title: Health Beliefs of Marshallese Regarding Type 2 Diabetes.
abstract: OBJECTIVE
  The Marshallese population suffers from disproportionate rates of type 2 diabetes. This study identifies the underlying beliefs and perceptions that affect diabetes self-management behavior in the US Marshallese population living in Arkansas.
  
  
  METHODS
  The study employs focus groups with a semi-structured interview guide developed using a community-based participatory research (CBPR) approach and the Health Belief Model. Data were collected from 41 participants; bilingual community co-investigators provided translation as needed.
  
  
  RESULTS
  The results show high-perceived threat, with most participants describing diabetes as inevitable and a death sentence. Participants are generally unaware of the benefits of diabetes self-management behaviors, and the Marshallese population faces significant policy, environmental, and systems barriers to diabetes self-management. The primary cue to action is a diagnosis of diabetes, and there are varying levels of self-efficacy.
  
  
  CONCLUSIONS
  The research grounded in the Health Belief Model provides important contributions that can help advance diabetes self-management efforts within Pacific Islander communities.
authors.affiliation: Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA. pamcelfish@uams.edu.
authors.forename: Pearl Anna
authors.initials: PA
authors.lastname: McElfish
authors.affiliation: Department of Sociology, University of Chicago, Chicago, IL, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Hallgren
authors.affiliation: University of Arkansas, Fayetteville, AR, USA.
authors.forename: L Jean
authors.initials: LJ
authors.lastname: Henry
authors.affiliation: University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
authors.forename: Mandy
authors.initials: M
authors.lastname: Ritok
authors.affiliation: University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
authors.forename: Jellesen
authors.initials: J
authors.lastname: Rubon-Chutaro
authors.affiliation: University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kohler
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008849:Micronesia; D044468:Native Hawaiian or Pacific Islander / Q000523:psychology*; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy