scholarly journals Perspectives from Underserved African Americans and their Healthcare Providers on the Development of a Diabetes Self-Management Smartphone Application: Exploratory Study (Preprint)

2020 ◽  
Author(s):  
Tai Barber-Gumbs ◽  
Ylva Trolle Lagerros ◽  
Laura M. Sena ◽  
Joel Gittelsohn ◽  
Larry W. Chang ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Low Income ◽  
Diabetes Education ◽  
Healthcare Providers ◽  
Smartphone Application ◽  
Self Management ◽  
The Us ◽  
Management Recommendations ◽  
P Type

BACKGROUND Type 2 diabetes mellitus (T2DM) affects ~10% of the US population, disproportionately affecting African Americans. Smartphone applications (apps) have emerged as promising tools to improve diabetes self-management, yet little is known about the use of this approach in low-income minority communities. OBJECTIVE The goal of the study was to explore which features of an app were prioritized for people with T2DM in a low-income African-American community. METHODS Between February 2016 and May 2018, we conducted formative qualitative research with 78 participants to explore how a smartphone app could be used to improve diabetes self-management. Information was gathered on desired features and app mockups were presented to receive comments and suggestions of improvements from smartphone users with prediabetes/T2DM, their friends and family members, and healthcare providers (in 6 interactive forums, 1 focus group and 15 in-depth interviews). We carried out thematic data analysis using an inductive approach. RESULTS All three types of participants reported that difficulties with access to healthcare was a main problem and suggested that an app could help address this. Participants also indicated that an app could provide information for diabetes education and self-management. Other suggestions included that the app should allow people with T2DM to log and track diabetes care-related behaviors and receive feedback on their progress in a way that would increase a person with T2DM’s engagement in self-management. CONCLUSIONS We identified educational and tracking smartphone features that can guide development of diabetes self-management apps for a low-income African-American population. Considering those features in combination gives rise to opportunities for more advanced support, such as determining self-management recommendations based on data in user's logs. CLINICALTRIAL

scholarly journals Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

2021 ◽  
Author(s):  
Justine Chan ◽  
Margaret De Melo ◽  
Jacqui Gingras ◽  
Enza Gucciardi
Keyword(s):  
Food Insecurity ◽  
Low Income ◽  
Local Community ◽  
Diabetes Education ◽  
Self Management ◽  
Semistructured Interview ◽  
Management Support ◽  
Urban Centre ◽  
Education Centre ◽  
Screening Questions

Objective. To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

scholarly journals How mHealth can facilitate collaboration in diabetes care: qualitative analysis of co-design workshops

2020 ◽  
Author(s):  
Meghan Bradway ◽  
Rebecca L Morris ◽  
Alain Giordanengo ◽  
Eirik Årsand
Keyword(s):  
Data Sharing ◽  
Healthcare Providers ◽  
End Users ◽  
Self Management ◽  
Afternoon Session ◽  
Data Types ◽  
Full Effect ◽  
Joint Workshop ◽  
Management Recommendations

Abstract Background: Individuals with diabetes are using mobile health (mHealth) to make and track their decisions regarding self-management. However, individuals can understand even more about their diabetes by sharing these patient-gathered data (PGD) with health professionals. We conducted experience-based co-design (EBCD) workshops, with the aim of gathering end-users’ needs and expectations for a PGD-sharing system. Methods: The first workshop (2017) included patients with Type 2 Diabetes (T2D) (n=4) and general practitioners (GPs) (n=3). The second workshop (2018) included patients with Type 1 Diabetes (T1D) (n=5), diabetes specialists (n=2) and a nurse. The workshops involved two sessions: separate morning sessions for patients and healthcare providers (HCPs), followed by a joint lunch and afternoon session for all participants together. A discussion guide was used to gather input regarding end-users’ expectations for the system. Participants then created and explained their own ideas for a data-sharing system, using paper-prototypes. Workshops were audio recorded, transcribed and translated from Norwegian to English. Inductive thematic analysis was performed. Results: The main emergent themes were mHealth technologies’ impacts on end-users, and functionalities of a data-sharing system. Patients and providers agreed that PGD could be used by HCPs to provide more concrete self-management recommendations. Participants made paper-prototypes to explain which data types to gather and display, and how the systems could be used to facilitate shared-decision making. However, all also agreed that a data-sharing system alone was not enough to achieve the full effect of mHealth. Conclusion: Participants’ feedback revealed that both patients and HCPs alike acknowledge that for mHealth integration to be successful, not only must the technology be validated but feasible changes throughout the healthcare education and practice must be addressed. Only then can both sides be adequately prepared for mHealth data-sharing in diabetes consultations. Subsequently, the design of the joint workshop sessions demonstrated that involving both participant groups in the same sessions led to efficient and concrete discussions about realistic solutions and limitations of sharing mHealth data in consultations.

