Managing Diabetes Mellitus in A U.S. Chinese Population

Rankin, Sally

Abstract

In response to an RFA on Diabetes in Minority Populations, the proposed one-year planning grant (R21) has been developed to refine an intervention for San Francisco, Chinese speaking persons with diabetes mellitus. During the planning grant, Chinese American perceptions of health and illness will be examined using Kleinman's questions pertaining to the specific cultural patterning and explanatory system for diabetes mellitus (n-30 subjects). Valid and reliable instruments will be translated into Chinese. Psychometric tests will be performed for the questionnaires. The planning year is preparatory for a three year study to test in a randomized, clinical trial metabolic, cognitive, and emotional outcomes (n-120) in a two factor repeated measures design. The Diabetes Educational Profile, the CES-D (depression scale), the Diabetes Quality of Life scale, a diabetes knowledge test, the Diabetes Family Behavior Checklist, the Family APGAR (family satisfaction), and glycosylated hemoglobins will be estimators of the dependent variables. Data will be analyzed using a repeated measures ANOVA design with two between subjects factors (family member present or absent and length of intervention [short or long]) and one within subjects factor (time [baseline, 3 and 12 months after intervention]). Independent variables include demographic variables and assignment to one of four treatment groups.
The aims of the study are: 1) during the R21: to characterize Chinese representations and explanatory systems of health and illness and their influence on the management of diabetes mellitus; and, 2) also during the R21: to translate, test, and develop psychometrics for measuring coping and appraisal in a U.S. Chinese population with NIDDM; and, 3) in a future study, to test the effect of length of treatment (one versus four days) and family member participation (present vs. absent) on metabolic control, cognitive, and psychosocial outcomes in a sample of U.S. diabetic Chinese subjects using a randomized clinical trial with a repeated measures design.