title: Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Data were collected in two community health centres and one elderly retirement village in Los Angeles, California.
  
  
  METHODS
  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.
authors.affiliation: Li Ka Shing Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong, Hong Kong Li Ka Shing Faculty of Medicine, Research Centre on Heart, Brain, Hormone and Healthy Aging, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Angela Yee Man
authors.initials: AY
authors.lastname: Leung
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, California, USA.
authors.forename: Ai
authors.initials: A
authors.lastname: Bo
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, California, USA.
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Hsiao
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, California, USA.
authors.forename: Song Song
authors.initials: SS
authors.lastname: Wang
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, California, USA.
authors.forename: Iris
authors.initials: I
authors.lastname: Chi
mesh_terms: D001213:Asian / Q000706:statistics & numerical data*; D002681:China / Q000208:ethnology; D003469:Culture; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D057220:Health Literacy / Q000379:methods / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000706:statistics & numerical data
keywords: Chinese immigrants; collectivism; diabetes; health literacy; qualitative study