Differential DNA Methylation and Cardiometabolic Risk in African American Mother-Adolescent Dyads

2021 ◽  
pp. 109980042110390
Author(s):  
Amanda Elswick Gentry ◽  
Jo Robins ◽  
Mat Makowski ◽  
Wendy Kliewer
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Dna Methylation ◽  
African American ◽  
African Americans ◽  
Waist Circumference ◽  
Low Income ◽  
Cardiometabolic Risk ◽  
Disease Risk ◽  
Cardiovascular Disease Risk

Background: Cardiovascular disease disproportionately affects African Americans as the leading cause of morbidity and mortality. Among African Americans, compared to other racial groups, cardiovascular disease onset occurs at an earlier age due to a higher prevalence of cardiometabolic risk factors, particularly obesity, hypertension and type 2 diabetes. Emerging evidence suggests that heritable epigenetic processes are related to increased cardiovascular disease risk, but this is largely unexplored in adolescents or across generations. Materials and Methods: In a cross-sectional descriptive pilot study in low-income African American mother-adolescent dyads, we examined associations between DNA methylation and the cardiometabolic indicators of body mass index, waist circumference, and insulin resistance. Results: Four adjacent cytosine and guanine nucleotides (CpG) sites were significantly differentially methylated and associated with C-reactive protein (CRP), 62 with waist circumference, and none to insulin resistance in models for both mothers and adolescents. Conclusion: Further study of the relations among psychological and environmental stressors, indicators of cardiovascular disease, risk, and epigenetic factors will improve understanding of cardiovascular disease risk so that preventive measures can be instituted earlier and more effectively. To our knowledge this work is the first to examine DNA methylation and cardiometabolic risk outcomes in mother-adolescent dyads.

scholarly journals Africultural Coping Systems Inventory: Psychometrics in a Clinical Sample of African American Women

2020 ◽  
Vol 46 (6-7) ◽  
pp. 457-481
Author(s):  
Natalie N. Watson-Singleton ◽  
Devon LoParo ◽  
Yara Mekawi ◽  
Joya N. Hampton-Anderson ◽  
Nadine J. Kaslow
Keyword(s):  
African American ◽  
African Americans ◽  
African American Women ◽  
Low Income ◽  
Clinical Sample ◽  
Reliability And Validity ◽  
General Factor ◽  
American Women ◽  
Structure Reliability ◽  
Clinical Counseling

The Africultural Coping Systems Inventory (ACSI) assesses African Americans’ culturally relevant stress coping strategies. Although its factor structure, reliability, and validity of the scores have been examined across ethnic groups of African descent, psychometric properties have not been investigated in an African American clinical sample. Thus, it is unclear if the ACSI is useful for research with African Americans with distress. To assess the ACSI’s psychometrics, we used data from 193 low-income African American women who in the past year encountered interpersonal trauma and attempted suicide. We tested four models: one-factor, four-factor, four-factor hierarchical, and bifactor. None of the models were optimal, suggesting possible revisions to ACSI items. Yet the bifactor model provided a better fit than other models with items loading onto a general factor and onto specific factors. Internal consistency of the scores was above the recommended criterion (i.e., .70), and the ACSI general factor was related to depressive symptoms, suicidal ideation (but not alcohol abuse), providing some support for its concurrent validity. Future directions, limitations, and clinical-counseling implications are discussed.

scholarly journals Folk Perception of African American English Regional Variation

2017 ◽  
Vol 5 (1) ◽  
pp. 1-16 ◽  
Author(s):  
David Mitchell ◽  
Marivic Lesho ◽  
Abby Walker
Keyword(s):  
African American ◽  
African Americans ◽  
American English ◽  
African American Vernacular English ◽  
Uniform Structure ◽  
Linguistic Features ◽  
Map Labeling ◽  
Perceptual Dialectology ◽  
Vernacular English ◽  
The Us

Contrary to previous “sociolinguistic folklore” that African American (Vernacular) English has a uniform structure across different parts of the US, recent studies have shown that it varies regionally, especially phonologically (Wolfram, 2007; Thomas & Wassink, 2010). However, there is little research on how Americans perceive AAE variation. Based on a map-labeling task, we investigate the folk perception of AAE variation by 55 participants, primarily African Americans in Columbus, Ohio. The analysis focuses on the dialect regions recognized by the participants, the linguistic features associated with different regions, and the attitudes associated with these beliefs. While the perceived regional boundaries mostly align with those identified by speakers in previous perceptual dialectology studies on American English, the participants consistently identified linguistic features that were specific to AAE. The participants recognized substantial phonological and lexical variation and identified “proper” dialects that do not necessarily sound “white”. This study demonstrates the value of considering African Americans’ perspectives in describing African American varieties of English.

