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Rutledge S, Hulbert L, Charter-Harris J, Smith A, Owens-Gary M. A qualitative exploration of facilitators and barriers to adopting a healthy lifestyle among Black, Hispanic, and American Indian males with diabetes or at risk for type 2 diabetes. ETHNICITY & HEALTH 2024; 29:447-464. [PMID: 38842432 DOI: 10.1080/13557858.2024.2359377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES Higher prevalence of several chronic diseases occurs in men in the United States, including diabetes and prediabetes. Of the 34 million adults with diabetes and 88 million with prediabetes there is a higher prevalence of both conditions in men compared to women. Black, Hispanic, and American Indian men have some of the highest rates of diabetes and diabetes complications. Adopting a healthy lifestyle including healthy eating and physical activity, is important in preventing type 2 diabetes and diabetes complications. DESIGN This study included six focus groups that explored facilitators and barriers to adopting a healthy lifestyle in Black, Hispanic, and American Indian men with diabetes or at risk for type 2 diabetes. Thematic analysis was used to identify facilitators and barriers to adopting a healthy lifestyle. RESULTS Participants included males 18 years of age and older identifying as Black, Hispanic, or American Indian and diagnosed with prediabetes, diabetes, hypertension, or otherwise at risk for type 2 diabetes. Thirty-seven men participated, 19 diagnosed with diabetes and 18 at risk for type 2 diabetes. Fourteen Black, 14 Hispanic, and 9 American Indian men participated. The themes of facilitators to a healthy lifestyle included: family and the social network; psychosocial factors; health status, health priorities and beliefs about aging; knowledge about health and healthy behavior; and healthy community resources. Themes of barriers to a healthy lifestyle also included: mistrust of the health care system, cost, and low socioeconomic status. CONCLUSIONS This study underscores the complexity of factors involved in adopting a healthy lifestyle for some racial and ethnic minority men with diabetes or at risk for type 2 diabetes.
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Affiliation(s)
- Stephanie Rutledge
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - LaShonda Hulbert
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jasmine Charter-Harris
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Akimi Smith
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle Owens-Gary
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ewen AM, Hawkins JM, Kloss KA, Nwankwo R, Funnell MM, Sengupta S, Jean Francois N, Piatt G. The Michigan Men's Diabetes Project Randomized Clinical Control Trial: A Pilot/Feasibility Study of a Peer-Led Diabetes Self-Management and Support Intervention for Black Men With Type 2 Diabetes. Am J Mens Health 2024; 18:15579883241258318. [PMID: 38879823 PMCID: PMC11181889 DOI: 10.1177/15579883241258318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 06/19/2024] Open
Abstract
Black men are disproportionately affected by type 2 diabetes (T2D) and experience higher diabetes-related complications than non-Hispanic White men. To address the complex barriers in diabetes self-management for Black men, we implemented a 3-month peer-led and empowerment-based Diabetes Self-Management Education (DSME) and Support (DSMS) intervention in Metro Detroit. Twenty-five Black men ≥55 years of age with self-reported T2D were randomized to the intervention group (n=12)-10 hr of DSME and 9 hr of DSMS-or enhanced usual care (EUC) group (n=13)-10 hr of DSME. Peer leaders (n = 3) were trained by certified diabetes care and education specialists (CDCESs) to cofacilitate the support sessions. Outcomes (hemoglobin A1c [HbA1c], diabetes self-care activities, and diabetes distress) were assessed preintervention and postintervention. In the intervention and EUC groups, mean HbA1c decreased by 0.20% (p = .52, SD = 0.99) and 0.13% (p = .68), respectively. General diet (p = .03, M change: 1.32, SD = 1.71) and blood glucose monitoring (p < .05, M change: 0.50, SD = 0.74) scores improved among those in the intervention group. General diet scores also improved in the EUC group: mean change: 1.77, p = .08, although changes were not statistically significant. Changes in diabetes distress scores differed based on the number of sessions attended, with a significant decrease in those attending 7 to 12 sessions (n = 7), >50%, (p = .003, M change: -5.71, SD = 3.20). Implementing a peer-led DSMS program for Black men was feasible, adopted, and led to positive changes in outcomes. Scaling up the intervention and assessing sustainability is warranted.
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Affiliation(s)
- Alana M. Ewen
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Robin Nwankwo
- Department of Learning Health Sciences, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Martha M. Funnell
- Department of Learning Health Sciences, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Srijani Sengupta
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | | | - Gretchen Piatt
- Department of Learning Health Sciences, School of Medicine, University of Michigan, Ann Arbor, MI, USA
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Sherman LD, Cisneros-Franco CL, Prochnow T, Patterson MS, Johannes BL, Alexander J, Merianos AL, Bergeron CD, Smith ML. Personal Agency and Social Supports to Manage Health Among Non-Hispanic Black and Hispanic Men With Diabetes. Am J Mens Health 2023; 17:15579883231211057. [PMID: 38032066 PMCID: PMC10691323 DOI: 10.1177/15579883231211057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
The prevalence of type 2 diabetes (T2D) is increasing among non-Hispanic Black and Hispanic communities, especially among men who develop this chronic condition at earlier ages. Personal agency and social support are vital aspects to diabetes management. However, less is known about the relationship between these variables among men living with diabetes. The purposes of this study were to identify (1) levels of personal agency to manage health, (2) sources of social supports to manage health based on personal agency levels, and (3) factors associated with lower personal agency to manage health. Cross-sectional data from non-Hispanic Black (n = 381) and Hispanic (n = 292) men aged 40 years or older with T2D were collected using an internet-delivered questionnaire. Three binary logistic regression models were fitted to assess sociodemographics, health indicators, and support sources associated with weaker personal agency to manage health. About 68% of participants reported having the strongest personal agency relative to 32.1% reporting weaker personal agency. Men who relied more on their spouse/partner (odds ratio [OR] = 1.22, p = .025), coworkers (OR = 1.59, p = .008), or faith-based organizations (OR = 1.29, p = .029) for ongoing help/support to improve their health and manage health problems were more likely to have weaker personal agency. Conversely, men who relied more on their health care providers for ongoing help/support to improve their health and manage health problems were less likely to have weaker personal agency to manage health (OR = 0.74, p < .001). Findings suggest personal agency may influence men's support needs to manage T2D, which may also be influenced by cultural, socioeconomics, and the composition of social networks.
