Kho Dua Mus - Keeping Diabetes Managed in the Hmong Community | Medical School

The Hmong community experiences disparities in diabetes outcomes in Minnesota. Data from Minnesota state registries (MN Community Measurement) identify that Hmong-speaking patients have the lowest rate of optimal diabetes care as defined by community standards (defined as achieving all of the following: A1c less than 8%, blood pressure lower than 140/90 mmHg, prescribed aspirin and statin medicines when indicated, and being tobacco free), at 34% in comparison to the statewide rate of 43.6%, and experience a subsequent increased risk of death from diabetes.

Surveys and interviews of Hmong patients in multiple unpublished data sets (available upon request) from the Twin Cities highlight the importance of diabetes control and indicate that the main barrier to achieving control was a lack of knowledge and a need for more education. The existing disparities reveal that the standard of care and available tools are insufficient for Hmong patients with diabetes. There is a need for pioneering, culturally relevant resources tailored to this community.

To fill this need, we have partnered and maintained an active Community Advisory Board (CAB), which together with our University and Community Partners, has guided the creation and evaluation of a diabetes education video tool. From this pilot work, we are now preparing for the creation of additional video tools for a comprehensive diabetes self-care curriculum, as well as investigating text-messaging as a way to disseminate this curriculum outside of a healthcare setting.

Image with text "Habits to build when you live with diabetes"

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Image with text "Habits to build when you live with diabetes"

Image with text "Diabetes is a health condition that affects the way your body breaks down sugar by decreasing insulin or making insulin less effective. Insulin acts like a key that allows sugar to enter your cells to be used as energy"

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Image with text "Diabetes is a health condition that affects the way your body breaks down sugar by decreasing insulin or making insulin less effective. Insulin acts like a key that allows sugar to enter your cells to be used as energy"

Image with text "A simple way to decrease your sugar intake at meals is to try to make half of your plate full of vegetables. Remember: traditional food is healthy!"

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Image with text "A simple way to decrease your sugar intake at meals is to try to make half of your plate full of vegetables. Remember: traditional food is healthy!"

Image of rice, greens, and meat

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Graphic with text "Try to add more movement into your day. It can make taking care of your diabetes easier An example would be a walk after dinner with your family"

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Graphic with text "Try to add more movement into your day. It can make taking care of your diabetes easier An example would be a walk after dinner with your family"

Graphic with "Ask your doctor how often you should check your blood sugar. If it is difficult to remember, ask a family member, friend, or roommate to help!"

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Graphic with "Ask your doctor how often you should check your blood sugar. If it is difficult to remember, ask a family member, friend, or roommate to help!"

Graphic with "For more information visit:"

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Study Staff

Study Staff

Community Advisory Board

Serena Xiong, Yeng Moua, Bai Vue, Kathie Culhane-Pera, Chef Yia Vang, Houa Vue-Her, Pa Chia Vue, Lindsey Lee, Khashia Yang, Patag Xiong, Chia Xiong, Aun Lim, Elizabeth Lee, Mai B Xiong, Munaa Mohammed, Pa Cha Vang, A Lee Xiong, Sadia Sheikh-Mohamed

University of Minnesota - Learners

Leslie Neher, Nirmal Lumpkin, Nouchee Xiong, Billy Moua, Matt Foman, Miller Balley, Abby Brustad, Emma McGrew, Kobe Perez

University of Minnesota Partnerships

Department of Family, Health, & Wellbeing, University of Minnesota Extension
John Gwinn, Janice Rasmussen

M Health Fairview Phalen Village Clinic

Department of Family Medicine and Community Health
1. Research Division
a. Mary Earm, Rebekah Pratt
2. Communications Team
a. Courtney Grace-Anderson

Department of Writing Studies
Marcy Bock Eastley, Emily Gresbrink, Jackie James, Jessica Remcheck

Community Partnerships

Ramsey County Public Health

Center for Hmong Arts & Talent

Hennepin County Public Health
Kassy Nystrom, Liliana Tobon Gomez

Publications associated with this study

Brown KM, Silveira C, Xiong S, Lumpkin N, Carlin C, Pang CJ, Montag Schafer K. A Digital Diabetes Storytelling Intervention for the Hmong Community - A Pilot Study. Health Promot Pract. 2023:15248399231208990. doi: 10.1177/15248399231208990.

Presentations of related work

Brown KM, Brustad A, Perez K, Montag Schafer K. Acceptability of a diabetes education unidirectional text message intervention for the Hmong community. Minnesota Academy of Family Physicians Research and Innovation Forum. Bloomington, MN. March 2025.

Brown KM, Kastman Breuch L, Montag Schafer K, Silveira C. Translating Knowledge into Actionable Change for Hmong Patients Living with Diabetes. Many Faces of Community Health Conference. Brooklyn Park, MN. October 2024.

Silveira C, Montag Schafer K. Kho Dua Mus - Keeping Diabetes Managed in the Hmong Community. 2023 National Health Outreach and Engagement Conference. Ithaca, NY. May 2023.

Montag Schafer K, Brown K, Silveira C. Partnering to Create Culturally Informed Diabetes Education Materials for the Hmong Community. Research Seminar and Innovation Lab - Department of Family Medicine and Community Health, C2DREAM and Program for Health Disparities Research. Virtual Platform. January 2023.

Funding

Grant-in-Aid of Research, Artistry and Scholarship (GIA), Office of the Vice President
University of Minnesota Medical School - Dean’s Funds
Department of Family, Health, & Wellbeing, University of Minnesota Extension
Minnesota Academy of Family Physicians

Principal Investigators

Katherine Montag Schafer; Kathryn Brown; Cassie Silveira