Journal of Behavioral Medicine

, Volume 39, Issue 5, pp 896–907 | Cite as

Acculturation and bicultural efficacy effects on Chinese American immigrants’ diabetes and health management

  • Kevin M. Chun
  • Christine M. L. Kwan
  • Lisa A. Strycker
  • Catherine A. Chesla


The primary goal of this study was to examine effects of bicultural efficacy, or perceived confidence in dealing with bicultural acculturation stressors, on type 2 diabetes management and health for first-generation, Cantonese-speaking, Chinese American immigrants (N = 162) recruited for a larger community-based diabetes intervention study (Chesla et al. in Res Nurs Health 36(4):359–372, 2013. doi:10.1002/nur.21543). The current study also tested whether a new Bicultural Efficacy in Health Management (BEFF-HM) scale is a more robust predictor of diabetes and health outcomes than proxy (years in the U.S.) and general acculturation measures. Hierarchical regression analyses of cross-sectional data revealed that high BEFF-HM was significantly related to positive outcomes on five of six diabetes and health measures as hypothesized after accounting for participant characteristics, proxy and general acculturation measures, and social support. Proxy and general acculturation measures failed to predict any study outcome supporting our secondary hypothesis that BEFF-HM is a better predictor of Chinese American immigrants’ diabetes and health management. An immigrant-focused research approach advances understanding of acculturation and bicultural efficacy effects on health by identifying key acculturation domains for study.


Acculturation Bicultural efficacy Diabetes Immigrant health Chinese American 


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kevin M. Chun
    • 1
  • Christine M. L. Kwan
    • 2
  • Lisa A. Strycker
    • 3
  • Catherine A. Chesla
    • 4
  1. 1.Department of PsychologyUniversity of San FranciscoSan FranciscoUSA
  2. 2.Sau Po Centre on AgeingThe University of Hong KongHong KongHong Kong
  3. 3.Oregon Research InstituteEugeneUSA
  4. 4.Department of Family Health Care NursingUniversity of CaliforniaSan FranciscoUSA

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