities in diabetes management among CA communities is crucial.

Purpose of the Study:

• To develop and pilot-test a culturally tailored DSME program, the Culturally Appropriate Strategies for Chinese Americans with Diabetes (CASCADe) program, integrating mobile health (mHealth) technology.
• To assess the preliminary efficacy of the CASCADe program in improving diabetes self-management among Chinese Americans.
• To leverage community partnerships and participatory approaches in program development.

Main Methods:

• A combined, theoretically driven, and community-participatory approach was used for program development, informed by focus groups, interviews, surveys, and literature reviews.
• A single-group pre- and posttest design over a 3-month period was employed to evaluate the program's feasibility and preliminary efficacy.
• The CASCADe program included home visits, weekly group sessions, and WeChat-based follow-up, incorporating monitoring devices and a widely used mobile messaging platform.

Main Results:

• The CASCADe program demonstrated a significant reduction in glycated hemoglobin (HbA1c) from 7.48% to 7.09% (P=.03).
• Participants showed significant improvements in self-efficacy for diabetes management (6.59 to 8.01, P=.003), quality of life (3.21 to 3.69, P=.005), and stress-coping skills (3.18 to 3.74, P=.01).
• 58% of participants achieved a clinically significant decrease (>0.5) in HbA1c.

Conclusions:

• The pilot study indicates that the CASCADe program is feasible for implementation among Chinese Americans with type 2 diabetes.
• The program shows promising results in improving diabetes self-management skills, glycemic control, and overall well-being.
• Further evaluation in a larger randomized controlled trial is warranted to confirm these findings.