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Type 2 diabetes affects Chinese Americans at an alarming rate. To address this health disparity, research in the area of cultural sensitivity and health literacy provide useful guidelines for creating culturally appropriate health education. In this article, we use discourse analysis to examine a group of locally-available, Chinese and English language diabetes print documents from a surface and deep structure level of culture. First, we compared these documents to research findings about printed health information to determine if and how these documents apply current best practices for health literacy and culturally appropriate health communication. Second, we examined how diabetes as a disease and diabetes management is being constructed. The printed materials addressed surface level culture through the use of Chinese language, pictures, foods and exercises. From a deeper cultural level, the materials constructed diabetes management as a matter of measurement and control that contrasted with previous research suggesting an alternative construction of balance. A nuanced assessment of both surface and deeper levels of culture is essential for creating health education materials that are more culturally appropriate and can lead to increase health literacy and improved health outcomes.


This is an Accepted Manuscript of an article published by Taylor & Francis in Health Communication on 21 Jan 2014, available online:

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