title: Pushing the envelope for cultural appropriateness: does evidence support cultural tailoring in type 2 diabetes interventions for Mexican American adults?
abstract: This study explores the potential utility of a culturally tailored diabetes management intervention approach by testing associations between acculturation and diabetes-related beliefs among Mexican-American adults with type 2 diabetes.
  
  
  
  Data from 288 Mexican-American adults with type 2 diabetes were obtained via a bilingual, telephone-administered survey. Participants were drawn from a stratified, random sample designed to obtain maximum variability in acculturation. The survey assessed diabetes-related beliefs, intervention preferences, and the following three acculturation constructs from the Hazuda acculturation and assimilation scales: Spanish use, value for preserving Mexican culture, and interaction with Mexican Americans.
  
  
  
  Only one outcome-preference for a program for Mexican Americans-was associated with all three acculturation variables. Spanish use was positively associated with belief in susto as a cause of diabetes, preference for expert-driven health guidance, and involvement of others in taking care of diabetes. Value for preserving Mexican culture was related to a more holistic view of health, as evidenced by an increased likelihood of consulting a curandero, use of prayer, and interest in a diabetes program with religious content. Value for cultural preservation was also related to higher suspicion of free diabetes programs. Interaction with Mexican Americans was associated with a belief that insulin causes blindness.
  
  
  
  Findings from this study suggest distinct relationships between acculturation constructs and diabetes-related beliefs and preferences, thus arguing against the use of a single acculturation construct to determine diabetes intervention design. Cultural tailoring may enhance the cultural appropriateness and ultimate effectiveness of diabetes interventions for Mexican American adults.
authors.affiliation: The Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan (Dr Davis, Dr Peterson)
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Davis
authors.affiliation: The Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan (Dr Davis, Dr Peterson)
authors.forename: Karen E
authors.initials: KE
authors.lastname: Peterson
authors.affiliation: Preventive Medicine, Rush University Medical Center, Chicago, Illinois (Dr Rothschild)
authors.forename: Steven K
authors.initials: SK
authors.lastname: Rothschild
authors.affiliation: The Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan (Dr Resnicow)
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D002140:California; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000534:rehabilitation*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D010353:Patient Education as Topic; D057240:Patient Preference; D013781:Texas