Accepted for/Published in: JMIR Formative Research
Date Submitted: May 12, 2025
Date Accepted: Dec 19, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Developing and Pilot-Testing A Culturally Tailored Diabetes Self-Management Education Program For Chinese Americans With Type 2 Diabetes
ABSTRACT
Background:
Minimal efforts on cultural adaptations of evidence-based Diabetes Self-Management Education programs have been made for Chinese Americans with type 2 diabetes.
Objective:
This study aimed to develop and test a culturally tailored diabetes self-management education program that integrated mHealth technology to improve the management of type 2 diabetes among Chinese Americans.
Methods:
The intervention curriculum called Culturally Appropriate Strategies for Chinese Americans with Diabetes (CASCADe) was developed based on information gleaned from focus groups, semi-structural interviews and a questionnaire survey among Chinese American diabetic patients, physicians and nurses, and extensive literature reviews of evidence-based program curriculums. A single-group pre- and post-test design with a study period of three months was then employed to test the preliminary efficacy of the program.
Results:
The CASCADe program consisted of a home visit in the first month for monitoring devices and WeChat app usage and acquiring family support, and eight sessions of a combined format of group classes, games, group exercises, video and discussions in the following two months. One important component of the program is to use the monitoring devices for behavioral self-monitoring with augmented solutions of WeChat follow-ups on education tips, data summary and feedback, bidirectional one-on-one between intervention providers and participants as well as group discussions among participants. The preliminary results from the pilot trial of the program showed a significant reduction of HbA1c and improvement of diabetes management knowledge, self-efficacy, quality of life and stress-coping skills among Chinese American patients with Type 2 diabetes.
Conclusions:
Our pilot study demonstrated the feasibility to implement our culturally tailored intervention program with mHealth integration among Chinese Americans to improve diabetes self-management skills.
Citation
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