Self-Management of Type 2 Diabetes in Adult Haitian Immigrants: A Qualitative Study

Abstract

Introduction: A large body of literature exists on self-management of type 2 diabetes (T2D) in a variety of populations. However, research is limited on how Haitian immigrants self-manage their T2D despite a prevalence of 6.9% in Haiti. The purpose of this study was to explore and describe the lived experience of adult Haitian immigrants managing T2D living in the United States. Methodology: Moustakas’s phenomenological approach guided this qualitative study. Adult Haitian immigrants diagnosed with T2D for at least 1 year were interviewed. Individual interviews were audio-recorded, transcribed verbatim, uploaded into NVivo, and analyzed using Moustakas’s existential data analysis process. Results: We interviewed 16 participants (mean age 56;12 females; an average of 11 years living in the United States; mean hemoglobin A1c 8.1%). Four themes emerged: self-reliance, spirituality, nostalgia for home, and a desire for positive patient–provider relationships. Cultural influences and health beliefs may affect individual self-management of T2D in this population. Conclusions: These results may assist clinicians in identifying factors that contribute to suboptimal self-management in Haitian immigrants and help patients reach glycemic control. Culturally competent assessment and interventions for Haitian immigrants with T2D may not be provided without considering these four themes.

Barriers to Type 2 Diabetes Management Among Older Adult Haitian Immigrants

“…8 The prevalence of T2DM in Haitian immigrants is difficult to quantify, in part because they are often categorized with other Black/non-Hispanics in government census reports. [8][9][10] Although studies have shown that this classification may contribute to treatment errors and health disparities among Haitian immigrants, [8][9][10] in government surveys and labor statistics reports, the category of Black/non-Hispanic includes all persons of color.…”

“…Additionally, the perceptions and cultural beliefs regarding health and causes of disease among Haitian immigrants differ from those of other Black populations. 8,9,11,12 In the Haitian culture, a disease is viewed as a curse (eg, punishment from God or evil spells), and such a belief makes the management of chronic diseases challenging. 9,12,13 These notions regarding health and disease are related to their nation of origin and different experiences and sensibilities that shape their lifestyle.…”

“…8,9,11,12 In the Haitian culture, a disease is viewed as a curse (eg, punishment from God or evil spells), and such a belief makes the management of chronic diseases challenging. 9,12,13 These notions regarding health and disease are related to their nation of origin and different experiences and sensibilities that shape their lifestyle. 8,[12][13][14] Furthermore, Haitian immigrants possess a strong sense of maintaining their cultural heritage, which is considered an essential part of their well-being that is manifested in their daily lives; this has important implications for the self-management of T2DM.…”

“…9,12,13 These notions regarding health and disease are related to their nation of origin and different experiences and sensibilities that shape their lifestyle. 8,[12][13][14] Furthermore, Haitian immigrants possess a strong sense of maintaining their cultural heritage, which is considered an essential part of their well-being that is manifested in their daily lives; this has important implications for the self-management of T2DM. 8,9,[12][13][14][15] Moreover, older adult Haitian immigrants are at risk of detrimental health consequences during the transitional period of adapting to their newly adopted country.…”

“…8,[12][13][14] Furthermore, Haitian immigrants possess a strong sense of maintaining their cultural heritage, which is considered an essential part of their well-being that is manifested in their daily lives; this has important implications for the self-management of T2DM. 8,9,[12][13][14][15] Moreover, older adult Haitian immigrants are at risk of detrimental health consequences during the transitional period of adapting to their newly adopted country. 9,[12][13][14][15] Subsequently, when compared with younger immigrants, for older immigrants, the process of acculturation, which may involve discrimination and acculturative stress, can be difficult because their health beliefs and barriers to acculturation, such as language (eg, limited English proficiency), differ from those of the younger generation and the natives of their newly adopted country.…”