ORIGINAL PAPER Incorporating Cultural Perspectives into Diabetes Self-Management Programs for East Asian Immigrants: A Mixed-Study Review Chorong Park • Soohyun Nam • Robin Whittemore Ó Springer Science+Business Media New York 2015 Abstract It is important to understand East Asian im- migrants (EAIs)’ unique perspectives in managing diabetes in order to provide culturally-competent care. However, it is not known whether EAIs’ perspectives are addressed in diabetes self-management interventions developed for EAIs. Therefore, a mixed-study review was conducted to identify EAIs’ perspective from qualitative research (n = 9 studies) and to evaluate the components of EAI diabetes self-management interventions (n = 7). Themes from the qualitative synthesis demonstrated that EAIs have unique cultural values and traditional health beliefs while strug- gling with multi-contextual barriers due to immigration. The evaluation of EAI diabetes self-management inter- ventions revealed that there was a lack of consensus on cultural strategies for EAIs’ across the interventions. Ad- dressing language barriers was the only factor consistently integrated in the cultural components of intervention by employing bilingual interventionists. EAIs’ perspectives and experiences need to be incorporated in the future dia- betes self-management interventions to better provide culturally-competent care. Keywords East Asian immigrants Á Cultural competency Á Diabetes mellitus type 2 Á Self-management Á Mixed-study review Introduction Type 2 diabetes mellitus (T2DM) is an increasing epidemic in Asian immigrants who are living in the US [1]. In par- ticular, East Asian immigrants (EAIs)—including Chinese, Korean, Japanese, and Taiwanese—who share similar health beliefs and cultural norms as defined by United Nations Statistics Division [2], have a high risk of devel- oping T2DM. Chinese immigrants, the largest Asian American subgroup (3.8 million) and one of the fastest growing populations (44 % increase from 2000 to 2010) [3] are twice as likely to develop T2DM (10.9 %) than the non-Hispanic white population (5.9 %), after adjusting for BMI and age [4]. Similar results have been reported in Korean (1.7 million, the fifth largest Asian subgroup and experiencing 47 % growth from 2000 to 2010) and Ja- panese immigrants (1.3 million, the sixth largest Asian subgroup) [3]; the BMI-and-age adjusted prevalence of diabetes was 12.6 % in Korean and 13.3 % in Japanese [4]. Despite the high risk for T2DM in EAIs, EAIs fre- quently demonstrate poor diabetes self-management, mostly due to linguistic and cultural barriers [5, 6]. The majority of EAIs (70–78 %) are first-generation [7] who often hold traditional cultural beliefs. In addition, more than half of EAIs report limited English proficiency [8] and difficulty in communication with their health care provi- ders [9]. These cultural and language barriers can not only lead to miscommunication [10], but also negatively influ- ence their health care practices [11]. EAIs sometimes feel that health care providers do not respect or understand their perspectives or lifestyle [10] and in turn, EAIs are often labeled as being ‘‘non-adherent’’ to diabetes self-manage- ment recommendations [12]. Given the escalating T2DM epidemic and multiple barriers to obtain diabetes care among EAIs, it is C. Park (&) Á S. Nam Á R. Whittemore School of Nursing, Yale University, 400 West Campus Drive, Orange, CT 06477, USA e-mail: Chorong.park@yale.edu 123 J Immigrant Minority Health DOI 10.1007/s10903-015-0181-5