Characteristics of Low-Income African-American and Caucasian Adults That Are Important in Self-Management of Type 2 Diabetes

2004 ◽  
Vol 29 (2) ◽  
pp. 155-170 ◽  
Author(s):  
Ruby H. Cox ◽  
John Paul Carpenter ◽  
Franklin A. Bruce ◽  
Kathleen P. Poole ◽  
Clark K. Gaylord
Keyword(s):  
Type 2 Diabetes ◽  
African American ◽  
Low Income ◽  
Self Management

scholarly journals How mHealth can facilitate collaboration in diabetes care: qualitative analysis of co-design workshops

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Meghan Bradway ◽  
Rebecca L. Morris ◽  
Alain Giordanengo ◽  
Eirik Årsand
Keyword(s):  
Data Sharing ◽  
Diabetes Care ◽  
Healthcare Providers ◽  
End Users ◽  
Self Management ◽  
Afternoon Session ◽  
Data Types ◽  
Joint Workshop ◽  
And Performance ◽  
Management Recommendations

Abstract Background Individuals with diabetes are using mobile health (mHealth) to track their self-management. However, individuals can understand even more about their diabetes by sharing these patient-gathered data (PGD) with health professionals. We conducted experience-based co-design (EBCD) workshops, with the aim of gathering end-users’ needs and expectations for a PGD-sharing system. Methods N = 15 participants provided feedback about their experiences and needs in diabetes care and expectations for sharing PGD. The first workshop (2017) included patients with Type 2 Diabetes (T2D) (n = 4) and general practitioners (GPs) (n = 3). The second workshop (2018) included patients with Type 1 Diabetes (T1D) (n = 5), diabetes specialists (n = 2) and a nurse. The workshops involved two sessions: separate morning sessions for patients and healthcare providers (HCPs), and afternoon session for all participants. Discussion guides included questions about end-users’ perceptions of mHealth and expectations for a data-sharing system. Activities included brainstorming and designing paper-prototypes. Workshops were audio recorded, transcribed and translated from Norwegian to English. An abductive approach to thematic analysis was taken. Results Emergent themes were mHealth technologies’ impacts on end-users, and functionalities of a data-sharing system. Within these themes, similarities and differences between those with T1D and T2D, and between HCPs, were revealed. Patients and providers agreed that HCPs could use PGD to provide more concrete self-management recommendations. Participants’ paper-prototypes revealed which data types should be gathered and displayed during consultations, and how this could facilitate shared-decision making. Conclusion The diverse and differentiated results suggests the need for flexible and tailorable systems that allow patients and providers to review summaries, with the option to explore details, and identify an individual’s challenges, together. Participants’ feedback revealed that both patients and HCPs acknowledge that for mHealth integration to be successful, not only must the technology be validated but feasible changes throughout the healthcare education and practice must be addressed. Only then can both sides be adequately prepared for mHealth data-sharing in diabetes consultations. Subsequently, the design and performance of the joint workshop sessions demonstrated that involving both participant groups together led to efficient and concrete discussions about realistic solutions and limitations of sharing mHealth data in consultations.

The Evolving Role of the Diabetes Educator—Changing Patient Behavior in Diabetes Self-management Education

2008 ◽  
Vol 04 (01) ◽  
pp. 29
Author(s):  
Daniel J Blackman
Keyword(s):  
Management Education ◽  
Diabetes Education ◽  
Diabetes Patient ◽  
Self Management ◽  
Diabetes Educator ◽  
Significant Difference ◽  
The Us ◽  
Patients With Diabetes ◽  
Diagnosed Diabetes ◽  
Diabetes Educators

In this day and age of evidence-based practice, we seek to provide interventions that we know will make a significant difference in the lives of our patients. For those of us who specialize in the care of people with diabetes, e.g. endocrinologists and diabetes educators, diabetes self-management education/training (DSME/T) has long been considered an essential intervention, a cornerstone of diabetes care. The government’s Healthy People 2010 objective that 60% of persons with diabetes should receive formal diabetes education supports this logic.1However, for many healthcare professionals outside of the specialty, this belief in the efficacy of DSME/T appears to be less solid, as evidenced by the poor referral rates for education. This disconnect is illustrated by the following findings. Although Medicare covers DSME/T as a benefit for patients with diabetes, only 1% of Medicare beneficiaries received this service in 2004 and 2005.2The Centers for Disease Control and Prevention (CDC) d ta indicate that only 54.3% of people who responded to a survey had ever attended some type of diabetes self-management class.3A 2007 Roper US Diabetes Patient Market Study found that only 26% of nearly 17 million diagnosed diabetes patients in the US had visited a diabetes educator within the past year.4Anecdotal reports from diabetes educators support the notion that with the current type 2 diabetes epidemic facing the US, education programs should be over-run with referrals for DSME/T. This, however, is far from the case for most programs. Most diabetes educators are sorely underutilized, and the rate of recognized diabetes education program closures is staggering, at three per week in the US.5

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