Title | Divergent models of diabetes among American Indian elders |
Publication Type | Journal Article |
Year of Publication | 2010 |
Authors | Henderson, LC |
Journal | J Cross Cult GerontolJ Cross Cult Gerontol |
Volume | 25 |
Pagination | 303-16 |
Date Published | Dec |
ISBN Number | 1573-0719 (Electronic)<br/>0169-3816 (Linking) |
Accession Number | 20931270 |
Keywords | Aged, 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 |
Abstract | The 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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