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- All Subjects: Diabetics--Health and hygiene.
- Creators: Marsiglia, Flavio F
Description
Nationally, African Americans suffer disproportionately from diabetes; with 13.2% of African Americans diagnosed with diabetes compared to 7.6% of non-Hispanic whites (CDC, 2014). Nearly one-half of all people with diabetes are non-adherent to their oral medications; adherence to insulin therapy was 60%-80% (Brunton et al., 2011; Cramer, 2004; Rubin, 2005). This study explored the question, "What mechanisms are associated with adherence to diabetes medication, including insulin, for African Americans in the Southwest?" Twenty-three people participated in the study; 17 participated in interviews and six participated in gendered focus groups. A community-based participatory research (CBPR) approach engaged the African American community as partners in research.
Major themes emerging from the data included illness perception, support, and the process of medication adherence. Acceptance of the diabetes diagnosis was imperative for medication adherence. Stigmatization of diabetes was salient in the recruitment process and as it related to mechanisms for adherence. Furthermore, many informants were not aware of a family history of diabetes before their own diagnosis. Four gendered emerging typologies were identified, which further illuminated major themes. Moreover, an eight-step process of medication adherence model is discussed. The researcher was able to identify culturally compatible strategies that may be extended to those struggling with medication adherence. The implications section suggests a set of strategies that healthcare providers can present to people with diabetes in order to increase medication adherence.
Major themes emerging from the data included illness perception, support, and the process of medication adherence. Acceptance of the diabetes diagnosis was imperative for medication adherence. Stigmatization of diabetes was salient in the recruitment process and as it related to mechanisms for adherence. Furthermore, many informants were not aware of a family history of diabetes before their own diagnosis. Four gendered emerging typologies were identified, which further illuminated major themes. Moreover, an eight-step process of medication adherence model is discussed. The researcher was able to identify culturally compatible strategies that may be extended to those struggling with medication adherence. The implications section suggests a set of strategies that healthcare providers can present to people with diabetes in order to increase medication adherence.
ContributorsWardian, Jana (Author) / Marsiglia, Flavio F (Thesis advisor) / Sun, Fei (Committee member) / Shaibi, Gabriel (Committee member) / Arizona State University (Publisher)
Created2015
Description
A secondary data analysis was conducted to investigate the direct and indirect effects of family traditionalism, family cohesion, and parent involvement on alcohol, cigarette, and marijuana use in a sample of pre-adolescent youth (N = 635) and their parents (N = 462). Aim one hypothesized that family cohesion and family traditionalism would be indicators of a higher order construct, operationalized as familismo. Aims two and three hypothesized that family traditionalism, family cohesion, and parent involvement would be protective against youth substance use. Finally, aim four hypothesized that acculturation would decrease the protective effects of family traditionalism and family cohesion on substance use.
Using second order confirmatory factor analysis, aim one found that family cohesion and family traditionalism were indicators of a second order structure. Regarding aims two and three, a consistent significant association was found between family cohesion and parent involvement across alcohol, cigarette, and marijuana use outcomes. As well, family cohesion was significantly and inversely associated with past 30-day alcohol use amount ( = -.21, p < 0.05), lifetime alcohol use ( = -.19, p < 0.05), and lifetime marijuana use ( = -.31, p < 0.001). Counter to what was hypothesized, a significant positive relationship between family traditionalism and past 30-day alcohol use amount was found. No significant indirect effects were found. Specific to aim four, significant moderation effects were found between family cohesion and acculturation on alcohol and cigarette use. Higher acculturated youth had greater past 30-day alcohol and cigarette use amount compared to low acculturated youth; as family cohesion increased, alcohol and cigarette use for both low and high-acculturated youth decreased.
This study has important implications for social work and future research specific to culture, family, and youth substance use. This study may assist direct social work practitioners, school personnel, and other professionals that work with Latino youth and families in the tailoring of services that are culturally sensitive and relevant to this population and provides further understanding regarding the impact of culture and family on Latino youth substance use. Findings and limitations are discussed specific to social work practice, policy, and research.
Using second order confirmatory factor analysis, aim one found that family cohesion and family traditionalism were indicators of a second order structure. Regarding aims two and three, a consistent significant association was found between family cohesion and parent involvement across alcohol, cigarette, and marijuana use outcomes. As well, family cohesion was significantly and inversely associated with past 30-day alcohol use amount ( = -.21, p < 0.05), lifetime alcohol use ( = -.19, p < 0.05), and lifetime marijuana use ( = -.31, p < 0.001). Counter to what was hypothesized, a significant positive relationship between family traditionalism and past 30-day alcohol use amount was found. No significant indirect effects were found. Specific to aim four, significant moderation effects were found between family cohesion and acculturation on alcohol and cigarette use. Higher acculturated youth had greater past 30-day alcohol and cigarette use amount compared to low acculturated youth; as family cohesion increased, alcohol and cigarette use for both low and high-acculturated youth decreased.
This study has important implications for social work and future research specific to culture, family, and youth substance use. This study may assist direct social work practitioners, school personnel, and other professionals that work with Latino youth and families in the tailoring of services that are culturally sensitive and relevant to this population and provides further understanding regarding the impact of culture and family on Latino youth substance use. Findings and limitations are discussed specific to social work practice, policy, and research.
ContributorsMartinez, Marcos Jerome (Author) / Marsiglia, Flavio F (Thesis advisor) / Kulis, Stephen (Committee member) / Anthony, Elizabeth (Committee member) / Arizona State University (Publisher)
Created2015