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Affiliation(s)
- Ledric D. Sherman
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
| | | | - Tyler Prochnow
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
| | - Megan S. Patterson
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | - Janae Alexander
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | | | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
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Lateef H, Adams L, Bernard D, Jellesma F, Frempong MRK, Boahen-Boaten BB, Leach BCB, Borgstrom E, Nartey PB. Mental Health Treatment-Seeking Appraisal, Afrocentric Cultural Norms, and Mental Health Functioning: Buffering Factors of Young Black Men's Externalizing Behavior. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01771-7. [PMID: 37624539 PMCID: PMC10894312 DOI: 10.1007/s40615-023-01771-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Depression rates are disproportionately high among Black American Men. This disparity--compounded by low mental healthcare seeking rates and high incorrect diagnosis rates in men--could be related to masculine norms, including self-reliance, restrictive emotionality, and stoicism. Furthermore, men are more likely to engage in externalized behavior, such as aggression, to cope with mental health challenges; this pattern is influenced by cultural and environmental factors. Contrary to these detrimental factors, social relationships, belief in social networks, and collectivism have been associated with positive mental health in these populations. Similarly, an Afrocentric worldview (including concepts like Ubuntu and African self-consciousness) has been hypothesized to promote positive mental health outcomes among Black American men. However, little research exists on harnessing these factors as a means of increasing health-seeking behaviors in young Black males. AIM To elucidate the effect of region, depression, African humanism, collectivism, and help-seeking values and needs concerning aggression in young Black males. METHOD This study included Black or African American participants (n = 428) identifying as male, aged 18-25 years, who responded to a Qualtrics survey with questions on region, aggression, depression, African humanism, collectivism, and help-seeking value and need. RESULTS Hierarchical linear regression revealed that collectivism, humanness, value, and the need for seeking treatment were inversely associated with aggression (p < 0.001). DISCUSSION/CONCLUSION Highlighting the effect of cultural norms and help-seeking behaviors and the aggravating effect of depression on aggression in young Black males can help to develop aggression-mitigating interventions rooted in Afrocentric Norms.
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Affiliation(s)
- Husain Lateef
- Washington University in St. Louis, St. Louis, MO, USA.
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Lertsakulbunlue S, Mungthin M, Rangsin R, Kantiwong A, Sakboonyarat B. Trends in predicted 10-year risk for cardiovascular diseases among patients with type 2 diabetes in Thailand, from 2014 to 2018. BMC Cardiovasc Disord 2023; 23:183. [PMID: 37020277 PMCID: PMC10077638 DOI: 10.1186/s12872-023-03217-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the leading causes of death globally, including Thailand. Approximately one-tenth of Thai adults have type 2 diabetes (T2D), a significantly increasing CVD. Our study aimed to determine the trends of predicted 10-year CVD risk among patients with T2D. METHODS A series of hospital-based cross-sectional studies were conducted in 2014, 2015 and 2018. We included Thai patients with T2D aged 30-74-year-old without a history of CVD. The predicted 10-year risk for CVD was calculated based on Framingham Heart Study equations both with simple office-based nonlaboratory and laboratory-based. Age- and sex-adjusted means and proportions of predicted 10-year risk for CVD were calculated. RESULTS A total of 84,602 patients with T2D were included in the present study. The average SBP among study participants was 129.3 ± 15.7 mmHg in 2014 and rose to 132.6 ± 14.9 mmHg in 2018. Likewise, the average body mass index was 25.7 ± 4.5 kg/m2 in 2014 and elevated to 26.0 ± 4.8 kg/m2 in 2018. The age- and sex-adjusted mean of the predicted 10-year CVD risk (simple office-based) was 26.2% (95% CI: 26.1-26.3%) in 2014 and rose to 27.3% (95% CI: 27.2-27.4%) in 2018 (p-for trend < 0.001). While the age- and sex-adjusted mean of the predicted 10-year CVD risk (laboratory-based) ranged from 22.4-22.9% from 2014 to 2018 (p-for trend < 0.001). The age- and sex-adjusted prevalence of the high predicted 10-year CVD risk (simple office-based) was 67.2% (95% CI: 66.5-68.0%) in 2014 and significantly rose to 73.1% (95% CI: 72.4-73.7%) in 2018 (p-for trend < 0.001). Nevertheless, the age- and sex-adjusted prevalence of the high predicted 10-year CVD risk (laboratory-based) ranged from 46.0-47.4% from 2014 to 2018 (p-for trend = 0.405). However, among patients with available laboratory results, a significantly positive correlation was noted between predicted 10-year CVD risk, simple office-based and laboratory-based (r = 0.8765, p-value < 0.001). CONCLUSION Our study demonstrated significant rising trends in the predicated 10-year CVD risk among Thai patients with T2D. In addition, the results empowered further improved modifiable CVD risks, especially regarding high BMI and high blood pressure.
