Table 3.

Key Characteristics and Findings of Quantitative Studies on Diabetes Self-Management in East Asian Americans

Quantitative studies	Research design	Population	Setting	Intervention/control group	Cultural tailoring	Outcome measures	Major findings
Wang and Chan34	Nonrandomized single-group cohort study based on empowerment model	33 Chinese Americans (52% female), mean age 68.8±10.1 years	Community clinic in Hawaii	10 weekly group education sessions with certified diabetes instructor/not applicable	Education integrating Chinese language, dietary examples, exercise suggestions, traditional medicine, and cultural beliefs into plans for self-management of disease with diet, exercise, medication, and self-care	Quality of life (modified DQOL), HbA1c levels, body weight, BP	Decreased mean HbA1c of 0.99% (p-value not reported, d=0.53, 95% CI [0.03–1.01]) and increased diabetes self-management knowledge at 3 months. Language of instruction and dietary suggestions were important features of the intervention
Kim et al.30	Randomized controlled trial based on CBPR	79 Korean Americans (44% female), mean age 56.5±7.9 years	Korean Resource Center in Washington DC/Baltimore Area	6 weekly group education sessions, followed by home glucose monitoring and individual monthly telephone counseling with bilingual nurse for 24 weeks/usual care	Education and counseling by trained bilingual nurses about diabetes, management, complications, healthy eating, culturally relevant food suggestions food labels, exercise, medications, and communicating with physician	Diabetes knowledge (DKT), Self-efficacy (SCDSE), Diabetes self-care activities (SDSCA), Depression (KDSKA), Quality of life (DQOL), HbA1c, fasting glucose	Decreased mean HbA1c of 0.9% (p=0.01, d=0.67, 95% CI [0.21–1.11]), fasting glucose 35.3 mg/dL (p=0.06). Increased diabetes knowledge (p<0.01), quality of life (p=0.03), self-care activities (p<0.01), and self-efficacy (p=0.01) at 30 weeks
Song et al.37	Randomized controlled trial based on CBPR	79 Korean Americans (44% female), mean age 56.5±7.9 years	Korean Resource Center in Washington DC/Baltimore Area	6 weekly group education and interactive sessions led by bilingual instructor/usual care	Education available in preferred language. Individually tailored serving tables and culture-specific food model with considerations for Korean-specific diet and food preparation	Diabetes knowledge (DKT), satisfaction survey with self-designed open-ended question survey	Increased diabetes-related nutrition knowledge (p<0.01), mean satisfaction of 2.7 out of 3 on educational content at 30 weeks
Ivey et al.29	Nonrandomized controlled cohort study based on Bodenheimer model	92 Chinese Americans (65% female), mean age 66.7±10.7 years	Asian Health Services in Oakland, CA	3 individual visits with physician and registered dietitian and follow-up calls with a health coach over a period of 6 months/usual care	Education by trained medical assistants with Chinese language diabetes education materials. Dieticians and physicians linguistically matched. Recommendations culture sensitive	HbA1c levels	Decreased mean difference of HbA1c 0.36% (p=0.14, d=0.28, 95% CI [−0.14 to 0.68]) at 8.5 months. Health coach addressed psychosocial factors affecting self-management such as navigating the health system and providing moral support
Choi and Rush27	Nonrandomized single-group cohort study	41 Korean Americans (54% female), mean age 70.3±8.4 years	Community center on the West Coast	2 group education sessions lead by a bilingual family nurse practitioner/not applicable	Education lead by bilingual family nurse practitioners with cultural tailoring employing native language, using cultural dietary preferences, and discussions of cultural beliefs in relationship to treatment and practices	Self-management (SDSCA), Diabetes knowledge (DKT), mood (PHQ-9), Health status (SF-12), HbA1c, BMI	Decreased mean HbA1c of 0.52% (p<0.001, d=0.36, 95% CI [0.07–0.80]), increased feet checks 1.4 times per week (p<0.001), increased diabetes knowledge (p=0.39), increased diabetes self-efficacy (p=0.098) at 3 months
Sun et al.38	Nonrandomized single-group cohort study based on CCM, TRA, and SCT	23 Chinese Americans (52% female), 52% age 70–79, 22% age 80–89	Medical office building in San Francisco	12 group support sessions lead by multidisciplinary bilingual team over 6 months and bilingual booklet on diabetes management/not applicable	Education lead by bilingual team of registered nurses, dietitians, and CDEs incorporated Chinese commonly practiced activities and culturally relevant foods into curriculum. Discussed use of traditional medicine and exercise	Diabetes knowledge (based off ADA recommendations), diabetes care activities (self-report questionnaire), and HbA1c	Decreased mean HbA1c of 0.76% (p=0.001, d=0.93, 95% CI [0.31–1.53]) and increased diabetes knowledge (p<0.01) at 6 months. Moral support in group setting helped to improve self-management

ADA, American Diabetes Association; BMI, body mass index; CBPR, community-based participatory research; CCM, chronic care model; CDE, certified diabetes educator; CI, confidence interval; DKT, diabetes knowledge test; DQOL, diabetes quality-of-life measure; KDSKA, Kim Depression scale for Korean Americans; N/A, not available; PHQ-9, Patient Health Questionnaire; SCDSE, Stanford Chronic Disease Self-Efficacy scale; SCT, social cognitive theory; SDSCA, summary of diabetes self-care activities; SF-12, Abbreviated Medical Outcomes SF-36 Health survey; TRA, theory of reasoned action.