Dnp-dpi- project revision -literature reviews

Ethnicity & Disease, Volume 28, Number 1, Winter 2018 25

Original Report:

Diabetes

IntroductIon

The incidence of type 2 diabetes
and related complications is dispro-
portionately higher among Afri-
can Americans (AAs) in the United
States.1,2 AAs with diabetes have twice
the rate of blindness and a three-fold
higher rate of diabetic neuropathy,
end stage renal disease, and non-
traumatic lower extremity amputa-
tions compared with non-Hispanic
Whites.3 In recent years, a recognition
of diabetes as one of the most chal-
lenging chronic illnesses to manage
led to a dramatic increase in research
focused on psychosocial issues related
to diabetes.4 This focus is important
especially for AAs who are likely to
face multiple psychosocial challenges
while living with the disease and are
likely to have varying perceptions of
diabetes that might shape their health
behavior.5 Based on limited quantita-

tive data regarding racial/ethnic mi-
norities with type 2 diabetes, culture,
socioeconomic status and psychoso-
cial factors (including social support,
self-efficacy) play a significant role
in explaining diabetes self-care be-
haviors and outcomes.6,7 Qualitative
research provides some additional in-
formation on the many psychosocial
factors influencing self-care manage-
ment among AAs with diabetes.8,9
However, in order to design cultur-
ally tailored treatment adherence in-
terventions for AAs with diabetes, it is
important to also explore how socio-
cultural factors might influence dis-
ease self-management and medication
adherence via illness representations,
especially given the social context in
which adherence behaviors occur.10

Various reasons, including AAs’
cultural beliefs, have been suggested
for the disproportionate burden of
diabetes among AAs and AAs’ low

Sociocultural influenceS on
african americanS’ repreSentationS

of type 2 DiabeteS:
a Qualitative StuDy

Olayinka O. Shiyanbola, PhD, BPharm1;
Earlise Ward, PhD2; Carolyn Brown, PhD3

Objective: Illness representations, known
as patients’ beliefs and expectations about
an illness, may be influenced by cultural
beliefs and personal experiences. This study
explored African Americans’ perceptions of
the sociocultural factors that influence their
representations of diabetes.

Design: Six semi-structured focus groups.

Setting: Private space at a convenient site.

Participants: Forty African Americans, aged
45-60 years with type 2 diabetes for at least
one year prior.

Results: Participants perceived that there
was a race-mediated effect of how they
developed diabetes because of poverty due
to past slavery, racial discrimination by health
care providers, and the stigma associated
with diabetes within the African American
community. Participants perceived that pov-
erty influenced African American

REVIEW
published: 28 August 2018

doi: 10.3389/fendo.2018.00479

Frontiers in Endocrinology | www.frontiersin.org 1 August 2018 | Volume 9 | Article 479

Edited by:

Jan Polák,

Charles University, Czechia

Reviewed by:

Jan Brož,

Charles University, Czechia

Stephanie Therese Chung,

National Institutes of Health (NIH),

United States

*Correspondence:

A. Enrique Caballero

[email protected]

Specialty section:

This article was submitted to

Diabetes,

a section of the journal

Frontiers in Endocrinology

Received: 22 February 2018

Accepted: 02 August 2018

Published: 28 August 2018

Citation:

Caballero AE (2018) The “A to Z” of

Managing Type 2 Diabetes in

Culturally Diverse Populations.

Front. Endocrinol. 9:479.

doi: 10.3389/fendo.2018.00479

The “A to Z” of Managing Type 2
Diabetes in Culturally Diverse
Populations
A. Enrique Caballero*

Office for External Education, Harvard Medical School, Boston, MA, United States

Type 2 diabetes affects racial/ethnic minorities at an alarming rate in the US and

in many countries around the world. The quality of health care provided to these

groups is often suboptimal, resulting in worse patient-related outcomes when compared

to those in mainstream populations. Understanding the complex biological elements

that influence the development and course of the disease in high-risk populations

is extremely important but often insufficient to implement effective prevention and

treatment plans. Multiple factors must be addressed in routine diabetes clinical care.

This paper discusses various key factors, organized in alphabetical order. These are

acculturation, biology, clinician’s cultural awareness, depression and diabetes-specific

emotional distress, educational level, fears, group integration, health literacy, intimacy and

sexual dysfunction, judging, knowledge of the disease, language, medication adherence,

nutritional preferences, other forms of medicine (alternative), perception of body image,

quality of life, religion and faith, socio-economic status, technology, unconscious bias,

vulnerable groups, asking why?, exercise, “you are in charge” and zip it! Considering

these factors in the development of type 2 diabetes prevention and treatment programs

will help improve diabetes-related outcomes in culturally diverse populations and reduce

health care disparities.

Keywords: type 2 diabetes, race, ethnicity, culture, health care disparities, social medicine, treatment,

26

Improving Medication Adherence among Type II Home Healthcare Diabetic Patients

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[Bola: You have several revisions that need to be made. You are still short of articles in your literature review and there are multiple areas that need to be changed to past tense. Please address all comments in the margins. Please consider enlisting the help of a formatter/editor to assist in formatting issues. Please make all the necessary changes.

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“Whatever you do, work at it with all your heart, as working for the Lord, not for men.” Colossians 3:23

Blessings,

Dr. JoAnna Cartwright

A Direct Practice Improvement Project Presented in Partial Fulfillment

of the Requirements for the Degree

Doctor of Nursing Practice

Grand Canyon University

Phoenix, Arizona

September 1, 2021

© Bola Odusola-Stephen, 2021

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