Determinants Of Successful Diabetes Self-Management Behaviors Among Women Of Arab Descent With Type 2 Diabetes

ABSTRACT Type 2 Diabetes (T2D) continues to be an escalating public health problem that contributes to increased morbidity and mortality worldwide (American Diabetes Association, 2017b). According to the National Diabetes Statistics Report (2017), approximately 30.3 million (9.4%) Americans have T2D. It accounted for 252,806 deaths in 2015 in the United States. Although the complications of T2D is a major threat to the health of women of Arab descent, there is lack of information about the health practices and diabetes self-management behaviors of this population. The purpose of this dissertation is to examine the impact of diabetes knowledge, social/family support, acculturation, and psychological adjustment to diabetes on DSM behaviors and glycemic control among women of Arab descent utilizing the Roy Adaptation Model. The specific aims of this study are the following: Specific Aim 1: To describe the prevalence of DSM behaviors and diabetes control (HbA1C) among women of Arabic descent with T2D. Specific Aim 2: To investigate the relationship among diabetes knowledge, social/family support, acculturation, and psychological adjustment to diabetes on DSM behaviors and glycemic control among women of Arab descent. Method: a non- experimental correlational descriptive design was implemented in this study. A convenience sample size of 118 women of Arab descent were recruited from two clinical sites. The women participate in the study if they were (1) of Arabic descent (2) diagnosed with T2D for at least a year, (3) 18 years and older, (4) non-pregnant, and (5) able to speak and read either English or Arabic. Results: The majority of the women were between the ages 50- 59 years (33.1%), were unemployed (45.8%), were receiving a monthly income between $500 and $1499 (49.1%), were married (68.6%), not smoker (70.7%), had diabetes education (51.7%), had diabetes for less than 5 years (42.2%), treated with oral hypoglycemic medication only (87.3%), had a good level of HbA1C (60%). Specific Aim 1: Among this sample, women reported moderate level of following healthy diet (M=15, range= 0- 28), moderate level of exercise (M= 6.4, range= 0- 14), moderate level of glucose testing (M= 7.5, range= 0- 14), low level of foot care (M=5.3, range= 0- 14), and high level of medication adherence (M= 12.7, range= 0- 14). Furthermore, the mean HbA1C of the participants was 6.9% (SD=1.2), ranging between 5% to 11.4%. Specific Aim 2: There was a positive significant association between the DSM behaviors and the diabetes knowledge. There was a negative and significant association between the psychological adjustment to diabetes and DSM behaviors. A step-type regression model was used to estimate the optimal model. The optimal model included BMI, Diabetes knowledge, psychological adaptation to diabetes, and the level of HbA1C explained 28% of the variance in DSM behaviors. Other variables, namely social/family support and acculturation were not significant. With other variables held constant (see table 5), DSM behaviors were negatively related to BMI decreasing by 0.77 for every extra unit increase in BMI. Similarly, DSM behaviors were negatively related to psychological adjustment to diabetes decreasing by 0.14 for every extra unit increase in psychological adjustment to diabetes. On the other hand, DSM behaviors were positively related to diabetes knowledge and HbA1C. For instance, DSM behaviors increased by 1.31 for every extra unit increase in diabetes knowledge