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Divergent models of diabetes among American Indian elders

TitleDivergent models of diabetes among American Indian elders
Publication TypeJournal Article
Year of Publication2010
AuthorsHenderson, LC
JournalJ Cross Cult GerontolJ Cross Cult Gerontol
Date PublishedDec
ISBN Number1573-0719 (Electronic)<br/>0169-3816 (Linking)
Accession Number20931270
KeywordsAged, Cultural Characteristics, Culture, Diabetes Mellitus, Type 2/epidemiology/ ethnology/therapy, Female, Health Behavior/ ethnology, Health Knowledge, Attitudes, Practice, Health Status, Healthcare Disparities, Humans, Indians, North American/ psychology, Interviews as Topic, Male, Middle Aged, Models, Psychological, Patient Acceptance of Health Care, Questionnaires, Self Care, United States/epidemiology
AbstractThe purpose of this study was to examine belief systems about diabetes in American Indian elders, and the effects of culture on care-seeking, adherence, and diabetes self-care. Health belief theory predicts that care-seeking and medical adherence are a function of culturally mediated beliefs that result in behaviors that effect health status. In order to elicit cultural meanings of diabetes, in-depth interviews were conducted with an intensity sample of 30 American Indian diabetic elders (55+). Two models of diabetes were identified, divergent in terms of 1) health behaviors, and 2) cultural identification. One model was characterized by delayed care-seeking, and a non-valuing of adherence to diabetes self-care. Non-adherence to medical recommendations was perceived as being socially desirable, because adherence placed the elder outside their peer group. The second model was characterized by early care-seeking and improved adherence to diabetes self-care. These divergent models of diabetes, in which care-seeking, diabetes self-care, and adherence vary as a function of cultural immersion, has implications for health education and disease management and may contribute substantially to health disparities.
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