Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Rebecca Benfield

Second Committee Member

Andrew Reyes

Third Committee Member

Reimund Serafica

Fourth Committee Member

Jennifer Pharr

Number of Pages



The purpose of this study was to explore the perception of social support among Mexican immigrant women with gestational diabetes mellitus (GDM) within the context of their culture and discern the process through which social support can influence their adherence to the GDM management protocols. The incidence of GDM is highest in low-income, ethnic minority communities such as the Mexican immigrant community. Adhering to the GDM management protocols may prove challenging for some women, especially if social support is lacking. If uncontrolled, GDM can result in adverse maternal-fetal outcomes. Among Mexican immigrant women, the incidence of poor glycemic control and adverse maternal-fetal outcomes related to GDM is high. The current GDM management protocols do not consider the contextual forces that could render GDM management goals unattainable for Mexican immigrant women. Recently immigrated Mexican women are predisposed to a lack of social support. This lack of social support may negatively impact their adherence to the stringent GDM management protocols. A constructivist grounded theory study design was used. In-depth individual interviews were conducted with 22 recently immigrated Mexican women with GDM. The core concept of Achieving Equipoise emerged from the grounded theory analysis, which elucidates the social support processes of Mexican immigrant women with GDM and the influence of social support on their adherence to the GDM management protocols. Three main processes of Achieving Equipoise (i.e., seeking family support, modulating support, and navigating cultural norms and values) also emerged from the grounded theory analysis, which demonstrated that the women could not achieve equipoise in social support without going through these three iterative, non-linear processes. The findings of this study provide a theoretical foundation to assessment processes and interventions that guide the development of disease management strategies for Mexican immigrant women with GDM and facilitate the implementation of and adherence to disease management. Importantly, this study lays a foundation for future research on the nuances and complexities of the process of social support among collectivistic cultures.


Adherence; Collectivistic culture; Culture and adherence; Gestational Diabetes Mellitus; Mexican Immigrant Women; Social support



File Format


File Size

1759 KB

Degree Grantor

University of Nevada, Las Vegas




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