Influences on day-to-day self-management of type 2 diabetes among African-American women - Spirituality, the multi-caregiver role, and other social context factors

OBJECTIVE - Many African-American women are affected by diabetes and its co mplications, and culturally appropriate lifestyle interventions that lead t o improvements in glycemic control are urgently needed. The aim of this qua litative study was to identify culturally relevant psychosocial issues and social context variables influencing lifestyle behaviors-specifically diet and physical activity-of southern African-American women with diabetes. RESEARCH DESIGN AND METHODS - We conducted 10 focus group interviews with 7 0 southern African-American women with type 2 diabetes. Group interviews we re audio-taped and transcripts were coded using qualitative data analysis s oftware. A panel of reviewers analyzed the coded responses for emerging the mes and trends. RESULTS - The dominant and most consistent themes that emerged from these f ocus groups were 1) spirituality as an important factor in general health, disease adjustment, and coping; 2) general life stress and multi-caregiving responsibilities interfering with daily disease management; and 3) the imp act of diabetes manifested in feelings of dietary deprivation, physical and emotional "tiredness," "worry," and fear of diabetes complications. CONCLUSIONS - Our findings suggest that influences on diabetes self-managem ent behaviors of African-American women may be best understood from a socio cultural and family context. Interventions to improve self-management for t his population should recognize the influences of spirituality, general lif e stress, multi-caregiving responsibilities, and the psychological impact o f diabetes. These findings suggest that family-centered and church-based ap proaches to diabetes care interventions are appropriate.