Diabetes in the Hmong population: Engaging community, health care providers and intermediaries to develop strategies for best practices in effective diabetes management

Ethnic minorities continue to be affected by preventable and manageable chronic diseases like diabetes, at disproportionate rates. Cultural and language barriers are common issues preventing successful intervention. The active and appropriate use of medical interpreters can assist in meeting the needs of the client. The aims were to 1) identify cultural and language barriers to effective diabetes management and 2) identify the challenges obstructing effective communication between health providers, interpreters, and Hmong patients. Focus groups were conducted in the Central Valley, CA. Participants (n=62) included Hmong health interpreters, young Hmong adults and community members. Informant interviews (n= 8) included clinicians and practitioners working with immigrant Hmong and other Southeast Asian groups. Knowledge and experiences encompassing the disease process, prevention, and management were assessed. Key informants were asked to address issues including experiences and challenges surrounding diabetes education, management with immigrant patient populations, and factors which predicted success and failure with disease management. Results indicated lack of transferable vocabulary and not necessarily a “language barrier”. There is considerable need for developing culturally relevant interventions to promote health, manage and prevent chronic diseases. Health care professionals need to articulate the cause of diabetes and the importance of consistent diets, medication, and healthy bodyweight with diabetes management in a culturally relevant way. It is critical for the provider to recognize existing communication barriers between not only provider and patient, but also provider and interpreter. These results have implications for design of successful chronic disease management strategies for implementation in the larger immigrant community.