Kevin M. Chun

Acculturation : advances in theory, measurement, and applied research

Conceptual Approaches to Acculturation, John W. Berry Major Approaches to the Measurement of Acculturation Among Ethnic Minority Populations - A Content Analysis and an Alternative Empirical Strategy, Nolan Zane, Winnie Mak Ethnic Identity and Acculturation, Jean S. Phinney Acculturation and Changes in Cutlural Values, Gerardo Marin, Raymond J. Gamba Acculturation Among Ethnic Minority Families, Kevin M. Chun, Phillip K. Akutsu The Influence of Acculturation Processes on the Family, Daniel A. Santisteban, Victoria B. Mitrani Overview of the Relation Between Acculturation and Ethnic Minority Mental Health, Pamela Balls Organista, Kurt C. Organista, Karen Kurasaki Acculturation and Physical Health in Racial/Ethnic Minorities, Hector F. Myers, Norma Rodriguez Acculturation, Psychological Distress and Alcohol Use - Investigating the Effects of Ethnic Identity and Religiosity, Fang Gong, David T. Takuchi, Pauline Agbayani-Siewert, Leo Tacata Idioms of Distress, Acculturation and Depression - the Puerto Rican Experience, Dharma E. Cortes Acculturation, Alcohol Consumption, Smoking and Drug Use Among Hispanics, Raul Caetano, Catherine L. Clark.

Accommodating Type 2 Diabetes in the Chinese American Family

In this interpretive study, the authors aimed to describe family responses to type 2 diabetes in Chinese Americans as reported by persons with diabetes (PWD) and spouses. Twenty participants representing 16 families completed multiple group interviews. The authors elicited positive and difficult diabetes care narratives and conducted narrative and thematic analysis of transcribed interview texts. Accommodation, the key family response, comprised the enactment of social concerns and practices to balance quality of life for individuals and families with quality of diabetes care. PWDs’ accommodation included negotiating disease disclosure, protecting the family’s meals, and maintaining ease in family relations despite diabetes symptoms. Accommodation by family members included developing shared diabetes care practices and indirect approaches to disagreements about diabetes management.

Patient-appraised couple emotion management and disease management among Chinese American patients with type 2 diabetes.

Family context exerts a strong influence on disease management among patients with chronic disease, but it is not clear which aspects of family life are most influential. This study examined the linkages between patient-appraised couple emotion management (conflict resolution, expressiveness, and respect) and disease management (biological, morale/depression, quality of life, and behavioral) among a relatively understudied group, Chinese American patients with type 2 diabetes. Significant main effects were found between patient-appraised couple emotion management, especially conflict resolution, and the morale component of disease management, but not the biological or behavioral components; both diabetes-specific and general relationship qualities (marital satisfaction) were independently linked to disease management. Acculturation did not qualify the findings. Similarities among ethnic groups in family and disease management relationships may be more common than differences.

Cultural issues in disease management for chinese americans with type 2 diabetes

The purpose of this study is to highlight culturally unique experiences and responses to type 2 diabetes among Chinese immigrant families. Patient and spouse narratives from 16 different families were elicited in a series of group interviews on this topic. Using interpretive phenomenology, 5 primary cultural considerations in diabetes management emerged from the narratives: (1) conceptualization of diabetes, illness and health, (2) significance and meaning of food, (3) perceptions of Chinese and Western medicines, (4) exercise and physical activity, and (5) effects of the disease on family dynamics. The relation of these cultural considerations to an interdependent view of the self, collectivistic social orientation, Chinese cultural beliefs and norms, and acculturation processes are discussed. Clinical recommendations for culturally appropriate disease management strategies are outlined.

Health Communication With Chinese Americans About Type 2 Diabetes

Purpose Chinese Americans are at high risk for type 2 diabetes and face some health disparities that can be attributed to language barriers, cultural differences, and access to care. The purpose of this article is to review current literature and establish best practices regarding health communication about type 2 diabetes for Chinese Americans. The authors reviewed clinical research literature from January 2000 to April 2011 to assess current knowledge about providing diabetes management guidance to Chinese Americans. Conclusions To improve health communication and dissemination of health information to Chinese Americans regarding diabetes and diabetes management, research scholars, health care providers, and diabetes educators can analyze current health messages by source, message, audience, channel, and destination characteristics. Extensive research has led to clear guidelines focusing on language-appropriate materials, an understanding of Chinese food beliefs and family practices, and the importance of culturally competent health care providers. However, many Chinese Americans are using Chinese foods and medicinal herbs with little communication between patients and providers about these practices. Although Chinese Americans are not a homogenous group, this article points to a set of cultural considerations that health care providers should address when working with Chinese Americans. By attending to various qualities of health messages, efforts at diabetes prevention and management may be greatly enhanced.

Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research.

Chinese Americans demonstrate greater prevalence of diabetes than non-Hispanic whites and find standard diabetes care disregards their cultural health beliefs. Academic researchers and Chinatown agencies collaborated to culturally adapt and test an efficacious cognitive-behavioral intervention using community-based participatory research. Using a delayed-treatment repeated-measures design, 145 adult Chinese immigrants with Type 2 diabetes completed treatment. Immediate benefits of treatment were evident in the improvement (p < .05) in diabetes self-efficacy, diabetes knowledge, bicultural efficacy, family emotional and instrumental support, diabetes quality of life, and diabetes distress. Prolonged benefits were evident in all changed variables 2 months post-intervention. The CBPR approach enabled the development of a culturally acceptable, efficacious behavioral intervention, and provides a model for working with communities that demonstrate health disparities.

Teaching an Undergraduate Course on Ethnic Diversity.

In this article, we describe a course, the Psychology of Ethnic Groups in the United States, to illustrate possible issues to address within an ethnic diversity psychology course. The purpose of this course is to educate, sensitize, and stimulate critical thinking about the role of culture and ethnicity in human social behavior with an emphasis on 4 major ethnic groups in the United States: African Americans, American Indians, Asian Americans, and Hispanics-Latinos. Basic concepts in ethnic psychology examined include the significance of race and ethnicity, racism and stereotyping, ethnic stratification, ethnic identity, acculturation, and biculturalism as well as a variety of psychosocial conditions (e.g., risk behaviors, adaptive health behaviors). Included are descriptions of in-class exercises, readings, and strategies that are helpful in teaching this type of course.

Social Relationships and Health Among Chinese Americans With Diabetes: Does Age Make a Difference?

This study examined whether social relationships were linked to health among Chinese Americans with diabetes, and whether age moderated these links given the norm of respect for the elderly. Chinese American immigrants with type 2 diabetes (n= 163) provided questionnaire and laboratory data. Relationships were assessed with diabetes family instrumental support, emotional support, and conflicts, as well as general support. Health was assessed with subjective health, depressive symptoms, and glucose regulation. When relationship predictors were examined simultaneously, more conflicts and less general support were associated with more depressive symptoms, after adjusting for covariates. More emotional support was associated with better glucose regulation only for midlife, not older, participants. Findings underscore cultural and life-stage considerations in studying social determinants of health.

Gender Differences in Factors Related to Diabetes Management in Chinese American Immigrants

Chinese American women with type 2 diabetes (T2DM) are more vulnerable to poor diabetes outcomes than men because immigrant status, ethnicity, and economics intersect with gender to diminish disease management opportunities. We explored gender differences in factors associated with diabetes management at intake and after treatment with a behavioral intervention in first-generation Chinese American immigrants. A sample of 178 Chinese Americans with T2DM was enrolled in a single-cohort, repeated-measures delayed-treatment trial. Data were collected at baseline, 8, 16, 24, and 32 weeks with 6-week treatment provided after 16 weeks. Gender differences at baseline and gender by treatment interactions were noted. Women at baseline reported significantly worse depressive symptoms and general health. Significant gender by treatment interactions were observed for diabetes self-efficacy, bicultural efficacy, family instrumental support, and diabetes quality of life–satisfaction. Only women showed improvement, suggesting women benefited more from the intervention in psychosocial factors related to diabetes management.

Cultural Adaptation of the Group Lifestyle Balance Program for Chinese Americans

Purpose The purpose of this pilot study was to develop and evaluate a culturally adapted, language-translated diabetes prevention program for Chinese Americans. Methods This pilot study had a single-group repeated-measures design. Participants were 25 first-generation (n = 20) or second-generation (n = 5) Chinese Americans at risk for diabetes because of overweight (using the Asian-specific criterion of body mass index ≥ 23) and either prediabetes or metabolic syndrome. The 16-session program was administered over 6 months in separate Mandarin (n = 9) and English (n = 16) groups. Outcomes were assessed at baseline and at 3 and 6 months. Four participants dropped out. Multilevel regression models were used to examine change in study outcomes over time. Results Participants lost an average of 5.4% of their body weight across the 6 months of the study. Self-report questionnaires suggested improved dietary intake and increased physical activity. Both total and low-density lipoprotein cholesterol levels improved. There were no statistically significant changes in fasting plasma glucose or A1C levels. Participants reported high satisfaction with and acceptance of the program. Conclusion Results suggest that the culturally adapted Group Lifestyle Balance program for Chinese Americans was both acceptable and effective. The culturally adapted program warrants further examination using scientific approaches for dissemination and implementation.