A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study.
Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader soc...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0261030 |
| _version_ | 1798035933766877184 |
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| author | Kathleen Abu-Saad Nihaya Daoud Giora Kaplan Arnona Ziv Arnon D Cohen Daphna Pollack Liraz Olmer Ofra Kalter-Leibovici Diabetes in the Arab Population in Israel (DAPI) Study Group |
| author_facet | Kathleen Abu-Saad Nihaya Daoud Giora Kaplan Arnona Ziv Arnon D Cohen Daphna Pollack Liraz Olmer Ofra Kalter-Leibovici Diabetes in the Arab Population in Israel (DAPI) Study Group |
| author_sort | Kathleen Abu-Saad |
| collection | DOAJ |
| description | Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants' knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men's, 5 women's) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants' communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09-4.63), people with disabilities (OR: 2.43; 95% CI: 1.28-4.64), and unemployed people (OR: 2.64; 95% CI: 1.28-5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25-4.09), unemployment (OR: 4.07; 95% CI: 1.64-10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03-1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants' knowledge, experience, and strengths has the potential to improve individuals' diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths. |
| first_indexed | 2024-04-11T21:04:08Z |
| format | Article |
| id | doaj.art-c167c8c71a17486389fb4d37a718e447 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T21:04:08Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c167c8c71a17486389fb4d37a718e4472022-12-22T04:03:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011612e026103010.1371/journal.pone.0261030A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study.Kathleen Abu-SaadNihaya DaoudGiora KaplanArnona ZivArnon D CohenDaphna PollackLiraz OlmerOfra Kalter-LeiboviciDiabetes in the Arab Population in Israel (DAPI) Study GroupIndigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants' knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men's, 5 women's) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants' communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09-4.63), people with disabilities (OR: 2.43; 95% CI: 1.28-4.64), and unemployed people (OR: 2.64; 95% CI: 1.28-5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25-4.09), unemployment (OR: 4.07; 95% CI: 1.64-10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03-1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants' knowledge, experience, and strengths has the potential to improve individuals' diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.https://doi.org/10.1371/journal.pone.0261030 |
| spellingShingle | Kathleen Abu-Saad Nihaya Daoud Giora Kaplan Arnona Ziv Arnon D Cohen Daphna Pollack Liraz Olmer Ofra Kalter-Leibovici Diabetes in the Arab Population in Israel (DAPI) Study Group A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. PLoS ONE |
| title | A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. |
| title_full | A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. |
| title_fullStr | A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. |
| title_full_unstemmed | A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. |
| title_short | A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. |
| title_sort | strengths based approach to exploring diabetes management in an indigenous minority population a mixed methods study |
| url | https://doi.org/10.1371/journal.pone.0261030 |
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