Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research


  • This project was supported by the National Institute of Nursing Research (1R01NR010693). We thank the following organizations and individuals: Doreen Der-McLeod and Monica Walters of Donaldina Cameron House; Daniel Chan and Edna Tam of North East Medical Services; Anita Au-Yeung and Doris Hung of University of California San Francisco; Eunice Lew and all study participants; members of our Community Advisory Board. We thank Margaret Grey of Yale University for her ongoing consultation. An earlier version of this work was presented in the American Diabetes Association Convention in Philadelphia in 2012.


Chinese Americans demonstrate greater prevalence of diabetes than non-Hispanic whites and find standard diabetes care disregards their cultural health beliefs. Academic researchers and Chinatown agencies collaborated to culturally adapt and test an efficacious cognitive-behavioral intervention using community-based participatory research. Using a delayed-treatment repeated-measures design, 145 adult Chinese immigrants with Type 2 diabetes completed treatment. Immediate benefits of treatment were evident in the improvement (p < .05) in diabetes self-efficacy, diabetes knowledge, bicultural efficacy, family emotional and instrumental support, diabetes quality of life, and diabetes distress. Prolonged benefits were evident in all changed variables 2 months post-intervention. The CBPR approach enabled the development of a culturally acceptable, efficacious behavioral intervention, and provides a model for working with communities that demonstrate health disparities. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36: 359–372, 2013