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Affiliation(s)
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Anupong Kantiwong
- Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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Hawkins J, Sengupta S, Kloss K, Kurnick K, Ewen A, Nwawkwo R, Funnell M, Mitchell J, Jones L, Piatt G. Michigan men's diabetes project II: Protocol for peer-led diabetes self-management education and long-term support in Black men. PLoS One 2023; 18:e0277733. [PMID: 36862648 PMCID: PMC9980828 DOI: 10.1371/journal.pone.0277733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Previous literature has indicated that Black men are twice as likely to develop type 2 diabetes compared to their non-Hispanic White counterparts and are also more likely to have associated complications. Furthermore, Black men have lower access to quality health care, and masculinity norms have been shown to hinder them from seeking the limited care that is available. In this study, we aim to investigate the effect of peer-led diabetes self-management education and long-term ongoing support on glycemic management. The first phase of our study will consist of modification of existing diabetes education content to be more appropriate for the population of interest, Then, in the second phase, we will conduct a randomized controlled trial to test the intervention. Participants randomized to the intervention arm will receive diabetes self-management education, structured diabetes self-management support, and a more flexible ongoing support period. Participants randomized to the control arm will receive diabetes self-management education. Diabetes self-management education will be taught by certified diabetes care and education specialists, while the diabetes self-management support and ongoing support period will be facilitated by fellow Black men with diabetes who will be trained in group facilitation, patient-provider communication strategies, and empowerment techniques. The third phase of this study will consist of post-intervention interviews and dissemination of findings to the academic community. The primary goal of our study is to determine whether long-term peer-led support groups in conjunction with diabetes self-management education are a promising solution to improve self-management behaviors and decrease A1C levels. We will also evaluate the retention of participants throughout the study, which has historically been an issue in clinical studies focused on the Black male population. Finally, the results from this trial will determine whether we can proceed to a fully-powered R01 trial or if other modifications of the intervention are necessary. Trial registration: Registered at ClinicalTrials.gov with an ID of NCT05370781 on May 12, 2022.
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Affiliation(s)
- Jaclynn Hawkins
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Srijani Sengupta
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Katherine Kloss
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Katie Kurnick
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Alana Ewen
- School of Public Health, University of Maryland, College Park, MD, United States of America
| | - Robin Nwawkwo
- Medical School, University of Michigan, Ann Arbor, MI, United States of America
| | - Martha Funnell
- Medical School, University of Michigan, Ann Arbor, MI, United States of America
| | - Jamie Mitchell
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Lenette Jones
- School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
| | - Gretchen Piatt
- Medical School, University of Michigan, Ann Arbor, MI, United States of America
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Daniel-Ulloa J, Reyes JA, Morales-Campos DY, Villareal E, López Cevallos DF, Hernandez H, Baquero B. Rural Latino Men’s Experiences and Attitudes Toward Health: A Pilot Photovoice Study. Am J Mens Health 2023. [PMCID: PMC9998422 DOI: 10.1177/15579883231158525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Much of the research regarding Latino men’s health tends to focus on specific health outcomes (e.g., HIV or diabetes). Few studies have examined how Latino men perceive factors that influence their health and/or health-related behaviors. This study explored rural Latino men’s experiences and attitudes toward health, using photovoice, in the context of a community-based participatory research partnership. We recruited nine Latino men living in a small town in Southeastern Iowa. Four to nine men attended four sessions and led a community forum. All the men were foreign-born, identified as Latino, aged between 34 and 67 years, and had lived in the United States for at least 7 years. Five themes were identified: (a) cultural conflict, (b) too much and discordant information, (c) lifestyles conflict, (d) sacrifice, and (e) family connectedness. An important implication of this study derives from familial and community connections and sacrifice. Feeling disconnected from family may impact physical and mental health and health-promoting behaviors. Future research should explore ways to inform community- and family-level interventions to connect rural Latino men more strongly to their family and local community and help them to take better control of their health.
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Affiliation(s)
- Jason Daniel-Ulloa
- College of Public Health, University of Iowa, Iowa City, IA, USA
- Department of Nursing and Health Studies, University of Washington, Bothell, Bothell, WA, USA
| | | | | | | | - Daniel F. López Cevallos
- School of Language, Culture, and Society, College of Liberal Arts, Oregon State University, Corvallis, OR, USA
- School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA, USA
| | | | - Barbara Baquero
- College of Public Health, University of Iowa, Iowa City, IA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
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Sloan-Aagard C, Glenn J, Nañez J, Crawford SB, Currey JC, Hartmann E. The Impact of Community Health Information Exchange Usage on Time to Reutilization of Hospital Services. Ann Fam Med 2023; 21:19-26. [PMID: 36690494 PMCID: PMC9870640 DOI: 10.1370/afm.2903] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/23/2022] [Accepted: 09/12/2022] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Few studies have determined whether clinician usage of a community health information exchange (HIE) directly improves patient care transitions. We hypothesized that lookup in the HIE by primary care physicians of patients recently released from the hospital would increase the time until hospital reuse. METHODS We identified a retrospective cohort of 8,216 hospital inpatients aged over 18 years that were discharged from January 1, 2021 through November 30, 2021 using the Paso del Norte Health Information Exchange, in El Paso County, Texas. All patients had a primary care physician visit within 30 days after hospital discharge, and we identified patients that were looked up in the HIE close to that visit. Of the cohort, 2,627 were rehospitalized and 3,809 visited an emergency department (ED) during the follow-up window. The remaining 1,780 patients were controls. We conducted survival analysis, censoring at the second ED or inpatient visit or end of the study window (January 31, 2022). The model was adjusted by ethnicity, gender, insurance, and age. RESULTS Lookup in the HIE was significantly associated with reducing the likelihood of visiting the ED by 53% and being rehospitalized by 61%. Lookup in the HIE was associated with an increased median time to use of the ED after inpatient discharge from 99 to 238 patient days. Ethnicity, insurance, gender, and age were also significant predictors of hospital reuse. CONCLUSIONS Increased utilization of community HIEs by primary care physicians on behalf of their recently discharged patients may dramatically increase the time until inpatient or ED reuse.
