Diabetes Self-Care Behaviors Among Marshallese Adults Living in the United States

Abstract

Marshallese experience high rates of type 2 diabetes. Proper management of diabetes requires multiple self-care behaviors, yet little is known about Marshallese's diabetes-related self-care behaviors. Survey data from 111 Marshallese adults with diabetes were used to examine relationships between self-care behaviors and socio-demographic characteristics. The most common self-care behavior was attending annual doctor visits, while the least common was maintaining a normal weight. Age group, education level, and having a regular doctor were significantly associated with engaging in self-care behaviors. Having a regular doctor had the most effect on performing self-care behaviors (p = 0.006); although, only 38.7% reported having a regular doctor. To minimize diabetes-related complications, efforts to improve self-care behaviors among the Marshallese should be developed. Alternatives to traditional healthcare providers, such as community health workers, may be a viable strategy with this population given only one-third reported having a regular doctor.

Diabetes Disparities and Promising Interventions to Address Diabetes in Native Hawaiian and Pacific Islander Populations

“…While NHPI community members have a high prevalence of diabetes, research suggests they face many challenges in accessing health care and education for diabetes prevention and management The available literature documents low rates of adherence to self-management behaviors [27], limited access and participation in formal diabetes self-management education (DSME) [25,[27][28][29][30][31], and high rates of medication nonadherence [32][33][34]. Furthermore, NHPIs experience higher risks of end-stage renal disease and myocardial infarction as a result of uncontrolled diabetes [35,36].…”

Factores sociodemográficos, clínicos y psicosociales relacionados con el autocuidado de la diabetes

“…Assim, maior adesão ao autocuidado com diabetes entre pessoas idosas não é incomum. Estudo realizado com imigrantes da República das Ilhas Marshall, no Pacífico, nas quais o diabetes tem alta prevalência, revelou que a probabilidade de realizar o autogerenciamento em diabetes foi quase três vezes maior entre os mais idosos e menor entre aqueles com escolaridade menor que o ensino médio 34 .…”

Family model diabetes self-management education and support in faith-based organizations in the republic of the Marshall Islands study protocol

“…This is particularly important for the successful implementation of a DSMES intervention in the RMI. Poor self-management, while frequently attributed to the patient, is often the product of her/his social and environmental context [ 24 , 25 , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] ]. Marshallese collectivist culture situates family at the center of decision-making [ 61 ].…”

“…Marshallese collectivist culture situates family at the center of decision-making [ 61 ]. Through their communications, habits, and attitudes, family members can greatly influence primary participants' decisions to follow recommended treatment and self-care regimens [ 13 , 25 , [53] , [54] , [55] , 57 , 58 , [60] , [61] , [62] , [63] , [64] ]. In the F-DSMES intervention, primary participants and family members learn, increase motivation, develop strategies, and set goals together.…”