An Exploration of the Barriers to Diabetes Management Among West African Immigrants in the United States

Purpose: To explore the barriers to diabetes management among West African immigrants living in Rhode Island. Study Design and Methods: Semi-structured interviews with adults (N=5); men (n=2), women (n=3), Nigerian (n=3), Liberian (n=1), and Ghanaian (n=1) ages ≥18 with Type 1 or Type 2 diabetes, living in Rhode Island. Demographic information of the participants was obtained using a questionnaire. Interviews were conducted by the researcher and lasted approximately 50 minutes, and were scheduled to accommodate participants’ needs. Interviews were audio-taped and statements of the study participants were recorded. Subjects were redirected to clarify responses when necessary. Content analysis and coding, as proposed by Miles and Huberman (1994), were completed. Eight pertinent themes were identified. Results: All participants had Type 2 diabetes and reported various barriers to diabetes management: (1) financial difficulties, (2) poor dietary habits, (3) non adherence to daily maintenance, (4) cultural attachment to traditional management of diabetes, (5) cultural beliefs, (6) negative relationship with primary care doctor, (7) non-adherence to medication regimen, and (8) their practitioner’s inadequate knowledge of cultural care. Clinical Implications: These findings revealed that barriers exist for suitable diabetes management by some West African immigrants living in RI. Reducing the risk for complications, morbidity, and mortality can only occur with reduction of identified barriers