More than translation: Culturally tailoring health education for Chinese Australians with type 2 diabetes

摘要

Background: The current practice on culturally tailoring health education to the Chinese relies on language-translating Western evidence-based material. It however, was shown to conflict with Chinese expectations, creating additional stress and frustration. Aim: To develop and evaluate a pilot diabetes group education program for Chinese Australians. Methods: A culturally-tailored group education program (Not Scared of Sugar) was developed and piloted with Melbourne-based Cantonese-speaking people with type 2 diabetes. Program teaching styles were aligned with the Confucian process of learning and incorporated cultural strategies to promote healthy behaviour change. Thirty-four individuals (35% male) attended the five-session program, delivered in language by multidisciplinary clinicians. Evaluative data were collected at baseline, on program completion and at 6 months follow-up. Results: Mean participant age was 69 ± 9 years, with a median duration of diabetes of 10 (IQR = 2.8, 20.5) years. On completion of the program, participant waist circumference was reduced from 90.5 ± 9.9 cm to 89.2 ± 9.9 cm (P < 0.001) and was maintained at 6 months. There was a significant increase in the number of diabetes self-care behaviours undertaken (American Association of Diabetes Educators Questionnaire Score: 30(22, 32.3) vs 33(29.8, 35.0), P < 0.001) at 6-month follow-up. Diabetes-related distress assessed by PAID-C was also significantly reduced at 6-month follow-up (P < 0.05). HbA1c was unchanged after 6 months (51 ± 7.9 vs 50 ± 7.8 mmol/mol, P = 0.316). Conclusions: Culturally tailoring health education is more than language-translation of the materials. To optimise clinical effectiveness and participant experience, health education should align with cultural learning orientation and incorporate specific behaviour change motivators.