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Affiliation(s)
- Chantel Sloan-Aagard
- Paso del Norte Health Information Exchange, El Paso, Texas
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Jeffrey Glenn
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Juan Nañez
- Paso del Norte Health Information Exchange, El Paso, Texas
| | - Scott B Crawford
- Department of Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas
| | - J C Currey
- Paso del Norte Health Information Exchange, El Paso, Texas
| | - Emily Hartmann
- Paso del Norte Health Information Exchange, El Paso, Texas
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Hawkins J, Kieffer EC, Sinco B, Piatt G, Jones L, Mitchell J, Espitia N, LeBron A, Kloss KA, Kurnick K, Palmsiano G, Spencer MS. Using Path Analysis and Linear Regression to Test for Gender and Participation: Effects in a Culturally Tailored Diabetes Intervention for Latino Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11982. [PMID: 36231282 PMCID: PMC9565909 DOI: 10.3390/ijerph191911982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/17/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
While the incidence and prevalence of type 2 diabetes is higher among Latino/as, Latino men are disproportionately affected and have poorer outcomes. We aimed to determine whether gender impacted any outcomes in a culturally tailored type 2 diabetes (T2D) intervention and to evaluate the effects of gender and intervention participation intensity on outcomes at 6-month follow-up. Nested path and regression models were compared with the likelihood ratio test and information criteria in a sample of Latino/a adults with T2D (n = 222) participating in a T2D community health worker (CHW)-led intervention. Path analysis showed that the effect of the intervention did not vary by gender. The intervention was associated with significant improvements in knowledge of T2D management 0.24 (0.10); p = 0.014, diabetes distress, -0.26 (0.12); p = 0.023, and self-efficacy, 0.61 (0.21); p = 0.005. At 6-month follow-up, improved self-management was associated with greater self-efficacy and Hemoglobin A1c (HbA1c) was lower by -0.18 (0.08); p = 0.021 for each unit of self-management behavior. Linear regressions showed that class attendance and home visits contributed to positive intervention results, while gender was non-significant. Pathways of change in a CHW-led culturally tailored T2D intervention can have a significant effect on participant behaviors and health status outcomes, regardless of gender.
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Affiliation(s)
- Jaclynn Hawkins
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Edith C. Kieffer
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Brandy Sinco
- Center for Healthcare Outcomes & Policy, University of Michigan, 2800 Plymouth Road, North Campus Research Complex, Bldg. 16, Ann Arbor, MI 48109, USA
| | - Gretchen Piatt
- Department of Learning Health Sciences, School of Medicine, University of Michigan, 1111 E. Catherine Street, Ann Arbor, MI 48109, USA
| | - Lenette Jones
- School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, USA
| | - Jamie Mitchell
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Nicolaus Espitia
- Department of Sociology, Anthropology, Social Work and Criminal Justice Oakland University, 614 Pioneer Dr, Rochester, MI 48309, USA
| | - Alana LeBron
- School of Public Health, University of California, Irvine, 3151 Social Science Plaza, SST 369 (Chicano/Latino Studies) OR 653 E Peltason Drive, AIRB 2026 (Public Health), Irvine, CA 92697, USA
| | - Katherine A. Kloss
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Katie Kurnick
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Gloria Palmsiano
- Community Health and Social Services Center, 5635 West Fort Street, Detroit, MI 48209, USA
| | - Michael S. Spencer
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA 98105, USA
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Perez-Brescia M, Beck CT, Alicea Planas J, Newlin-Lew KH, Whittemore R, Juarez A. Famalismo Primero and Puerta Cerrada in Self-Managing Diabetes Among Hispanics: A Qualitative Meta-Synthesis. J Transcult Nurs 2022; 33:666-674. [DOI: 10.1177/10436596221109834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Type 2 diabetes (T2D) prevalence is increasing at concerning rates for Hispanics. Researchers have attempted to understand why through quantitative or qualitative studies. This meta-synthesis examines qualitative studies concerning barriers and facilitators that Hispanics face while managing their diabetes. Method: Noblit and Hare’s (1988) defined method of analysis was used to synthesize 15 qualitative studies on Hispanics’ diabetes self-management. Results: Findings revealed two themes: (a) famalismo primero and (b) puerta cerrada, translating to family first and closed door, respectively. In famalismo primero, Hispanics with T2D prioritize family, and receive support, motivation, and knowledge from them first; puerta cerrada is tied to barriers such as cost of services and patient–provider relationships. Discussion: Inclusion of family in diabetes self-management provides support and motivation for Hispanics. Hispanics experience barriers to access health care that may interfere with diabetes self-management, which need to be addressed to promote health equity.
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Affiliation(s)
| | | | | | | | | | - A. Juarez
- University of Texas Medical Branch, Galveston, USA
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11
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Zvolensky MJ, Rogers AH, Mayorga NA, Shepherd JM, Bakhshaie J, Garza M, Viana AG, Ochoa-Perez M, Lemaire C, Ruiz A, Peraza N. Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care. Transcult Psychiatry 2022; 59:337-348. [PMID: 35018872 DOI: 10.1177/13634615211038159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults (Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, 14743University of Houston, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, 14743University of Houston, Houston, TX, USA
| | - Andrew H Rogers
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Nubia A Mayorga
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Justin M Shepherd
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Jafar Bakhshaie
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | | | - Andres G Viana
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | | | | | - Ana Ruiz
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Natalia Peraza
- Department of Psychology, 14743University of Houston, Houston, TX, USA
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12
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Rao D, Meyer J, Maurer M, Shiyanbola OO. Perceptions of psychosocial and interpersonal factors affecting self-management behaviors among African Americans with diabetes. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 3:100057. [PMID: 35480599 PMCID: PMC9029920 DOI: 10.1016/j.rcsop.2021.100057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/19/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022] Open
Abstract
Background Objective Methods Results Conclusion
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Affiliation(s)
- Deepika Rao
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, United States of America
| | - Jodi Meyer
- School of Pharmacy, University of Wisconsin-Madison, United States of America
| | - Martha Maurer
- Sonderegger Research Center, School of Pharmacy, University of Wisconsin-Madison, United States of America
| | - Olayinka O. Shiyanbola
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, United States of America
- Corresponding author at: School of Pharmacy, University of Wisconsin, 777 Highland Avenue, Madison, WI 53705, United States of America.
