ArticleJMIR formative research2026
A Culturally Tailored Diabetes Self-Management Education Program With Mobile Health Integration for Chinese Americans With Type 2 Diabetes: Development and Pilot Evaluation Study.
Article in JMIR formative research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04737499 (Implementation and Evaluation of A Culturally Tailored Diabetes Self-Management Program for Chinese Americans), which is not on this map. Cited by 1 paper.
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Implementation and Evaluation of A Culturally Tailored Diabetes Self-Management Program for Chinese Americans
Who cites it
1 citing paper in PubMed.
- Using Group Chats to Drive Behavior Change in Digital Health Interventions: Scoping Review and Realist Synthesis.Journal of medical Internet research · 2026Article
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9 authors.
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Abstract
backgroundAlthough progress has been made in improving the efficacy of Diabetes Self-Management Education (DSME) programs, there remains a dearth of research on culturally adapted, evidence-based DSMEs for Chinese Americans (CAs) with type 2 diabetes.
objectiveThrough collaborative partnerships with 2 large community recreation centers and the AHMC Hospital Network in San Gabriel Valley, California, we developed and pilot-tested a culturally tailored DSME program with integrated mobile health (mHealth) technology, entitled Culturally Appropriate Strategies for Chinese Americans with Diabetes (CASCADe).
methodsThe CASCADe program utilized a combined, theoretically driven, and community-participatory approach and was developed based on information gleaned from focus groups, semistructured interviews, and a questionnaire survey conducted among CA patients with diabetes, physicians, and nurses, as well as from extensive literature reviews of evidence-based program curricula. A single-group pre- and posttest design with a 3-month study period was then employed to assess the program's preliminary efficacy. The study protocols were registered on ClinicalTrials.gov.
resultsThe CASCADe program consisted of (1) a home visit in the first month for training in monitoring device use and WeChat app (a mobile instant-messaging platform widely used in the Chinese population) usage, as well as for acquiring family support; (2) 8 weekly sessions over the following 2 months, delivered in a combined format of group classes, games, group exercises, videos, and discussions; and (3) WeChat follow-up involving education tips, monitoring data summaries, and group discussions after each of the 8 weekly sessions. Topics covered in the weekly sessions included recognition of diabetes and its complications, risk factors, nutrition knowledge, dietary practices, exercise, behavioral self-monitoring, medication adherence, and stress management. The monitoring system used a smartphone to coordinate cloud-based data transmission from a set of wireless devices to capture daily monitoring data on physical activity, body weight, blood pressure, and blood glucose levels. Behavioral self-monitoring was further facilitated by the WeChat app, which provided daily messages related to the diabetes education curriculum; weekly summary reports of monitoring data; feedback; bidirectional 1-on-1 communication between intervention providers and participants; and group discussions among participants regarding readings and the implications of monitoring results. The pre- and postcomparison from the 3-month pilot trial showed a significant reduction in glycated hemoglobin (HbA1c; 7.48 vs 7.09, P=.03), with all but 1 participant demonstrating a reduction and 7 out of 12 (58%) achieving a >0.5 decrease in HbA1c. Significant improvements were also observed in self-efficacy in diabetes management (6.59 vs 8.01, P=.003), quality of life (3.21 vs 3.69, P=.005), and stress-coping skills (3.18 vs 3.74, P=.01) at 3 months after baseline among CA patients with type 2 diabetes.
conclusionsOur pilot study demonstrated the feasibility of implementing the CASCADe program among CAs to improve diabetes self-management skills and yielded promising results, warranting further evaluation in a larger randomized trial.
trial registrationClinicalTrials.gov NCT04737499; https://clinicaltrials.gov/ct2/show/NCT04737499.
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