Objectives. We examined rates of mental health–related service use (i.e., any, general medical, and specialty mental health services) as well as subjective satisfaction with and perceived helpfulness of care in a national sample of Asian Americans, with a particular focus on immigration-related factors. Methods. Data were derived from the National Latino and Asian American Study (2002–2003). Results. About 8.6% of the total sample (n=2095) sought any mental health–related services; 34.1% of individuals who had a probable diagnosis sought any services. Rates of mental health–related service use, subjective satisfaction, and perceived helpfulness varied by birthplace and by generation. US-born Asian Americans demonstrated higher rates of service use than did their immigrant counterparts. Third-generation or later individuals who had a probable diagnosis had high (62.6%) rates of service use in the previous 12 months. Conclusions. Asian Americans demonstrated lower rates of any type of mental health–related service use than did the general population, although there are important exceptions to this pattern according to nativity status and generation status. Our results underscore the importance of immigration-related factors in understanding service use among Asian Americans.

Objectives. We examined whether self-reported everyday discrimination was associated with chronic health conditions among a nationally representative sample of Asian Americans. Methods. Data were from the Asian American subsample (n = 2095) of the National Latino and Asian American Study conducted in 2002 and 2003. Regression techniques (negative binomial and logistic) were used to examine the association between discrimination and chronic health conditions. Analyses were conducted for the entire sample and 3 Asian subgroups (Chinese, Vietnamese, and Filipino). Results. Reports of everyday discrimination were associated with many chronic conditions, after we controlled for age, gender, region, per capita income, education, employment, and social desirability bias. Discrimination was also associated with indicators of heart disease, pain, and respiratory illnesses. There were some differences by Asian subgroup. Conclusions. Everyday discrimination may contribute to stress experienced by racial/ethnic minorities and could lead to chronic illness.

Objectives. We tested the effectiveness of a culturally tailored, behavioral theory–based community health worker intervention for improving glycemic control.Methods. We used a randomized, 6-month delayed control group design among 164 African American and Latino adult participants recruited from 2 health systems in Detroit, Michigan. Our study was guided by the principles of community-based participatory research. Hemoglobin A1c (HbA1c) level was the primary outcome measure. Using an empowerment-based approach, community health workers provided participants with diabetes self-management education and regular home visits, and accompanied them to a clinic visit during the 6-month intervention period.Results. Participants in the intervention group had a mean HbA1c value of 8.6% at baseline, which improved to a value of 7.8% at 6 months, for an adjusted change of -0.8 percentage points (P < .01). There was no change in mean HbA1c among the control group (8.5%). Intervention participants also had significantly greater improvements in self-reported diabetes understanding compared with the control group.Conclusions. This study contributes to the growing evidence for the effectiveness of community health workers and their role in multidisciplinary teams engaged in culturally appropriate health care delivery.

OBJECTIVE—Knowledge of one’s actual and target health outcomes (such as HbA_1c values) is hypothesized to be a prerequisite for effective patient involvement in managing chronic diseases such as diabetes. We examined 1) the frequency and correlates of knowing one’s most recent HbA_1c test result and 2) whether knowing one’s HbA_1c value is associated with a more accurate assessment of diabetes control and better diabetes self-care understanding, self-efficacy, and behaviors related to glycemic control. RESEARCH DESIGN AND METHODS—We conducted a cross-sectional survey of a sample of 686 U.S. adults with type 2 diabetes in five health systems who had HbA_1c checked in the previous 6 months. Independent variables included patient characteristics, health care provider communication, and health system type. We examined bivariate and multivariate associations between each variable and the respondents’ knowledge of their last HbA_1c values and assessed whether knowledge of HbA_1c was associated with key diabetes care attitudes and behaviors. RESULTS—Of the respondents, 66% reported that they did not know their last HbA_1c value and only 25% accurately reported that value. In multivariate analyses, more years of formal education and high evaluations of provider thoroughness of communication were independently associated with HbA_1c knowledge. Respondents who knew their last HbA_1c value had higher odds of accurately assessing their diabetes control (adjusted odds ratio 1.59, 95% CI 1.05–2.42) and better reported understanding of their diabetes care (P < 0.001). HbA_1c knowledge was not associated with respondents’ diabetes care self-efficacy or reported self-management behaviors. CONCLUSIONS—Respondents who knew their HbA_1c values reported better diabetes care understanding and assessment of their glycemic control than those who did not. Knowledge of one’s HbA_1c level alone, however, was not sufficient to translate increased understanding of diabetes care into the increased confidence and motivation necessary to improve patients’ diabetes self-management. Strategies to provide information to patients must be combined with other behavioral strategies to motivate and help patients effectively manage their diabetes.