Abstract
Diabetes self-management education and support (DSMES) programs are essential for navigating the complexity of diabetes management, yet engagement in these programs is poor.1,2 A gap remains in understanding AAs' DSMES engagement due to the exclusion of their perspectives and the tendency to treat them as a monolithic group,3 missing nuanced experiences. This lack of understanding prevents the creation of interventions to improve DSMES engagement among AAs. Therefore, this study aimed to describe the determinants of DSMES engagement among AAs with T2DM. We used an interpretive descriptive qualitative approach to explore how AAs engage with DSMES programs. We conducted semi-structured individual interviews with participants from diverse groups, including Filipinos, Koreans, South Asians, Cambodians, and Vietnamese Americans. Participants were recruited through direct outreach, referrals, and social media. Recruitment continued until data saturation was achieved, which occurred after interviewing 11 participants. All interviews were audio-recorded and transcribed verbatim. The data analysis used a rigorous, iterative approach, beginning with open coding to generate initial codes, developing a codebook, and proceeding to a second coding level and thematic analysis to interpret key patterns. Analysis revealed four major themes:
- Cultural barriers and facilitators, including language discordance, traditional healing practices, and dietary cultural conflicts;
- Healthcare system navigation, highlighting issues with insurance coverage, appointment scheduling, education delivery, and provider communication;
- Family dynamics and social support, emphasizing the dual role of the family as both supporters and barriers to DSMES engagement; and
- Access and awareness gaps, including limited knowledge about DSMES accessibility, social media as a resource, and preference to virtual, time-efficient programs.
Notably, participants expressed a strong preference for culturally tailored DSMES programs that incorporate traditional Asian health beliefs and dietary practices. The study findings highlight the need for culturally responsive DSMES programs tailored to AA, emphasizing family-centered approaches, language support, and cultural beliefs. Improving DSMES engagement requires multi-level interventions addressing systemic and individual barriers, highlighting the complex interplay of cultural, social, and structural factors in diabetes management.
Notes
References:
1. Powers MA, Bardsley J, Cypress M, et al. Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Care. 2015;38(7):1372-1382. doi:10.2337/dc15-0730
2. Baicker K, Chandra A, Skinner JS. Geographic variation in health care and the problem of measuring racial disparities. Perspect Biol Med. 2005;48(1 Suppl):S42-53.
3. Adia AC, Nazareno J, Operario D, Ponce NA. Health conditions, outcomes, and service access among Filipino, Vietnamese, Chinese, Japanese, and Korean Adults in California, 2011-2017. Am J Public Health. 2020;110(4):520-526. doi:10.2105/AJPH.2019.305523
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Equity or Social Determinants of Health, Public and Community Health, Diabetes Self-Management, Diabetes Self-care, Patient Education
Recommended Citation
Boy, Paul R.; Long, Sorina; Sidhu, Manpreet; Roces, Barbara; and Tolentino, Dante Anthony, "Bridging the Gap: Opportunities and Barriers in Diabetes Self-Management Education" (2025). International Nursing Research Congress (INRC). 101.
https://www.sigmarepository.org/inrc/2025/posters_2025/101
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Bridging the Gap: Opportunities and Barriers in Diabetes Self-Management Education
Seattle, Washington, USA
Diabetes self-management education and support (DSMES) programs are essential for navigating the complexity of diabetes management, yet engagement in these programs is poor.1,2 A gap remains in understanding AAs' DSMES engagement due to the exclusion of their perspectives and the tendency to treat them as a monolithic group,3 missing nuanced experiences. This lack of understanding prevents the creation of interventions to improve DSMES engagement among AAs. Therefore, this study aimed to describe the determinants of DSMES engagement among AAs with T2DM. We used an interpretive descriptive qualitative approach to explore how AAs engage with DSMES programs. We conducted semi-structured individual interviews with participants from diverse groups, including Filipinos, Koreans, South Asians, Cambodians, and Vietnamese Americans. Participants were recruited through direct outreach, referrals, and social media. Recruitment continued until data saturation was achieved, which occurred after interviewing 11 participants. All interviews were audio-recorded and transcribed verbatim. The data analysis used a rigorous, iterative approach, beginning with open coding to generate initial codes, developing a codebook, and proceeding to a second coding level and thematic analysis to interpret key patterns. Analysis revealed four major themes:
- Cultural barriers and facilitators, including language discordance, traditional healing practices, and dietary cultural conflicts;
- Healthcare system navigation, highlighting issues with insurance coverage, appointment scheduling, education delivery, and provider communication;
- Family dynamics and social support, emphasizing the dual role of the family as both supporters and barriers to DSMES engagement; and
- Access and awareness gaps, including limited knowledge about DSMES accessibility, social media as a resource, and preference to virtual, time-efficient programs.
Notably, participants expressed a strong preference for culturally tailored DSMES programs that incorporate traditional Asian health beliefs and dietary practices. The study findings highlight the need for culturally responsive DSMES programs tailored to AA, emphasizing family-centered approaches, language support, and cultural beliefs. Improving DSMES engagement requires multi-level interventions addressing systemic and individual barriers, highlighting the complex interplay of cultural, social, and structural factors in diabetes management.
Description
This study examined the factors influencing the engagement of Asian Americans with diabetes self-management education/support (DSMES) programs. We uncovered four key themes: cultural barriers and facilitators, healthcare system navigation challenges, family dynamics and social support, and access and awareness gaps. The findings underscore the importance of culturally tailored DSMES programs that recognize the complex interplay of cultural, social, and structural factors in diabetes management.