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.

Growing research finds that reports of discrimination are associated with mental health. However, many US studies are focused on regional samples and do not control for important confounders such as other stressors and health conditions.

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.

Everyday discrimination may contribute to stress experienced by racial/ethnic minorities and could lead to chronic illness.

Current theoretical models suggest that the most potent and impacting discrimination experienced by African Americans in the post Jim Crow era are subtle and unconscious forms of discrimination that are experienced on a daily basis. This study investigates the relationship between perceived everyday discrimination and anxiety and depressive symptoms. Further, we examine gender as a moderator of this relationship. Data come from the 1995 Detroit Area Study data with 570 African American respondents. Results indicate that perceived discrimination is directly related to both symptoms of depression and anxiety. Gender moderates the relationship between discrimination and anxiety symptoms, but not discrimination and depressive symptoms. Overall, different patterns of relationships were apparent for men and women.

A culturally tailored diabetes lifestyle intervention delivered by trained community residents produced significant improvement in dietary and diabetes self-care related knowledge and behaviors as well as important metabolic improvements.

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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. 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 Ͻ 0.001). HbA 1c knowledge was not associated with respondents' diabetes care self-efficacy or reported self-management behaviors. RESEARCH DESIGN AND METHODS CONCLUSIONS -Respondents who knew theirHbA 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. Diabetes Care 28:816 -822, 2005A growing body of evidence suggests that patients with chronic diseases who are engaged and active participants in their health care have better health outcomes (1-4). For example, patients who have completed chronic disease self-management training programs have improved self-efficacy and physical functioning and less acute care use than nonparticipants (2,5-8). Chronic illness care self-efficacy is positively associated with health outcomes (9 -15). Similarly, collaborating with health care providers and engaging in shared clinical decision making are associated with better selfcare behaviors and disease outcomes (1,6,14,16 -20).Less is known, however, about the specific skills, knowledge, beliefs, and motivations that patients need to most effectively participate in their chronic disease management. Patient knowledge of actual and target disease management outcomes (e.g., HbA 1c test results) is hypothesized to be an important prerequisite for effective patient "activation." Providing immediate feedback of HbA 1c values to insulin-taking diabetic adults and their providers (21) and graphical information to patients on their HbA 1c and other laboratory values has been found to improve glycemic control and other diabetes outcomes (22). Organizations such as the American Diabetes A...