Barriers and Facilitators to Perceived Diabetes Self-Management in Arab Americans with Diabetes

Arab Americans (AAs) are at increased risk of type 2 diabetes, with a reported prevalence of 18%. Despite the increasing prevalence, there remains a lack of data on diabetes self-management (DSM) practices and barriers to care in this population. The purpose of this study was to assess patient perceptions of DSM behaviors in order to facilitate individualized care plans by providers. A 39-item survey was created based on focus group discussions designed to understand the impact of AA culture on DSM. The survey assessed diet, adherence to medications, exercise, healthy lifestyle, and family support. Two hundred AAs with diabetes completed the survey via face-to-face interviews. Most participants were above fifty years of age (79%), females (59%), and originated from Lebanon (73%). Individuals receiving Arabic instructions perceived that good portion control (p=0.07), food selection (p=0.01), and maintaining a healthy lifestyle (p=0.003) were important DSM behaviors, compared to those who did not receive Arabic instructions. Unemployed individuals were less likely to perceive regular exercise (p=0.05), portion control (p=0.06), and maintaining a healthy lifestyle (p=0.08) as important DSM behaviors compared to employed individuals. Individuals who had family support and encouragement were more likely to perceive that discussions with their clinicians were important (p=0.003) compared to those without family support. Individuals with family who understood their food choices were more likely to perceive regular exercise (p=0.03) as important compared to those with families who did not understand food choices.

In conclusion, this survey may serve as a valuable tool for providers to assess perceptions surrounding DSM behaviors in order to provide patient-centered care that will help to improve patient outcomes. This study supports the importance of integrating cultural influences into DSM education and support when providing care to a population with a strong cultural identity.