Researchers created a special diabetes education program designed specifically for Chinese Americans who speak limited English. The program used videos on WeChat (a popular messaging app) and phone calls from health workers to teach people about managing diabetes through diet, exercise, and taking medicine on time. In a test with 60 Chinese American adults with type 2 diabetes, those who used the program felt more confident about managing their diabetes, felt less stressed about their condition, and ate healthier foods compared to people who didn’t get the program. This suggests that programs designed for specific cultures and languages might work better than one-size-fits-all approaches.

The Quick Take

  • What they studied: Does a diabetes education program that’s customized for Chinese Americans and taught in Chinese help people feel more confident managing their diabetes and reduce their stress about the disease?
  • Who participated: 60 Chinese American adults (average age 54) with type 2 diabetes who had high blood sugar levels. Most spoke limited English, had a high school education or less, and were married.
  • Key finding: People in the program felt significantly more confident about managing their diabetes after 3 months, felt less stressed about diabetes after 6 months, and ate healthier diets at both 3 and 6 months compared to the control group.
  • What it means for you: If you’re a Chinese American with type 2 diabetes who speaks limited English, a program designed specifically for your culture and language may help you feel more in control and less worried about your condition. However, this was a small test study, so larger studies are needed to confirm these benefits.

The Research Details

Researchers divided 60 Chinese American adults with type 2 diabetes into two groups. One group (30 people) received the special CARE program, which included two educational videos per week for 12 weeks delivered through WeChat, plus phone calls every two weeks from community health workers who helped them set goals and solve problems. The other group (30 people) was put on a waiting list and didn’t receive the program during the study period.

The program covered important diabetes topics like eating healthy foods, being physically active, and taking medicines correctly. The videos and phone calls were all in Chinese and designed to fit Chinese cultural values and beliefs about health. Researchers measured how confident people felt about managing their diabetes, how much stress they felt about their condition, and how well they followed healthy eating habits at the start, after 3 months, and after 6 months.

Many Chinese Americans with diabetes face special challenges because of language barriers and cultural differences. Standard diabetes programs are often taught in English and may not match Chinese cultural values about food, family, and health. By creating a program specifically for Chinese Americans, researchers could address these unique barriers and potentially help more people successfully manage their diabetes.

This was a well-designed study because it randomly assigned people to either get the program or wait (which helps prove the program itself caused the improvements, not other factors). The study measured outcomes at multiple time points (baseline, 3 months, and 6 months), which shows whether benefits lasted. However, this was a small pilot study with only 60 people, so the results need to be tested with a much larger group before we can be completely confident. The study was conducted in New York City, so results might be different in other areas.

What the Results Show

People who received the CARE program showed meaningful improvements in three important areas. First, their confidence in managing diabetes (called self-efficacy) increased significantly after 3 months—the improvement was about 8.5 points on a scale, which was statistically significant. Second, their stress and worry about diabetes (called diabetes distress) decreased noticeably after 6 months. Third, their healthy eating habits improved at both the 3-month and 6-month check-ins, with improvements of about 1.6 points on the measurement scale.

These improvements were compared to the control group, which didn’t receive the program. The control group didn’t show the same level of improvement, suggesting that the program itself caused the positive changes. All of these improvements were statistically significant, meaning they were unlikely to have happened by chance.

While the study focused on confidence, stress, and diet, the program was originally designed to help lower blood sugar levels (hemoglobin A1c). The fact that it improved confidence and reduced stress is important because these psychological factors often help people stick with their diabetes management long-term. When people feel more confident and less stressed, they’re more likely to keep following healthy habits.

This research builds on earlier work showing that the CARE program could lower blood sugar levels. This new analysis shows that the program also helps with the emotional and behavioral side of diabetes management. Previous research has shown that standard diabetes programs often don’t work as well for Chinese Americans because of language and cultural barriers. This study suggests that tailoring programs to specific cultures and languages may be more effective than using generic programs for everyone.

The study was relatively small with only 60 participants, so the results need to be confirmed with a much larger group. The study only included Chinese Americans in New York City, so results might be different in other parts of the country or for Chinese Americans with different backgrounds. The study lasted only 6 months, so we don’t know if the benefits continue longer than that. Some people may have dropped out of the study, which could affect the results. Additionally, people knew they were being studied, which sometimes causes them to behave differently than they normally would.

The Bottom Line

If you’re a Chinese American with type 2 diabetes and speak limited English, ask your doctor about culturally tailored diabetes programs like CARE. These programs appear to help people feel more confident managing their diabetes and reduce stress. However, this is still early research, so more studies are needed. In the meantime, working with a community health worker or diabetes educator who speaks your language and understands your culture may be helpful. (Confidence level: Moderate—this is promising research but needs larger studies to confirm.)

This research is most relevant for Chinese Americans with type 2 diabetes, especially those who speak limited English and may have difficulty accessing standard diabetes programs. It’s also important for healthcare providers, community health centers, and health systems serving Chinese American communities. Family members of people with diabetes may also benefit from understanding how cultural and language barriers affect diabetes care. People from other cultural or language backgrounds might also benefit from similar tailored programs, though this study specifically tested the approach with Chinese Americans.

Based on this study, you might notice improvements in how confident you feel about managing your diabetes within 3 months of starting the program. Reductions in stress and worry about diabetes may take about 6 months to become noticeable. Improvements in eating habits can happen within 3 months. However, these timelines are based on a small study, so individual results may vary.

Want to Apply This Research?

  • Track your confidence in managing diabetes weekly using a simple 1-10 scale. Also track how many days per week you eat healthy meals (aim to increase this number). Record your stress level about diabetes on a 1-10 scale weekly to see if it decreases over time.
  • Use the app to receive reminders for healthy eating goals, log your meals to track diet improvements, and set weekly diabetes management goals with your health coach. The app could send you educational tips in your language and help you schedule check-in calls with your community health worker.
  • Set up monthly reviews of your confidence scores, stress levels, and healthy eating habits. Compare your scores from month to month to see your progress. Share these tracking results with your doctor or health worker during regular check-ins to adjust your diabetes management plan as needed.

This research describes a promising diabetes education program for Chinese Americans, but it is a small pilot study and should not replace medical advice from your doctor. The findings suggest potential benefits but need to be confirmed with larger studies. If you have type 2 diabetes, always consult with your healthcare provider before making changes to your diabetes management, medications, diet, or exercise routine. This summary is for educational purposes only and is not medical advice. Individual results may vary based on your specific health situation, medications, and other factors.