title: "It's a wild thing, waiting to get me": stance analysis of African Americans with diabetes.
abstract: This mixed methods study uses a unique approach from social science and linguistics methodologies, a combination of positioning theory and stance analysis, to examine how 20 African Americans with type 2 diabetes make sense of the practices that led to recurrent emergency department visits to identify needs for more effective intervention.
  
  
  
  In a purposive sample of postemergency department visit interviews with a same-race interviewer, people responded to open-ended questions reflecting on the decision to seek emergency department care. As applied to diabetes education, positioning theory explains that people use their language to position themselves toward their disease, their medications, and the changes in their lives. Transcriptions were coded using discourse analysis to categorize themes. As a form of triangulation, stance analysis measured language patterns using factor analysis to see when and how speakers revealed affect, attitude, and agentive choices for action.
  
  
  
  Final analysis revealed that one third of the sample exhibited high scores for positive agency or capacity for decision-making and self-management, while the rest expressed less control and more negative emotions and fears that may preclude self-management. This approach suggests a means to tailor diabetes education considering alternative approaches focused on communication for those facing barriers.
authors.affiliation: The Department of English/Applied Linguistics, University of North Carolina at Charlotte, North Carolina (Dr Davis)
authors.forename: Boyd H
authors.initials: BH
authors.lastname: Davis
authors.affiliation: Charleston REAP, Ralph H. Johnson Department of Veterans Affairs Medical Center, (Dr Pope)|Medical University of South Carolina College of Nursing, Charleston, South Carolina (Dr Pope, Dr Magwood, Dr Jenkins)
authors.forename: Charlene
authors.initials: C
authors.lastname: Pope
authors.affiliation: Next Generation Marketing Insights, Charlotte, North Carolina (Dr Mason)
authors.forename: Peyton R
authors.initials: PR
authors.lastname: Mason
authors.affiliation: Medical University of South Carolina College of Nursing, Charleston, South Carolina (Dr Pope, Dr Magwood, Dr Jenkins)
authors.forename: Gayenell
authors.initials: G
authors.lastname: Magwood
authors.affiliation: Medical University of South Carolina College of Nursing, Charleston, South Carolina (Dr Pope, Dr Magwood, Dr Jenkins)
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Jenkins
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006300:Health Services Misuse; D006801:Humans; D008037:Linguistics; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care / Q000523:psychology; D013022:South Carolina