diabetes; self-care management; rural; health disparities




Purpose: The purpose of this study was to identify facilitators and barriers to self-management of type 2 diabetes mellitus (T2DM) among African American adults living in rural communities. Research indicates that African Americans experience higher rates of T2DM and diabetes-related complications than other ethnic groups. In Kentucky, diabetes is now the fourth leading cause of death by disease among African Americans.

Methods: Twenty-two African American adults with T2DM were recruited from three churches in rural communities in Kentucky. Three focus groups were conducted to identify factors that made managing diabetes easier (facilitators) and factors that made managing diabetes more difficult (barriers). Demographic data were collected using a 15-item survey, focused on the participants’ personal, social and medical history related to T2DM.

Results: Support was the primary facilitator of self-management. Support from family, friends, and health care providers which encouraged them to seek information and adhere to diet and medications helped with management. Identified barriers to self-management included fear, perceived beliefs about their health status, and difficulty making lifestyle changes.

Discussion and Conclusion: T2DM is a serious health problem in the African American population. Interventions should be designed that focus on providing support for African Americans with T2DM. Additionally, interventions should focus on overcoming the identified barriers to assist them in taking control and feeling empowered to effectively self-manage T2DM.

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