Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study

BMJ Open. 2014 Nov 18;4(11):e005294. doi: 10.1136/bmjopen-2014-005294.


Objectives: To investigate why first-generation Chinese immigrants with diabetes have difficulty obtaining, processing and understanding diabetes related information despite the existence of translated materials and translators.

Design: This qualitative study employed purposive sampling. Six focus groups and two individual interviews were conducted. Each group discussion lasted approximately 90 min and was guided by semistructured and open-ended questions.

Setting: Data were collected in two community health centres and one elderly retirement village in Los Angeles, California.

Participants: 29 Chinese immigrants aged ≥45 years and diagnosed with type 2 diabetes for at least 1 year.

Results: Eight key themes were found to potentially affect Chinese immigrants' capacity to obtain, communicate, process and understand diabetes related health information and consequently alter their decision making in self-care. Among the themes, three major categories emerged: cultural factors, structural barriers, and personal barriers.

Conclusions: Findings highlight the importance of cultural sensitivity when working with first-generation Chinese immigrants with diabetes. Implications for health professionals, local community centres and other potential service providers are discussed.

Keywords: Chinese immigrants; collectivism; diabetes; health literacy; qualitative study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian Americans / statistics & numerical data*
  • China / ethnology
  • Culture
  • Diabetes Mellitus, Type 2 / ethnology*
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • Focus Groups
  • Health Literacy / methods
  • Health Literacy / statistics & numerical data*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Los Angeles
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Qualitative Research
  • Self Care / methods
  • Self Care / statistics & numerical data