Older African American Men’s Perspectives on Factors That Influence Type 2 Diabetes Self-Management and Peer-Led Interventions

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.

Perceptions of psychosocial and interpersonal factors affecting self-management behaviors among African Americans with diabetes

“…Pharmacists helped provide guidance with medications and in making changes to prescriptions to improve medication adherence. Contrary to previous research, 27 , 28 most participants described having good relationships with healthcare professionals and having efficient communication through portals, secure messages, and in-person visits. However, some mentioned poor communication with previous providers.…”

“…, 20 , 21. access to transportation, 13 , 18 gender, 22 , 23 , 24 religion or spirituality, 25 , 26 and quality of patient-provider communication, 13 , 24 , 27 , 28 on health behaviors such as medication adherence, adherence to diet or exercise recommendations, and checking blood glucose. Although these studies provide some insights into perceptions of diabetes self-management among African Americans, a theoretical conceptualization of behavior change because of specific psychosocial and interpersonal factors has not been adequately studied in this population.…”

Telemedicine for the Self-Management of Type 2 Diabetes: A Literature Review

“…Other reasons are fear of needles and dependence on insulin for life. According to Hawkins, Mitchell, Piatt, and Ellis's (2018) research, fear is a contributing factor to self-management in elderly men with type 2 diabetes.…”

Michigan men’s diabetes project II: protocol for peer-led diabetes self-management education and long-term support in Black men

“…checking blood glucose levels daily), low-income Black men face a multitude of additional challenges to maintaining a healthy diet, such as limited availability of healthy foods [2][3][4][5]. Black men also often experience barriers that interfere with diabetes management behaviors such as a lack of social support, negative patient-provider relationships, cost and long work hours [6,7]. Though existing studies find that Black men are at elevated risk for suboptimal diabetes management, they are also less likely to participate in research studies that test diabetes self-management interventions [8].…”