Diabetes beliefs among low-income, white residents of a rural North Carolina community.
BACKGROUND
Every social group shares beliefs about health and illness. Knowledge and understanding of these health beliefs are essential for education programs to address health promotion and illness prevention.


OBJECTIVE
This analysis describes the diabetes Explanatory Models of Illness (EMs) of low-income, rural, white Southerners who have not been diagnosed with diabetes.


METHODS
In-depth interviews were conducted with low-income white women (n = 19) and men (n = 20) aged 18 to 54 years who resided in a rural Southern town. The tape-recorded interviews were completed by trained interviewers and were transcribed verbatim. Computer-assisted text analysis was used, and all transcripts were coded by 2 investigators.


RESULTS
Although all the participants had heard of diabetes, their EMs were vague and undeveloped. Women were more knowledgeable than men were. Family and heredity were widely believed to be causes, with heredity including genetic and learned behavior components. Participants disagreed about the role of diet and weight in causing diabetes; exercise was not perceived as related to causation. Participants had knowledge of those symptoms, complications, and treatments that could be observed.


CONCLUSIONS
These rural, white Southerners did not share well-developed EMs for diabetes, with most having a vague and incomplete understanding of this disease. The diabetes beliefs of these rural Southerners differ significantly from current medical knowledge. To be effective, culturally appropriate primary prevention programs must recognize these lay beliefs.
Arcury
Thomas A
TA
Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1084, USA. tarcury@wfubmc.edu
Skelly
Anne H
AH
Gesler
Wilbert M
WM
Dougherty
Molly C
MC
D000328:Adult; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000208:ethnology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D033262:Narration; D009657:North Carolina / Q000453:epidemiology; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000592:standards; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000193:education / Q000523:psychology*