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13
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Olivari CF, Gonzáles-Santa Cruz A, Mauro PM, Martins SS, Sapag J, Gaete J, Cerdá M, Castillo-Carniglia A. Treatment outcome and readmission risk among women in women-only versus mixed-gender drug treatment programs in Chile. J Subst Abuse Treat 2021; 134:108616. [PMID: 34483012 PMCID: PMC9052114 DOI: 10.1016/j.jsat.2021.108616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/20/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
Introduction: Traditional treatment programs for substance use disorder (SUD) tend to be male-dominated environments, which can negatively affect women’s access to treatment and related outcomes. Women’s specific treatment needs have led some providers to develop women-only SUD treatment programs in several countries. In Chile, women-only programs were only fully implemented in 2010. We compared treatment outcomes and readmission risk for adult women admitted to state-funded women-only versus mixed-gender SUD treatment programs in Chile. Methods: We used a registry-based retrospective cohort design of adult women in women-only (N = 8200) and mixed-gender (N = 13,178) SUD treatment programs from 2010 to 2019. The study obtained data from the National Drug and Alcohol Service from Chile. We used a multistate model to estimate the probabilities of experiencing treatment completion, discharge without completion (i.e., patient-initiated discharge and administrative discharge), or readmission, as well as the likelihood of being readmitted, conditioned on prior treatment outcome. We adjusted models for multiple baseline characteristics (e.g., substance use, socioeconomic). Results: Overall, 24% of women completed treatment and 54% dropped out of treatment. The proportion of patient-initiated discharges within the first three month was larger in women-only than in mixed-gender programs (19% vs. 12%). In both programs, women who completed treatment were more likely to experience readmission at three months, and one and three years. In the long term, women in the women-only programs were more likely to complete treatment than women in mixed-gender programs (34% vs. 23%, respectively). The readmission probability was higher among women who previously completed treatment than those who had a discharge without completion (40% vs 21% among women in women-only programs; 38% vs. 19% among women in mixed-gender programs, respectively); no differences occurred in the risk of readmission between women-only and mixed-gender programs. Conclusions: In terms of treatment outcomes and readmission risk, women-only programs had similar results to mixed-gender programs in Chile. The added value of these specialized programs should be addressed in further research.
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Affiliation(s)
- Carla F Olivari
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Suite 1305, Las Condes, Santiago, Chile; Faculty of Education, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, Santiago, Chile
| | - Andrés Gonzáles-Santa Cruz
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Suite 1305, Las Condes, Santiago, Chile
| | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032, United States.
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032, United States.
| | - Jaime Sapag
- Department of Public Health and Family Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
| | - Jorge Gaete
- Faculty of Education, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, Santiago, Chile; Research Center for School Mental Health, Faculty of Education (ISME), Universidad de los Andes, Chile; Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.
| | - Magdalena Cerdá
- Department of Population Health and Center for Opioid Epidemiology and Policy, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, United States.
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Suite 1305, Las Condes, Santiago, Chile; Department of Population Health and Center for Opioid Epidemiology and Policy, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, United States; School of Public Health, Universidad Mayor, José Toribio Medina 38, Santiago, Chile.
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14
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National trends in the prevalence of glycemic control among patients with type 2 diabetes receiving continuous care in Thailand from 2011 to 2018. Sci Rep 2021; 11:14260. [PMID: 34253809 PMCID: PMC8275592 DOI: 10.1038/s41598-021-93733-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/30/2021] [Indexed: 12/22/2022] Open
Abstract
Diabetes is one of the largest global health problems and exhibits a constantly increasing trend. A series of nationwide hospital-based cross-sectional surveys of clinical outcomes was performed annually from 2011 to 2015 and 2018 among patients with type 2 diabetes aged ≥ 20 years receiving medical care for at least 12 months. A two-stage stratified cluster that was proportional to the size sampling technique was used to select a nationally and provincially representative sample of patients with type 2 diabetes in Thailand. A total of 186,010 patients with type 2 diabetes were enrolled in the study from 2011 to 2018. The prevalence of adequate glycemic control (hemoglobinA1c level < 7.0%) among patients with type 2 diabetes were estimated to be 34.5% (95%CI 33.8–35.2%) in 2011, 33.0% (95%CI 32.4–33.6%) in 2012, 34.7% (95%CI 34.1–35.4%) in 2013, 35.5 (95%CI 34.9–36.1%) in 2014, 35.6 (95%CI 35.0–36.2%) in 2015, and 35.6% (95%CI 35.0–36.2%) in 2018, respectively (p for trend < 0.001). Independent factors related to poor glycemic control (hemoglobinA1c ≥ 7%) were being female, younger aged, living in the northeastern region, received care form hospitals lower than regional level, under universal health coverage scheme, greater duration of diabetes, higher body mass index level and absence of hypertension comorbidity.
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15
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Eanes LS, Huerta C, Fuentes LA, Bautista B. Nurse Practitioner Students' Perceptions on Delivering Culturally Congruent Care to Vulnerable Mexican Immigrants: A Qualitative Study. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:56-65. [PMID: 34132139 DOI: 10.1177/15404153211020417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increasingly, nurse practitioners serve as vanguards in providing primary health care to vulnerable Mexican immigrants. The aims of this study were to explore the lived experiences of nurse practitioner students in caring for Mexican immigrant patients and to capture their meaning of cultural influences deemed essential to the delivery of culturally congruent care. An exploratory descriptive design was employed. Purposive sampling was used to select 17 nurse practitioner students who volunteered to complete a semistructured face-to-face audio-taped interview and follow-up focus group discussion. Constant comparison was utilized to analyze data. From this process, four distinct themes emerged: Culturally congruent care extends beyond race and ethnicity, understands the importance of therapeutic communication, accepts complementary and alternative medical modalities, and recognizes the importance of eating patterns, food choices, and perceptions of ideal weight and health. These findings build on our understanding of key evidence-based cultural beliefs and practices that are important in delivering culturally congruent care to this subgroup.
