Self management factors that influence health outcome among individuals with type 2 diabetes in the U.S. Virgin Islands

Racial and ethnic health disparities in diabetes diagnosis, management, and outcomes have been demonstrated in the United States. Diabetes is also a major public health problem in the U.S. Virgin Islands (U.S.V.I.), and is the fifth leading cause of death in the territory. Prior research has demonstrated the important role of patient self-management in improving outcomes in patients diagnosed with diabetes. Although previous studies have focused on how race and ethnicity influence self-management, less is known about how this translates to a U.S. territory with a culturally distinct population that is predominantly of African descent.

Therefore, this research study aimed to answer the following questions: 1) How do patient factors, i.e. level of education, diabetes baseline knowledge, and income, influence self-management in a U.S.V.I. patient population ; 2) How do social contextual factors influence self-management? and 3) What experiences have encouraged or discouraged study participants to assume greater control of their diabetes management?

A mixed methods research design utilizing descriptive statistics, correlations and in-depth, structured qualitative interviews was employed. Data were collected from 53 Virgin Islanders diagnosed with type 2 diabetes within the prior 10 years. Qualitative transcripts were independently analyzed and Atlas ti 5.2 software was used to facilitate qualitative data organization and retrieval. SPSS 14 for Windows was used to analyze the unadjusted and adjusted relationships between patient characteristics, scores on multiple instruments, and HbA1C values.

Several recurrent themes are emerging from preliminary qualitative analysis such as the importance of fear in motivating behaviors and loose interpretations of advised medication regimens. Preliminary statistical analysis demonstrates low knowledge level scores across the sample. HbA1C values range from 5.0% to 13.0% with a mean of 7.36%. Further analysis will examine the association between HbA1C values and diabetes knowledge, social support, and several other measures.

There is very little research conducted on self management of chronic conditions in this population. Therefore, our findings will have several implications. This study willprovide the necessary insight to help clients and health care providers identify strategies