Evaluating a Culturally and Linguistically Competent Health Coach Intervention for Chinese-American Patients With Diabetes

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Abstract
Background. Type 2 diabetes is a growing concern among medically underserved Chinese Americans. However, very few interventions have been developed or adapted for Chinese Americans with diabetes. Objective. To use a participatory research approach to evaluate the effectiveness of a culturally tailored, linguistically appropriate model for diabetes care employing health coaches to improve A1C levels among Chinese-American patients in a federally qualified health center setting. Methods. We compared change in A1C between intervention participants (n = 46), who received a health coaching intervention, and control participants (n = 46), who received usual care over a period of ~ 6 months. Results. Intervention participants showed a decrease in mean A1C at follow-up (−0.40%) compared to control subjects (+0.04%), although this difference was not statistically significant. At the 6-month follow-up, a significantly higher percentage of intervention participants (45.7%) had well-controlled A1C levels compared to control subjects (23.9%) (P = 0.048). Conclusions. It is feasible to implement a culturally tailored, linguistically appropriate teamlet model of care for Chinese Americans with type 2 diabetes. Such a model may be helpful in reducing A1C levels. Given trends in A1C improvement during a 6-month pilot, future randomized trials with a larger sample capable of providing adequate statistical power to detect improvements are warranted.