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Affiliation(s)
- Linda S Eanes
- 12331The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Carolina Huerta
- School of Nursing, 12331The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | | | - Beatriz Bautista
- 12331The University of Texas Rio Grande Valley, Edinburg, TX, USA
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16
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Hu J, Mion LC, Tan A, Du Y, Chang MW, Miller C, Joseph JJ. Perceptions of African American Adults With Type 2 Diabetes on Family Support: Type, Quality, and Recommendations. Sci Diabetes Self Manag Care 2021; 47:302-311. [PMID: 34075831 DOI: 10.1177/26350106211018994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The overall purpose of the study was to explore perceptions of family support in diabetes self-management among African American adults with type 2 diabetes. METHODS A qualitative study using focus group methodology and individual interviews was conducted. Thirty-seven African American adults with type 2 diabetes were recruited in the Midwest, United States. Data were analyzed using qualitative content analysis. RESULTS Themes emerged from the perspectives of the social interdependence theory. Positive family support included emotional support, instrumental support, and specific information or advice on diabetes management strategies. Positivity, family communication, and healthy eating/meal planning were perceived as helpful family behaviors. Negative support was perceived as intentional or unintentional behaviors. Family members' help in decision-making included goal setting with family member(s) and help in making decisions on diet and exercise. Recommendations included exercise and nutritional programs, support groups, family involvement, and materials and resources. Motivations for attending diabetes programs included involving family members, sharing success stories, seeing positive results, encouraging and caring, and providing incentives. CONCLUSIONS Intervention programs for African Americans should specifically target challenges in family support, healthy eating, and physical activity at an interpersonal level. Health care providers should assess family roles and family support to facilitate diabetes self-management for African Americans.
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Affiliation(s)
- Jie Hu
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Lorraine C Mion
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Alai Tan
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Yang Du
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Mei-Wei Chang
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Carla Miller
- The Ohio State University, Department of Human Sciences, Human Nutrition, Ohio
| | - Joshua J Joseph
- The Ohio State University, College of Medicine, Columbus, OH
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Hawkins J, Kloss K, Funnell M, Nwankwo R, Schwenzer C, Smith F, Piatt G. Michigan Men's diabetes project (MenD): protocol for a peer leader diabetes self-management education and support intervention. BMC Public Health 2021; 21:562. [PMID: 33752609 PMCID: PMC7983198 DOI: 10.1186/s12889-021-10613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background Black men are more likely to be diagnosed with type 2 diabetes (T2D) compared to non-Hispanic White men, and this disparity increases among men over the age of 55. A growing body of literature demonstrates the critical role of gender in the management of health behaviors such as T2D and shows that male gender norms can conflict with healthy behaviors. These studies suggest that tailoring diabetes self-management interventions to address the needs of Black men may be critical to helping them to achieve optimal health outcomes. Further, our own research on Blacks with T2D found gender disparities in participation in diabetes interventions, with males participating at significantly lower rates than females. Peer leaders are trained lay individuals who are used to provide ongoing diabetes self-management support to people with diabetes, particularly in minority communities. However, despite studies showing that diabetes management interventions using peer leaders have been successful, the majority of peer leaders as well as the participants in those studies are women. The limited studies to date suggest that Black men with T2D prefer peer-led, male-to-male T2D programs, however, this research consists primarily of nonrandomized, small sample feasibility studies calling for additional studies to establish the efficacy of these approaches. The proposed study will develop and preliminarily validate the effectiveness of an adapted peer leader diabetes self-management support (PLDSMS) intervention designed to improve diabetes-related lifestyle and self-management behaviors in Black men (over 55) with T2D. Method We propose to tailor an existing intervention by 1) our using male peers and 2) modifying the peer leader training content to focus on material appropriate for men. The proposed study includes a developmental phase (development of the intervention with expert feedback, followed by feasibility testing with Black men) and a validation phase [randomized clinical trial (RCT)]. Discussion If successful, this study will lead to the development and dissemination of an intervention that will address the unique needs of Black men with T2D, helping them to achieve optimal diabetes self-management and health outcomes. Trial registration Registered at ClinicalTrials.gov with an ID NCT04760444 on February 17, 2021
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Affiliation(s)
- Jaclynn Hawkins
- University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA.
| | - Katherine Kloss
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
| | - Martha Funnell
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
| | - Robin Nwankwo
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
| | - Claudia Schwenzer
- University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA
| | - Fonda Smith
- University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA
| | - Gretchen Piatt
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
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18
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Driver R, Allen AM, Finneran S, Maksut JL, Eaton LA, Kalichman SC. Masculine ideology and Black men who have sex with men's interest in HIV pre-exposure prophylaxis (PrEP). J Health Psychol 2020; 26:2908-2920. [PMID: 32638629 DOI: 10.1177/1359105320941236] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We examined how traditional masculinity and stigma surrounding HIV pre-exposure prophylaxis (PrEP) affect PrEP interest among Black men who have sex with men (BMSM). One hundred twenty-three men attending a Black Gay Pride event completed measures assessing traditional masculinity, PrEP stigma, and PrEP interest along with two behavioral measures of interest in PrEP. Results demonstrated that avoidance of femininity directly related to interest in PrEP and indirectly through conformity to heterosexual self-presentation. Further, PrEP stigma differentially moderated both of these relationships. Interventions designed to improve engagement of PrEP for BMSM should be attentive to traditional masculinity as a barrier.
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Eley NT, Namey E, McKenna K, Johnson AC, Guest G. Beyond the Individual: Social and Cultural Influences on the Health-Seeking Behaviors of African American Men. Am J Mens Health 2020; 13:1557988319829953. [PMID: 30767594 PMCID: PMC6440067 DOI: 10.1177/1557988319829953] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Morbidity and mortality rates are alarmingly high among African American men and are influenced by the health-seeking behaviors of this population. This study examined data from 40 focus groups with African American men in Durham, North Carolina, to better understand social and cultural influences on health-seeking behaviors. Data were analyzed using inductive thematic analysis. Three broad types of social/cultural influence on motivation to seek health care services were identified: family, culture and upbringing, and peers. Study findings confirm the importance of social relationships in influencing African American men’s health-seeking behaviors and offer characterization of the nature of influence across different types of relationships, according to the direct support or indirect messages they provide. Future programs can draw on these data to inform efforts to include family and peers as well as utilize existing cultural gender norms to the advantage of health promotion for African American men.
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Rodríguez-Santamaría Y, Juárez-Medina L, Zúñiga-Vargas M, Cadena-Santos F, Mendoza-Catalán G. Hombres con diabetes mellitus tipo 2: autoeficacia y factores psicológicos que influyen en el autocuidado. ENFERMERÍA UNIVERSITARIA 2020. [DOI: 10.22201/eneo.23958421e.2020.1.707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introducción: La prevalencia global de diabetes mellitus tipo 2 (DMT2) en los hombres es alta. Para el tratamiento de la enfermedad el hombre debe realizar acciones de autocuidado, por lo que es importante conocer factores relacionados con su cumplimiento.
