The Starr County Border Health Initiative: Focus Groups on Diabetes Prevention in Mexican Americans

Abstract

Purpose The purpose of the study was to conduct focus groups with Mexican Americans in an impoverished rural community on the Texas-Mexico border to identify current barriers to adopting healthier lifestyles and to obtain recommendations for diabetes prevention. Methods Three separate 2-hour focus groups were led by an experienced bilingual Mexican American moderator. Interviews included questions about cultural factors and barriers that influence lifestyle behaviors, aspects of previous diabetes self-management interventions that were helpful for motivating behavioral change, and recommendations for diabetes prevention. Results Twenty-seven participants attended a focus group session; each session involved 7 to 12 informants. Individuals were diagnosed with prediabetes or type 2 diabetes mellitus; most were female, foreign born, and Spanish speaking. Interviews documented the cultural importance of food. Informants raised priority issues for diabetes prevention, including the need to learn how to prepare healthier foods and track caloric intake. Major barriers to healthier lifestyles included high costs of healthy foods, fatigue from busy schedules and working multiple jobs, a cultural view that exercise is a waste of valuable time, and fear of deportation. Conclusions Cultural influences and barriers to implementing healthy lifestyles should be assessed regularly and strategies implemented to overcome them. Such factors may change as environmental, sociocultural, and political environments change.

Burden and management of type 2 diabetes in rural United States

“…Adults across rural populations vary by age, race/ethnic composition, desire to incorporate technology for T2DM self‐management, and preference for individual versus group interventions. The success of interventions will also rely on their cultural competence, as shown for T2DM self‐management programs 73–78 …”

A Qualitative Study on the Perspectives of Latinas Enrolled in a Diabetes Prevention Program: Is the Cost of Prevention Too High?

“…Furthermore, because the health of family members is a high priority and motivator among Latinas, assessing key family relationships and engaging relatives should be explored at time of diagnosis. 7 …”

“…Furthermore, because the health of family members is a high priority and motivator among Latinas, assessing key family relationships and engaging relatives should be explored at time of diagnosis. 7 While knowing the benefits of preventive behaviors may influence willingness to adopt a behavior in some, it is not sufficient. 30,31 In one study, increased knowledge positively affected the behavior of Whites, but not that of Latinos.…”

“…Several studies have partially attributed unhealthy behaviors and the resulting health disparities among low-income Latinos to lack of access to healthy food, transportation, and childcare, 7 , 8 while recent studies indicate “food deserts” (areas with reduced access to affordable healthy food, if any) have little impact on eating behaviors of low-income communities. 9 Still other studies have credited successful adoption of preventive behaviors to readiness to change (RTC) behaviors.…”

Barriers to Access to Care in Hispanics With Type 2 Diabetes: A Systematic Review

“…A lack of time to access health care was an interesting finding. Similar research supports that working Hispanics believe a lack of time is a "significant barrier" (Testerman & Chase, 2018, p. 56) to seek diabetes care due to long commutes by public transportation (Chaufan et al, 2012) working multiple jobs (Brown et al, 2018;Perry et al, 2017), and family reasons related to time (Hu et al, 2016). Hispanics often make work a priority with their time over personal diabetic care needs.…”