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

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.