Integrative Medicine Focus Groups as a Source of Patient Agency and Social Change for Chinese Americans with Type 2 Diabetes
Chinese Americans (CAs) are at higher risk for developing type 2 diabetes mellitus (T2DM) compared to White Americans at the same BMI. In this chapter, we use a Culture-Centered Approach to investigate patient agency as it intersects with structure and culture in the talk during focus group interviews. The interviewees were CAs with T2DM discussing their diet and eating practices to manage this chronic condition. These interviews were conducted as part of a larger study to create an integrative diabetes diet that uses Chinese medicine-based diet suggestions for diabetes that are also nutritionally acceptable from a biomedical perspective. As we will present, CAs both use and are seeking ways to use Chinese medicine as a culturally informed way of asserting agency in how they manage their diabetes. CAs were often challenged in fully using Chinese medicine because of a variety of structural constraints including lack of access to information for determining the legitimacy of health practices. However, the participants were also quick to share information with one another to help others be more self-reliant and thus demonstrate how complementary and integrative healthcare can be a form of social justice.
KeywordsCulture-centered approach Integrative medicine Chinese American Type 2 diabetes Agency Social change
We wish to thank our research participants for generously sharing their time and their stories with us and UCSF’s Asian Health Institute and the University of San Francisco’s Faculty Development Fund for sponsoring this project.
- Baer, H. A. (2001). Biomedicine and alternative healing systems in America. Madison, WI: The University of Wisconsin Press.Google Scholar
- Centers for Disease Control and Prevention (2014). National diabetes statistics report: Estimates of diabetes and its burden in the United States, 2014. Retrieved from Atlanta, GA:Google Scholar
- Dutta, M. J. (2008). Communicating Health Cambridge, England: Polity Press.Google Scholar
- Ho, E. Y., Leung, G., Pritzker, S., Chi, H.-L., Hsieh, E., Chan, D., … Seligman, H. K. (2015a). Creating and pilot testing an integrative Chinese medicine diet for Chinese Americans with type 2 diabetes [Abstract]. Diabetes, 64(Suppl 1), A623. doi:10.2337/db15-742-931Google Scholar
- Ho, E. Y., Leung, G., Pritzker, S. E., Chi, H.-L., Hsieh, E., Chan, D., … Seligman, H. K. (2015b). Pilot and feasibility testing of an integrative Chinese medicine/biomedicine diet for Chinese Americans with type 2 diabetes. Paper presented at the International Conference on Communication in Healthcare, New Orleans, LA.Google Scholar
- Hsu, E. (2008). The history of Chinese medicine in the People’s Republic of China and its globalization. East Asian Science, Technology and Society, 2(4), 465–484.Google Scholar
- Karter, A. J., Schillinger, D., Adams, A. S., Moffet, H. H., Liu, J., Adler, N. E., & Kanaya, A. M. (2013). Elevated rates of diabetes in Pacific Islanders and Asian subgroups: The diabetes study of Northern California (DISTANCE). Diabetes Care, 36(3), 574–579. doi: https://doi.org/10.2337/dc12-0722CrossRefGoogle Scholar
- NICOS-Chinese-Health-Coalition. (2004). Chinese community health report: Summary of key findings. San Francisco, CA.Google Scholar
- Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 (2010)Google Scholar
- Seligman, H. K., Wallace, A. S., DeWalt, D. A., Schillinger, D., Arnold, C. L., Shilliday, B. B., … Davis, T. C. (2007). Facilitating behavior change with low-literacy patient education materials. American Journal of Health Behavior, 31 Suppl 1, S69–78. doi: https://doi.org/10.5555/ajhb.2007.31.supp.S69
- U.S. Census Bureau News, U. S. Department of Commerce (2015). Facts for Features Asian/Pacific American Heritage Month: May 2015. Retrieved from http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb13-ff09.html
- Washington, G., & Wang-Letzkus, M. F. (2009). Self-care practices, health beliefs, and attitudes of older diabetic Chinese Americans. Journal of Health & Human Services Administration, 32(3), 305–323.Google Scholar