TY - JOUR
T1 - Understanding Type 2 Diabetes Self-Management in Racial/Ethnic Minorities
T2 - Application of the Extended Parallel Processing Model and Sensemaking Theory in a Qualitative Study
AU - Bass, Sarah Bauerle
AU - Swavely, Deborah
AU - Allen, Shaneisha
AU - Kelly, Patrick J.
AU - Hoadley, Ariel
AU - Zisman-Ilani, Yaara
AU - Durrani, Maryyam
AU - Brajuha, Jesse
AU - Iwamaye, Amy
AU - Rubin, Daniel J.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2022/10
Y1 - 2022/10
N2 - Purpose: The purpose of the study was to understand the role of perceived disease threat and self-efficacy in type 2 diabetes (T2DM) patients’ self-management by using the extended parallel processing model (EPPM) and sensemaking theory. Methods: Semistructured interviews (n = 25) were conducted with T2DM patients from an urban safety-net hospital. Participants were 50% male/female median age was 55 years and 76% were Black. Participants were categorized by EPPM group based on validated questionnaires (high/low disease threat [HT/LT]; high/low self-efficacy [HE/LE]). Nine were HT/HE, 7 HT/LE, 6 LT/HE, and 3 LT/LE. Interviews were transcribed and analyzed using inductive and deductive coding. Sensemaking theory was applied to contextualize and analyze data. Results: Those with HT indicated threat fluctuated throughout diagnosis but that certain triggers (eg, diabetic complications) drove changes in disease view. Those in the HT/HE group more frequently expressed disease acceptance, whereas the HT/LE group more often expressed anger or denial. HT/HE participants expressed having adequate social support and higher trust in health care providers. HT/LE participants reported limited problem-solving skills. In those with LT, the HE group took more ownership of self-management behaviors. The LT/LE group had heightened positive and negative emotional responses that appeared to limit their ability to perform self-care. They also less frequently described problem-solving skills, instead expressing reliance on medical guidance from their providers. Conclusions: EPPM and sensemaking theory are effective frameworks for understanding how perceived health threat and self-efficacy may impede T2DM self-care. A greater focus on these constructs is needed to improve care among low-income minority patients, especially those with low threat and self-efficacy.
AB - Purpose: The purpose of the study was to understand the role of perceived disease threat and self-efficacy in type 2 diabetes (T2DM) patients’ self-management by using the extended parallel processing model (EPPM) and sensemaking theory. Methods: Semistructured interviews (n = 25) were conducted with T2DM patients from an urban safety-net hospital. Participants were 50% male/female median age was 55 years and 76% were Black. Participants were categorized by EPPM group based on validated questionnaires (high/low disease threat [HT/LT]; high/low self-efficacy [HE/LE]). Nine were HT/HE, 7 HT/LE, 6 LT/HE, and 3 LT/LE. Interviews were transcribed and analyzed using inductive and deductive coding. Sensemaking theory was applied to contextualize and analyze data. Results: Those with HT indicated threat fluctuated throughout diagnosis but that certain triggers (eg, diabetic complications) drove changes in disease view. Those in the HT/HE group more frequently expressed disease acceptance, whereas the HT/LE group more often expressed anger or denial. HT/HE participants expressed having adequate social support and higher trust in health care providers. HT/LE participants reported limited problem-solving skills. In those with LT, the HE group took more ownership of self-management behaviors. The LT/LE group had heightened positive and negative emotional responses that appeared to limit their ability to perform self-care. They also less frequently described problem-solving skills, instead expressing reliance on medical guidance from their providers. Conclusions: EPPM and sensemaking theory are effective frameworks for understanding how perceived health threat and self-efficacy may impede T2DM self-care. A greater focus on these constructs is needed to improve care among low-income minority patients, especially those with low threat and self-efficacy.
UR - http://www.scopus.com/inward/record.url?scp=85135840082&partnerID=8YFLogxK
U2 - 10.1177/26350106221116904
DO - 10.1177/26350106221116904
M3 - Article
C2 - 35950550
AN - SCOPUS:85135840082
SN - 2635-0106
VL - 48
SP - 372
EP - 386
JO - Science of Diabetes Self-Management and Care
JF - Science of Diabetes Self-Management and Care
IS - 5
ER -