Objetivo: Identificar la relación entre variables demográficas, clínicas, la angustia, la depresión, la autoeficacia y su influencia sobre el autocuidado en hombres con DMT2. Métodos: Estudio transversal y correlacional, en una muestra de 96 hombres con DMT2, usuarios de 13 centros de salud. Los instrumentos utilizados fueron el cuestionario de acciones de cuidado en diabetes, la escala Self-Efficacy for Diabetes, la escala depresión (CES-D) y la escala angustia por diabetes (DDS).
Resultados: El autocuidado se correlacionó de manera positiva con la autoeficacia y negativamente con la angustia por diabetes. Las variables que explicaron el autocuidado con el 47.7% de varianza fueron: la autoeficacia (β = .39), el consumo de alcohol (β = -.29), las horas sentado/parado (β= -.27), el tiempo de diagnóstico (β= -.22) y la edad (β =.18).
Discusión: Los hombres tuvieron un bajo autocuidado y mantienen conductas de riesgo, lo cual puede atribuirse a sus creencias, estilo de vida o al tipo de trabajo que desempeñan.
Conclusiones: Los resultados ofrecen evidencia sobre factores que influyen en el autocuidado de hombres con DMT2, que pueden orientar a los profesionales de enfermería en la atención del paciente. Se sugiere realizar investigaciones de enfermería en hombres, que contribuyan a mejorar la autoeficacia y el autocuidado.
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McIlvennan CK, Morris MA, Guetterman TC, Matlock DD, Curry L. Qualitative Methodology in Cardiovascular Outcomes Research: A Contemporary Look. Circ Cardiovasc Qual Outcomes 2019; 12:e005828. [PMID: 31510771 DOI: 10.1161/circoutcomes.119.005828] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Qualitative research offers unique opportunities to contribute to cardiovascular outcomes research. Despite the growth in qualitative research over the last decade, outcomes investigators in cardiology still have relatively little guidance on when and how best to implement these methods in their investigations, leaving the full potential of these methods unrealized. We offer a contemporary look at qualitative methods, including publication trends of qualitative studies in cardiology journals from 1998 to 2018, novel emerging data collection and analytic methods, and current use and examples of cardiovascular outcomes research that apply qualitative methods such as user-centered design, preimplementation evaluation, implementation evaluation, effectiveness evaluation, and policy analysis.
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Affiliation(s)
- Colleen K McIlvennan
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (C.K.M., M.A.M., D.D.M.), University of Colorado School of Medicine, Aurora.,Division of Cardiology (C.K.M.), University of Colorado School of Medicine, Aurora
| | - Megan A Morris
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (C.K.M., M.A.M., D.D.M.), University of Colorado School of Medicine, Aurora
| | | | - Daniel D Matlock
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (C.K.M., M.A.M., D.D.M.), University of Colorado School of Medicine, Aurora.,Veteran Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO (D.D.M.)
| | - Leslie Curry
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.C.).,Yale Global Health Leadership Institute, Yale University, New Haven, CT (L.C.)
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Meo SA, Sheikh SA, Sattar K, Akram A, Hassan A, Meo AS, Usmani AM, Qalbani E, Ullah A. Prevalence of Type 2 Diabetes Mellitus Among Men in the Middle East: A Retrospective Study. Am J Mens Health 2019; 13:1557988319848577. [PMID: 31055980 PMCID: PMC6505246 DOI: 10.1177/1557988319848577] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 12/15/2022] Open
Abstract
The rising prevalence of diabetes mellitus (DM) is a serious global health concern. The world is experiencing type 2 diabetes epidemics and prevalence differs by gender, regions, and level of socioeconomic development. Type 2 diabetes mellitus (T2DM) in men increased at a faster rate and numbers are continuing to rise in some regions of the world. This study aimed to estimate the prevalence of T2DM among men in the Middle East countries. Seventy-four research articles were identified through search engines including Web of Science, Medline, PubMed, EMBASE, Scopus, and Ovid databases by using keywords "epidemiology," "prevalence," "diabetes mellitus," and individual names of the Middle East states. Finally, 17 studies were included for the assessment of prevalence of T2DM among men in the Middle East. In the Middle East, high prevalence of T2DM among men was identified in Bahrain (33.60%), Saudi Arabia (29.10%), United Arab Emirates (UAE; 25.83%), and Kuwait (25.40%), whereas low prevalence was reported in Iran (9.90%) and Yemen (9.80%). The random pooled prevalence in the Gulf Cooperation Council (GCC) states was (24.0%) compared to non-GCC states (16.0%), and in both GCC and non-GCC countries combined, it was 19%. The prevalence was significantly associated with the gross domestic product of these states ( p = .0005). Despite different socioeconomic and cultural settings in the Middle East, the rising T2DM prevalence among men was identified in Bahrain, Saudi Arabia, UAE, and Kuwait. These states must incorporate future diabetes defensive strategies targeting the Middle East population to minimize the burden of DM from the region.
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Affiliation(s)
- Sultan Ayoub Meo
- Department of Physiology, College of
Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed A. Sheikh
- Department of Pharmacology, College of
Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Kamran Sattar
- Department of Medical Education, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ashfaq Akram
- Department of Medical Education, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Asim Hassan
- Endocrinology Department, Armed Forces
Hospital, Alhada, Taif, Saudi Arabia
| | - Anusha Sultan Meo
- Army Medical College, National
University for Health Sciences, Rawalpindi, Pakistan
| | - Adnan Mehmood Usmani
- University Diabetes Centre, College of
Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Anhar Ullah
- Department of Cardiac Sciences, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
PURPOSE OF REVIEW This article discusses the state of type 2 diabetes (T2D) self-management research on non-Hispanic Black men with a focus on their knowledge of diabetes, factors that impact T2D self-management and intervention research that specifically targets non-Hispanic Black men with T2D. RECENT FINDINGS Studies on T2D knowledge and barriers and facilitators to T2D self-management in non-Hispanic Black men are limited to small qualitative focus group and in-depth interviews. To date, few T2D interventions for non-Hispanic Black men have been developed and tested. Research shows that non-Hispanic Black men's knowledge of T2D may be less than optimal compared to non-Hispanic white men. Factors that influence T2D self-management in non-Hispanic Black men include gender-related values and beliefs, and a range of other psychosocial (e.g., social support) and structural (e.g., access to health care) factors. Interventions with gender-specific programming may show promise. More studies with larger sample sizes and longitudinal designs are needed to develop programming to effectively target this at-risk population.
