Family support important in intervention programs for Black adults with type 2 diabetes
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Family support is a crucial part of self-management for Black adults with type 2 diabetes and should be a focus in interventions, according to a qualitative study published in The Science of Diabetes Self-Management and Care.
“Family support buffers diabetes distress and influences diabetes self-management, food choices and physical activity,” Jie Hu, PhD, RN, FAAN, associate professor at The Ohio State University College of Nursing, told Healio. “The supportive family behaviors, such as positivity, family communications — particularly when the participant is depressed — and family strategies for healthy eating and physical activity with participants, may facilitate self-management behaviors and enhance a participant’s self-efficacy to manage the disease.”
Hu and colleagues interviewed 37 Black adults with type 2 diabetes from the Midwest (mean age, 59 years; 62% women). Participants were recruited from an outpatient endocrinology clinic at a university medical center where about 90% were Black adults and at a pharmacy predominantly serving a large Black community. Fourteen participants took part in focus groups consisting of two to four participants each, whereas the remaining 23 participants engaged in a one-on-one interview. Focus groups and interventions were conducted by an interview guide who asked semi-structured questions centered on family support in diabetes self-management, family behaviors that encumbered a participant’s physical activity or healthy eating, family members’ roles in making self-management decisions, and suggestions for intervention programs for Black adults with type 2 diabetes.
Most participants shared positive ways family members were helpful to their diabetes self-management. Many participants said they received emotional support from family as well as instrumental support, such as help with grocery shopping or obtaining medication. Some of the interviewees also praised family members for providing information or exercising together. The most helpful family behaviors listed included positivity and family communication, healthy eating and meal planning, and receiving informational support or advice.
A few participants listed negative family behaviors that detracted from their diabetes self-management, both intentional and unintentional.
“Some participants reported family behaviors that were a hindrance to their diabetes self-management,” Hu said. “They felt that family members lacked understanding of the disease and knowledge in healthy eating and engaging in physical activity.”
Other negative behaviors included critical communication about participants’ diabetes self-management or neutral responses toward self-management. Some participants said they did not want or refused family support.
Most participants said they felt that diabetes intervention programs should include elements for family members. Some asked for educational content that included exercise and meal planning classes with family members. Many participants said they felt that a support group involving family members would help the family better understand the experience of living with diabetes. Some participants also said they felt that intervention programs needed to be affordable and flexible and include some video formats in addition to in-person sessions.
“Health care providers should assess family roles and family support to facilitate diabetes self-management for African Americans,” Hu said. “The importance of family roles and family support in diabetes self-management need to be integrated into educational programs for African Americans.”
For more information:
Jie Hu, PhD, RN, FAAN, can be reached at hu.1348@osu.edu.
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