Acculturation and diabetes self-management practices among Hispanics in U.S.-Mexico border communities

The purpose of this study is to explore the relationship between acculturation and diabetes self-management practices (healthy dietary intake and habits, participation in physical activity, self-monitoring of blood glucose, and foot self-inspection). The study utilizes data from participants in Alliance for a Healthy Border, a chronic disease prevention program targeting the high incidence of diabetes and heart disease in U.S.-Mexico border communities.

Surveys were administered to a sample of 982 Hispanic participants with diabetes. The Short Acculturation Scale for Hispanics, focusing on language use, was utilized to evaluate acculturation. To assess dietary habits, four measures were calculated (fruit and vegetable consumption, three dietary habits subscales reflecting fat/cholesterol intake, salt/sodium intake, and general habits). To measure physical activity, participants were classified as active or inactive. Participants also reported their daily blood glucose self-monitoring and foot self-inspection routines. After controlling for socio-demographic and health variables, regression results revealed that less acculturated individuals exhibited healthier habits in terms of fruit and vegetable consumption (p<.05) and sodium intake (p<.01) relative to those with low to moderate levels of acculturation. However, the former group was less likely to self-monitor blood glucose levels (OR: 0.44; 95% CI: 0.27, 0.74). No significant relationship was detected between acculturation and dietary habits reflecting fat/cholesterol intake, physical activity, and daily foot self-inspection. Having taken a diabetes self-management class positively influenced all aspects of self-management practices.

Results highlight the two-sided role of acculturation in the self-management of diabetes and the importance of culturally-appropriate prevention and education programs for individuals with diabetes.