Assessing the Cultural in Culturally Sensitive Printed Patient-Education Materials for Chinese Americans With Type 2 Diabetes

Abstract

Type 2 diabetes affects Chinese Americans at an alarming rate. To address this health disparity, research in the area of cultural sensitivity and health literacy provides useful guidelines for creating culturally appropriate health education. In this article, we use discourse analysis to examine a group of locally available, Chinese- and English-language diabetes print documents from a surface level and deep structure level of culture. First, we compared these documents to research findings about printed health information to determine whether and how these documents apply current best practices for health literacy and culturally appropriate health communication. Second, we examined how diabetes as a disease and diabetes management is being constructed. The printed materials addressed surface level culture through the use of Chinese language, pictures, foods, and exercises. From a deeper cultural level, the materials constructed diabetes management as a matter of measurement and control that contrasted with previous research suggesting an alternative construction of balance. A nuanced assessment of both surface and deeper levels of culture is essential for creating health education materials that are more culturally appropriate and can lead to increased health literacy and improved health outcomes.

Notes

¹ Numerous very specific examples abound, ranging in scope from the Iowa Infant Feeding Attitude Scale (Chen et al., 2013) to the Core Outcome Measures Index (COMI) for low back pain (Qiao et al., 2013).

² We did not use a professional translation service in reading the Chinese documents. However, to confirm the work of the second author, we gave a sample of the materials (one full document and a selection of translation differences) to a Chinese language and linguistics professor who has done professional translation work. He confirmed the points made by the second author.

³ People with type 2 diabetes monitor current blood glucose levels (using a finger-stick and a glucometer), as well as long-term blood glucose levels using the hemoglobin A1C (a blood test that indicates variations in blood glucose over the last 3 months). Maintaining stable glucose levels is important to preventing more serious problems such as heart disease, kidney disease, amputation, or blindness.