JMIR Publications

ABSTRACT

Background:

Chinese immigrants bear a high diabetes burden and face significant barriers to accessing diabetes self-management education and counseling (DSME) programs.

Objective:

The goal of this study was to examine the feasibility and acceptability and to pilot test the potential efficacy of a social media-based DSME intervention in low-income Chinese immigrants with type 2 diabetes (T2D) in New York City (NYC).

Methods:

This was a single group pre- and post-test study in 30 Chinese immigrants with T2D. The intervention included 24 culturally and linguistically tailored DSME videos, focusing on diabetes education and behavioral counseling techniques. Over 12 weeks, participants received 2 brief videos each week via WeChat, a free social media app popular among Chinese immigrants. Primary outcomes included the feasibility and acceptability of the intervention. Feasibility was evaluated by recruitment processes, retention rates, and the video watch rate. Acceptability was assessed via a satisfaction survey at 3 months. Secondary outcomes, including HbA1c, self-efficacy, dietary intake, and physical activity were measured at baseline, 3 months, and 6 months. Descriptive statistics and pair-t tests were used to summarize baseline characteristics and changes before and after the intervention.

Results:

The sample (N=30) was mostly female (70%), married (63%), with limited English proficiency (100%), and a mean age of 61 (SD=7) years. Most reported an annual household income of < $25,000 (80%) and a high school education or less (63%). Thirty participants were recruited within 2 months (January-February 2020), 97% were retained at 6 months, and a video watch rate of 92% was achieved. The mean baseline HbA1c was 7.3% (SD=1.3%) and declined by 0.5% (95% CI: -0.8%- -0.2%, p=0.003) at 6 months. The mean satisfaction score was 9.9 (SD=0.6) out of 10 indicating a high level of satisfaction with the program. All strongly agreed or agreed that they preferred this video-based DSME to face-to-face visits. Compared to baseline, there were significant improvements in self-efficacy, dietary, and physical activity behaviors at 6 months.

Conclusions:

This pilot study demonstrated that a social media-based DSME intervention is feasible, acceptable, and potentially efficacious in a low-income Chinese immigrant population with T2D. Future studies need to examine the efficacy in an adequately powered clinical trial.