Interviews highlight the importance of culturally-tailored diabetes education to address health care disparities in the Mexican American community.
Interviews with Mexican American adults with type 2 diabetes (T2D) revealed that most feel supported by their family regarding their diabetes management in general, but many still desired more familial social support and support around dietary changes, feeling that their family members don’t understand what it means to live with diabetes.
Additionally, focus groups that included both Mexican American adults with T2D and their relatives showed that most family members want to learn more about how to help their relatives manage their diabetes, while also acknowledging how cultural norms can affect their relatives’ well-being.
These findings were published in Hispanic Health Care International and highlight the need for family-wide education on diabetes management. The authors drew these conclusions after analyzing data from 34 semi-structured interviews with Hispanic adults with diabetes and 6 focus groups with a total of 37 adults with diabetes and their family members.
It’s important to note that all participants were recruited from a primarily low-income, Mexican American immigrant community in Chicago, Illinois, where there are several risk factors contributing to compromised health and increased diabetes-related mortality. The research team employed methods such as distributing flyers in local churches and relying on community word of mouth for participant recruitment.
Family-related facilitators to T2D self-management included familial support, motivation, and the desire to help prevent diabetes in the family.
Among the 71 total participants, 39 (55%) highlighted the significance of family as a pillar of support in managing their diabetes. Out of these, 22 participants emphasized that their families played a crucial role in offering practical assistance, including ensuring access to healthy meals, supporting medication compliance, and facilitating transportation to medical appointments. Some participants also mentioned that their families were accommodating to their specific needs, with a few individuals noting direct involvement in daily diabetes management.
Several participants also said their family members provided valuable informational support, offering guidance, suggestions, and reminders to aid in diabetes management, in addition to providing emotional and companionship support.
Twenty-four participants (34%) cited family as a motivating factor for engaging in diabetes self-care practices, often expressing a desire to support future generations and share a healthier life with their grandchildren. Additionally, many mentioned that witnessing diabetes-related complications in family members served as motivation to prioritize their own well-being. A notable portion (20%) of the participants had family members with diabetes, while only one participant reported no family history of diabetes.
“If I didn’t do what I was supposed to have done, I’d probably be in a hospital, somewhere laid up, sick…No, I don’t want that,” one participant noted. “I’ve seen my mother already there and um, that was too much for me.”
Additionally, 21 (30%) of all participants expressed the desire to be more educated on diabetes so they can help prevent it in themselves and their family members.
Family-related challenges around T2D management included lack of support, family responsibilities, and family-related stress. Presence of these factors was reported by 15, 16, and 7 participants, respectively.
“We found that while lack of social support, family responsibilities, and stress from family can undermine successful diabetes management, many participants with diabetes had family available to support their diabetes management but wanted them to provide more social support,” the study authors said.
Fifteen participants reported challenges with engaging their families in a healthy lifestyle, describing instances where they found it difficult to adhere to healthy habits in the presence of family members, especially when resisting unhealthy food, and occasionally feeling discouraged by their family's unhealthy choices. Regarding the effect of family responsibilities, nearly a quarter of participants said caring for others in their family prevents them from taking care of themselves.
“[I consume] a lot of tortillas,” one participant with diabetes noted. “When you’re eating with a lot of other people, and they heat them up and say ‘Here are the tortillas!’ As my aunt says, ‘take them and eat up!’ Yeah, more than anything, it's [hard to resist] tortillas.”
“I am in charge of taking [my mother] to the doctor, and my father-in-law when it is my turn, my husband, two daughters, three single daughters, three dogs that are like children also, so I am very busy,” another participant added. “I would like to have a bit more time to do a bit more [exercise].”
For relatives of those with T2D, seeing loved ones struggling with diabetes and striving to prevent diabetes in the generations to come were identified as sources of inspiration to take care of their own health and do their best to prevent T2D onset.
“Diabetes knowledge was shared within the family unit, and family members had a desire to learn more about the disease but didn’t know how to best support at times due to conflict from cultural family norms,” the authors wrote. “Further research should use our findings to inform culturally-tailored diabetes education efforts in order to improve health care disparities in the Hispanic community.”
Jordan OJ, Benitez A, Burnet DL, Quinn MT, Baig AA. The role of family in diabetes management for Mexican American adults. Hisp Health Care Int. Published online October 23, 2023. doi:10.1177/15404153231206086