Gender Differences in Diabetes Self-Management Among African American Adults

Chlebowy, Diane Orr; Hood, Sula; LaJoie, A. Scott

doi:10.1177/0193945912473370

Cited by 37 publications

(45 citation statements)

References 21 publications

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“…al (2013) found that African American men with type 2 diabetes cited lack of time at work, lack of family support, and lack of knowledge as the most frequent barriers to achieving self-management. 18 While men in our study also identified the latter two as challenges, lack of time at work was not discussed as a barrier; in this sample nearly all of the participants were unemployed. The importance of convenience and ease of access emerged as key factors for participation in a community-based intervention.…”

Section: Discussionmentioning

confidence: 56%

“…24,25 Unden et al (2008) found that men with type 2 diabetes reported fewer diabetes-related worries and better coping abilities than men, while Chlebowy et al (2013) reported men were more likely to use more problem-focused and less emotion-focused methods for diabetes self-management. 18,26 The participants in our study frequently cited low self-esteem, depression, denial, and fear as emotional hurdles. Additionally, some of the greatest needs that emerged from the focus groups included emotional support and support group meetings.…”

Section: Discussionmentioning

confidence: 70%

“…18 Understanding gender-specific differences could facilitate the creation of tailored interventions that may resonate more with the intended audience and lead to improved self-management practices and health outcomes. 18 …”

mentioning

confidence: 99%

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Diabetes Connect

et al. 2014

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Purpose The purpose of the study is to explore African American men’s perceptions of how community-based, community-health worker (CHW)–delivered diabetes interventions might best be implemented. Methods Four 90-minute focus groups were guided by a trained moderator with a written guide to facilitate discussion on the topic of diabetes management and preferences for community-based programs. Participants were recruited from the diabetes education database at a safety-net health system in Jefferson County, AL. Two independent reviewers performed content analysis to identify major themes using an iterative, combined deductive and inductive approach. Results There were 25 male participants. Mean years living with diabetes was 9.6 (range, 1-20). Participants demonstrated knowledge of self-management strategies and identified various hardships including emotional and physical manifestations of diabetes, dietary restrictions, and institutional frustrations with the health system that contributed to self-management barriers. Their preferred CHW responsibilities were to educate, hold support groups, help track daily activities, and help find resources. Potential concerns included the need for confidentiality and fears of being stereotyped. Conclusions Participants identified critical self-management strategies but endure hardships that present barriers to daily diabetes management. Preferences for community-based programs and suggested CHW responsibilities could help to overcome many of those barriers by increasing access and providing support.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 70%

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Diabetes Connect

et al. 2014

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“…Education was provided during the day: comments from participants indicated that they did not want to close their shop or could not find anyone to cover for them; students had classes and others were working. A previous USA study found that men of African American origins [28] were able to take time away from work for GP appointments, normally of shorter duration than an education session, but not for education for self management. We had planned to use two of the Conversation Maps TM over different sessions but this did not occur due to participants' comments that they were not able to return for a second session.…”

Section: Recruitment and Attendancementioning

confidence: 98%

Discussion of Challenges in Engaging Urdu/Punjabi Speak People with Type 2 Diabetes in Structured Group Patient Education Using Interpretation and Established Educational Tools in Two Health Boards in Scotland

McDowell¹

2016

Int Arch Nurs Health Care

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IntroductionPeople from black and minority ethnic (BME) communities who live in upper-middle and high income countries [1] are at higher risk of type 2 diabetes than white Caucasians and they develop this at lower clinical points than white Caucasians [2,3]. A Scottish survey found that Scottish Pakistani and Indian people with type 2 diabetes were more likely to have poor diabetes control compared to white Scottish people with type 2 diabetes [4] and the Scottish Diabetes Action Plan (2010) aimed to address these inequities [5].Scotland's health is managed through 14 Boards and each Board has a disease specific Managed Clinical Network (MCN). The BME population in Scotland is concentrated mainly in the large cities of Glasgow, Edinburgh, Aberdeen and Dundee, spanning 4 of the 14 MCNs with smaller numbers dispersed across the rest of Scotland. The BME Scottish population is 4% [6] and the largest category is from Asia (3%) [6].Education and information, as well as being tailored to individuals' culture and beliefs, have been identified as two of the key themes necessary to support self-management for people with long-term-conditions [7]. MCNs within each Health Board are responsible for ensuring that culturally appropriate care is provided for people from the BME communities.Culturally appropriate care is defined as 'health education tailored to the cultural or religious beliefs and linguistic and literacy skills of the community being studied' [8]. A literature review identified two aspects to culturally appropriate care: one focuses on values, beliefs, traditions and language of a people group that may not meet the specific needs of individuals [9]. The second approach explains an individual's health status according to their social status rather than by their beliefs and behaviours. This second approach is considered as cultural safety and there is limited evidence of its use in health care. This paper considers culturally appropriate care within the context of language, beliefs and traditions. AbstractAim: Structured patient education is one aspect of supporting selfmanagement for people with diabetes. People from the black and minority ethnic groups who live in upper-middle and high income countries are at higher risk of developing type 2 diabetes mellitus than white Caucasians and providing structured patient education in a multicultural society can be challenging for practitioners. To promote a sustainable model of care, with language support, this paper discusses the use of culturally appropriate structured patient education with established tools within routine care.Methods: Structured patient education was provided for people with type 2 diabetes from the Urdu/Punjabi speaking communities in two Health Boards in Scotland during 2013 with language support. Diabetes Nurse Specialists and Practice Nurses with expertise in delivering structured patient education delivered Conversation Maps TM , as part of routine care, using Linkworkers in Lothian Health Board and Interpreters in Greater Glasgow and Clyde ...

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“…African-American women have been found to have greater perceived barriers to self-management than men [9]. However, few studies examine why these barriers exist.…”

Section: Introductionmentioning

confidence: 99%

The “invisible caregiver”: multicaregiving among diabetic African-American grandmothers

2014

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Purpose To explore the multicaregiving roles African American grandmothers assume while self-managing their diabetes. Design & Methods This longitudinal, qualitative pilot study explored the challenges of self-managing diabetes among six African-American caregiving grandmothers. Data were collected at 5 times points across 18 months. Content analysis, guided by the Adaptive Leadership framework, was conducted using data matrices to facilitate within-case and cross-case analyses. Results Although participants initially stated they cared only for grandchildren, all had additional caregiving responsibilities. Four themes emerged which illustrated how African-American caregiving grandmothers put the care of dependent children, extended family and community before themselves. Using the Adaptive Leadership framework, technical and adaptive challenges arising from multicaregiving were described as barriers to diabetes self-management. Implications When assisting these women to self-manage their diabetes, clinicians must assess challenges arising from multicaregiving. This might require developing collaborative work relationships with the client to develop meaningful and attainable goals.

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Gender Differences in Diabetes Self-Management Among African American Adults

Cited by 37 publications

References 21 publications

Diabetes Connect

Diabetes Connect

Discussion of Challenges in Engaging Urdu/Punjabi Speak People with Type 2 Diabetes in Structured Group Patient Education Using Interpretation and Established Educational Tools in Two Health Boards in Scotland

The “invisible caregiver”: multicaregiving among diabetic African-American grandmothers

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