13 The research team discussed this site the opinions and feelings of participants, with particular attention

to potential ethnocultural biases. Results Sample characteristics Table 1 displays the demographic characteristics of the 29 participants. Sixty-two per cent of the participants were men, and the mean age of all participants was 63.6 years (SD=12.2). The majority of participants (69%) were married and 42% reporting having received at least a high school education. Years since immigration ranged from 6 to 39, with an average of 15 years. Fewer than half of the participants were retired, approximately 30% had a part-time job and 20% had a full-time job. About one third of all participants had been diagnosed with diabetes for 1–5 years, another third had been diagnosed with diabetes for 6–10 years and the rest

had been diagnosed for 11 years or more. All participants indicated that either Cantonese or Putonghua (Mandarin) was their preferred language that was commonly used at home. Approximately two thirds of participants spoke Mandarin Chinese and the other third spoke Cantonese. Most of the participants reported having fair, good or very good health; only slightly more than 10% considered themselves as being in poor health. Almost all the participants did not speak or spoke very little English. Table 1 Demographic characteristics of participants Identified themes Eight key themes were found to potentially affect different components of health literacy among Chinese immigrants with diabetes: cultural factors (three themes), structural barriers (three themes), and personal barriers (two themes; table 2). Three cultural factors, namely high regard for authority, a desire to avoid being burdensome to others, and a desire to be together or follow a collective approach, were identified. Beliefs or perceptions among participants seemed consistent across interviews and were grounded in Chinese culture.14 Structural barriers, such as insurance, transportation issues and limited information in Chinese-speaking communities,

were identified. These structural barriers did not seem to provide a favourable environment for Chinese immigrants to obtain health information (HL1) and communicate with information providers Batimastat (HL2). When processing the information, Chinese immigrants said they found it hard to apply it to daily practices (HL3). Personal factors, namely unawareness of self-care responsibility and age related limitations, might affect their capacity to obtain health information (HL1) and communicate with others (HL2). Below are detailed descriptions of the eight themes. Table 2 Meanings and interpretations of key themes High regard for authority A positive attitude towards authority was the most common characteristic among all participants. Almost all participants reported that they preferred to receive health education information directly from doctors. Physicians were viewed as highly respected figures.