Promoting Community Resources for Type 2 Diabetes Self- Management: Findings from an African-American Case Study in Rural Arkansas

BACKGROUND: Though underreported, type 2 diabetes (T2D) is ranked the number four health priority in Arkansas (AR). Within AR, 14.7% of African Americans (AAs) 20 years of age or older have a T2D diagnosis compared to 9.8% of non-Hispanic Whites and 10.4% of Hispanics. This case study presents a community-based qualitative research conducted among African Americans in rural AR. The study sought to identify possible ways of strengthening culture-specific, health-promoting factors and addressing barriers to T2D health care in an underserved AA community. METHODS: Qualitative data was collected from open-ended interviews with individuals who had a T2D diagnosis. These interviews focused on the roles of culture, self-care practices, social network and social support, spirituality, racism and discrimination, family health history, and health insurance status in T2D self-management. This study applied a grounded theory approach to its systematic, qualitative analysis of interview transcripts and development of themes and patterns. FINDINGS: A comprehensive model, one that covers interactive social, cultural, environmental, and economic factors and their interactions, is imperative to understanding the participants' health care seeking behaviors. CONCLUSIONS: This case study presents research findings and discusses: 1) perceptions of diabetes and its prevention and care within this rural AR community; 2) the influences of socio-historical contexts upon community norms, spirituality, and health care seeking behaviors; and 3) the promotion of better T2D prevention, management and treatment through better understanding of this community's cultural strengths in its own collectivist sociocultural contexts.