title: Self-management among patients living with diabetes in the United States Virgin Islands.
abstract: The United States Virgin Islands (USVI) is facing a diabetes epidemic similar to the one on the U.S. mainland, yet little is known regarding the cultural context relevant to self-management in this U.S. territory. We conducted in-home interviews (n=53) supplemented by self-administered questionnaire and A1c testing with U.S. Virgin Islanders to characterize self-management knowledge, attitudes, and behaviors among patients living with diabetes. The mean glycosylated hemoglobin (A1c) was 7.63 (Range=5-13); a composite score of traditional self-management behaviors was not associated with A1c. Several recurrent themes emerged from qualitative analysis including: 1) cultural nuances shaped perspectives on self-management, 2) culturally-specific challenges were barriers to effective self-management, 3) medical homes were rarely viewed as the primary source of education and support, and 4) fear largely motivated or stalled self-management practices. This study highlights the need for culturally-tailored measures and interventions to address the specific needs within this population.
authors.affiliation: University of the Virgin Islands, St. Thomas, United States Virgin Islands. mnunez@uvi.edu
authors.forename: Maxine A
authors.initials: MA
authors.lastname: Nunez
authors.forename: Hossein
authors.initials: H
authors.lastname: Yarandi
authors.forename: Marcella
authors.initials: M
authors.lastname: Nunez-Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003466:Cultural Characteristics; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012648:Self Care; D011795:Surveys and Questionnaires; D014767:United States Virgin Islands
chemical_list: D006442:Glycated Hemoglobin