The proposed project is part of a program of research to improve management of type 2 diabetes (T2DM) through a community-academic partnership that addresses cultural factors in disease management. Specific aims are to: 1. Strengthen a community-academic partnership with the immigrant Chinese community in San Francisco to improve diabetes management; 2. Adapt and test a behavioral diabetes intervention, Coping Skills Training, to addresses family and cultural issues in immigrant Chinese patients with T2DM; and 3. Disseminate the adapted Coping Skills Training Program findings via the community-academic partnership to the immigrant Chinese American community through service programs, ethnic media, and professional/scientific publications. A mixed-methods CBPR approach will be used to interpretively adapt a behavioral intervention to be culturally appropriate, and test its efficacy using a repeated measures design. Two historically significant social service and health agencies serving immigrant Chinese in San Francisco are collaborating with this nurse-led interdisciplinary research team.

The goal of the culturally adapted Chinese Coping Skills Training (CCST) is to increase immigrant Chinese patients' skills and mastery in diabetes management by identifying and diminishing non-constructive coping responses to difficult social situations, while expanding the repertoire of positive coping responses and disease management behaviors. The CCST comprises a series of six small-group sessions focused on the topics of social problem solving, communication skills, cognitive behavior modification and conflict resolution. It also includes a review of basic diabetes management information.

Inclusion Criteria:

• Diagnosed with type 2 diabetes mellitus,
• Treated with insulin, oral medications and/or diet and exercise,
• Self-identify as Chinese American or Chinese,
• Identify a family member (spouse, child, sibling or other person identified as family) with whom participant lives or has at least weekly contact, who is involved in care of diabetes.
• First-generation immigrant ie. foreign-born, first generation to arrive in the U.S. from any source country

Exclusion Criteria:

• Diagnosed with type 1 diabetes mellitus
• Cannot read or write Chinese