Health Beliefs of Marshallese Regarding Type 2 Diabetes

Abstract

Objectives The Marshallese population suffers from disproportionate rates of type 2 diabetes. This study identifies the underlying beliefs and perceptions that affect diabetes self-management behavior among the US Marshallese population living in Arkansas. Methods The study uses qualitative focus groups with a semi-structured interview guide developed using a community-based participatory research (CBPR) approach and the Health Belief Model. Data was collected from a total of N = 41 participants and bilingual community co-investigators provided translation as needed. Results The results show high-perceived threat, with most participants describing diabetes as inevitable and a death sentence. Participants are generally unaware of the benefits of diabetes self-management behaviors, and the Marshallese population faces significant policy, environmental, and systems barriers to diabetes self-management. The primary cue to action is a diagnosis of diabetes, and there are varying levels of self-efficacy. Conclusions The research grounded in the Health Belief Model provides important contributions that can help advance diabetes self-management efforts within Pacific Islander communities.

Engagement practices that join scientific methods with community wisdom: designing a patient‐centered, randomized control trial with a Pacific Islander community

“…The Marshallese stakeholders also explained that any changes to eating habits and behavior must be focused on the family unit in order to be effective, and stakeholders reinforced that incorporating collectivist and family-centered concepts into the DSME curriculum and delivery method was imperative. Stakeholders recommended that DSME be implemented within an extended family model so additional family members could benefit and the patient with diabetes would be supported by their family members (Hallgren et al, 2015; McElfish et al., 2016). Stakeholders continue to work side by side with researchers to culturally adapt DSME for implementation in a family model (McElfish, Bridges, et al, 2015).…”

“…Although patient stakeholders have only wanted limited involvement in the quantitative analysis, they have been more intensively involved in the qualitative data analysis (Hallgren et al, 2015; McElfish et al, 2016). Community co-investigators have shown significant interest and ownership in how the data is interpreted and disseminated.…”

Lessons learned through a partnership with Marshallese faith-based organizations to screen for hypertension and diabetes

“…Arkansas has the largest population of Marshallese in the continental US with a population of 12,000 persons. (3,(6)(7)(8)(9)(10) This growth is primarily focused in Springdale, Arkansas and has been perpetuated by employment in the poultry industry.…”

“…UAMS used a community-based participatory approach to work with the Marshallese community in Arkansas to identify and address community health concerns. (6,24,(27)(28)(29) Marshallese community members identified faith-based organizations (FBOs) as important to their culture and recommended that we work closely with FBOs. Stakeholders stated that virtually all Marshallese attend at least one FBO on a regular basis.…”

“…Other projects are described in prior articles. (6,9,24,(27)(28)(29)(30)(31)(32) In this article, we present the lessons learned from the health screenings.…”