Online Program

Black women and eating behavior change trajectories after diagnosis with type II diabetes: What facilitates and what constrains change?

Monday, November 4, 2013

Johanna D.C. Eldridge, ABD, BS, Division of Nutritional Sciences, Cornell University, Ithaca, NY
Carol M. Devine, PhD, RD, Division of Nutritional Sciences, Cornell University, Ithaca, NY
Introduction: Black women are disproportionately at risk for type II diabetes-related complications and fatality. Healthy eating behavior changes (EBCs) are prescribed to treat diabetes and prevent complications, yet are demonstrably difficult to follow. What facilitates EBC, even briefly, among women newly diagnosed with diabetes? What contributes to EBC reversion? Methods: This qualitative study explored how 15 Black women recently diagnosed with diabetes experienced making EBCs upon diagnosis and over time. Each woman was interviewed three times over nine months. Interviews covered past and current eating behaviors, facilitators and constraints to making EBCs. Data were analyzed using the constant comparative method, generating EBC trajectories for each woman from diagnosis through the study. Results: Participants discussed three major EBC areas: meal content, portion control, and timing of eating episodes. Women differed in extent, constancy, and longevity of EBCs with trajectories categorized by those who: (1) “respected diabetes”, overhauled diet and maintained changes; (2) were “on the mend”, made specific EBCs with varying constancy; (3) made extensive EBCs immediately following diagnosis then waned; or (4) made minimal or no EBCs after diagnosis. Key themes influencing EBC included agency over irregular meal times and content, beliefs about fatalism/prevention of complications, having a health professional to comfortably communicate with, stress, and uncertainty with recommended practices. Themes shifted in importance and relevance throughout EBC trajectories. Discussion: EBC trajectories highlight the dynamic and static nature of immediate and upstream factors affecting EBCs for Black women recently diagnosed with diabetes, informing public health interventions to prevent diabetes-related complications.

Learning Areas:

Chronic disease management and prevention
Social and behavioral sciences

Learning Objectives:
Discuss the usefulness of examining prospective eating behavior change trajectories after diabetes diagnosis. Describe and compare factors that facilitate or constrain eating behavior change before and after diabetes diagnosis, noting the dynamic or static nature of factors.

Keyword(s): Diabetes, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a fourth year PhD student conducting research on the experiences of low-income and minority overweight adults in a weight loss intervention and am the principal investigator on my dissertation research project exploring how Black women newly diagnosed with diabetes adjust to life after diagnosis and how their social environment both helps and hinders their adjustment.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.