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Affiliation(s)
- Jaclynn M Hawkins
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI, 48109, USA.
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24
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Sherman LD, Comer-Hagans D, Pattin AJ. Experiences With Stress Among African American Men Living With Type 2 Diabetes: A Qualitative Inquiry. SAGE Open Nurs 2019; 5:2377960819871806. [PMID: 33415253 PMCID: PMC7774394 DOI: 10.1177/2377960819871806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/23/2019] [Accepted: 08/01/2019] [Indexed: 12/04/2022] Open
Abstract
Self-managing type 2 diabetes (T2D) is critical but often presents a challenge among African American men. Stress may exacerbate both mental and physical problems, which can lead to poor self-management; however, the evidence is sparse. The purpose of this manuscript is to examine the relationship the role of stress in type 2 diabetes management among a prospective group of African American men living in the southern United States. Nineteen African American men with T2D were recruited from barbershops and churches. Interviews were conducted using a semi structured interview guide. Transcripts were analyzed using a phenomenological approach and focused on identifying common themes describing the responses regarding any stress that the participants have pertaining to living with and managing T2D. The themes that emerged from the participant responses are: (a) experiencing less stress, (b) stress not attributed from diabetes, (c) avoid thinking about stress, and (d) some stress is prevalent. Overall, participants expressed either that diabetes was not attributing to the stress that they have or that they have less stress than they did prior to being diagnosed with T2D. In this sample of African American men, stress became a factor for some participants when considering the complications that can occur from diabetes. These findings suggest the need for key considerations to only incorporate general information about diabetes and stress management, but should be gender and culturally relevant to African American men.
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Affiliation(s)
- Ledric D. Sherman
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - DeLawnia Comer-Hagans
- Department of Health Administration, Governors State University, University Park, IL, USA
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Hawkins J, Mitchell J, Piatt G, Ellis D. Older African American Men's Perspectives on Factors That Influence Type 2 Diabetes Self-Management and Peer-Led Interventions. Geriatrics (Basel) 2018; 3:geriatrics3030038. [PMID: 31011076 PMCID: PMC6319245 DOI: 10.3390/geriatrics3030038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 11/16/2022] Open
Abstract
Older African American men are at increased risk of Type 2 Diabetes (T2D) but demonstrate high rates of poor illness management. They also participate in interventions targeting illness management at extremely low rates and are at high risk for dropout from clinical trials. One modifiable factor that has been identified in the literature that contributes to these disparities is health beliefs particular to men. Yet, despite the fact that illness management interventions have been developed to meet the needs of African Americans, none have followed recommendations to use gender-sensitive programming to meet the needs of men. The primary aim of this study was to advance our understanding of the intersection of age, race/ethnicity and gender on T2D self-management among older African American men, and to explore their preferences for a peer-led T2D self-management intervention. Two focus groups were conducted with older African American men (n = 12) over a 6-month period. Sessions lasted 90 min, were audiotaped, and analyzed using thematic content analysis techniques. The most prominent themes included: (a) the influence of gendered values and beliefs on health behavior; (b) quantity and quality of patient-provider communication; (c) social and structural barriers to T2D self-management; and (d) preferences for peer-led T2D self-management interventions. Results suggest that these themes may be particularly salient for T2D self-management in older African American men, and that this population may be receptive to a peer-led T2D self-management intervention.
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Affiliation(s)
- Jaclynn Hawkins
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Jamie Mitchell
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Gretchen Piatt
- School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Deborah Ellis
- School of Medicine, Wayne State University, Detroit, MI 48202, USA.
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Assari S, Lee DB, Nicklett EJ, Moghani Lankarani M, Piette JD, Aikens JE. Racial Discrimination in Health Care Is Associated with Worse Glycemic Control among Black Men but Not Black Women with Type 2 Diabetes. Front Public Health 2017; 5:235. [PMID: 28955703 PMCID: PMC5600936 DOI: 10.3389/fpubh.2017.00235] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A growing body of research suggests that racial discrimination may affect the health of Black men and Black women differently. AIMS This study examined Black patients with diabetes mellitus (DM) in order to test gender differences in (1) levels of perceived racial discrimination in health care and (2) how perceived discrimination relates to glycemic control. METHODS A total of 163 Black patients with type 2 DM (78 women and 85 men) provided data on demographics (age and gender), socioeconomic status, perceived racial discrimination in health care, self-rated health, and hemoglobin A1c (HbA1c). Data were analyzed using linear regression. RESULTS Black men reported more racial discrimination in health care than Black women. Although racial discrimination in health care was not significantly associated with HbA1c in the pooled sample (b = 0.20, 95% CI = -0.41 -0.80), gender-stratified analysis indicated an association between perceived discrimination and higher HbA1c levels for Black men (b = 0.86, 95% confidence intervals (CI) = 0.01-1.73) but not Black women (b = -0.31, 95% CI = -1.17 to -0.54). CONCLUSION Perceived racial discrimination in diabetes care may be more salient for glycemic control of Black men than Black women. Scholars and clinicians should take gender into account when considering the impacts of race-related discrimination experiences on health outcomes. Policies should reduce racial discrimination in the health care.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Daniel B. Lee
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Emily Joy Nicklett
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | | | - John D. Piette
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, United States
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States
| | - James E. Aikens
- Department of Family Medicine, Michigan Medicine, Ann Arbor, MI, United States
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