Perceptions of Behavioral and Lifestyle Changes Among African American Women With Type 2 Diabetes

Perceptions of Behavioral and Lifestyle Changes Among African American Women With Type 2 Diabetes by Myriam Almonor MA, Fairleigh Dickinson University, 2001 BS, State University of New York at Stony Brook, 1993 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Epidemiology Walden University August 2016 Abstract The prevalence of type 2 diabetes (T2D) continues to rise and is predicted to increase to 30 million people by 2030 in the United Sates alone. African Americans (AA) have one of the highest prevalence rates of T2D among all ethnic groups. African American Women (AAW) are 100% more likely to develop T2D compared with their white counterparts. The aim of this study was to quantitatively investigate the relationship ofThe prevalence of type 2 diabetes (T2D) continues to rise and is predicted to increase to 30 million people by 2030 in the United Sates alone. African Americans (AA) have one of the highest prevalence rates of T2D among all ethnic groups. African American Women (AAW) are 100% more likely to develop T2D compared with their white counterparts. The aim of this study was to quantitatively investigate the relationship of the perceptions of AAW not previously identified that could lead to a reduction in risk of T2D among AAW. A cross-sectional study of 183 AAW 20 to 65 years old was conducted to identify any correlation among the variables, using validated surveys. The participants were recruited via flyers and online. The health belief model and the theory of planned behavior served as the theoretical framework. Spearman’s rho correlation was used to determine the strength of the correlations. The majority of respondents had moderate to high lifestyle and behavior changes relative to diet (59%) and blood sugar testing (93%), as well as low participation for exercise (62%). The majority of the AAW had low awareness of T2D severity (72%), low interference to daily activities (88%), and low social support for diabetes management (74%). A significant correlation was observed between healthy diet and severity, interference, outcome expectancies, and selfefficacy (p < .001). A significant relationship was found between exercise and severity, interference, outcome expectancies, and self-efficacy (p < .001). This study may inspire social change by creating awareness among healthcare workers regarding educational resources, environmental changes, and community interventions to reduce the economic burden associated with health care costs, to mitigate T2D, and to reduce health disparity. Perceptions of Behavioral and Lifestyle Changes Among African American Women With Type 2 Diabetes by Myriam Almonor MA, Fairleigh Dickinson University, 2001 BS, State University of New York, Stony Brook, 1993 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Epidemiology Walden University August 2016 Dedication To God all the Glory! I could not have reached this milestone without the inspiration and guidance from my God. He has given me strength, motivation and His energy has kept me uplifted throughout this assiduous journey. He has given me confidence and wisdom to pursue my dreams. He has removed all obstacles from my path and kept me focused throughout this challenging project. This manuscript is dedicated primarily to the loving memory of my late father, Antoine J. Almonor, who has always believed in me. Dad, rejoice, your daughter has honored you again! I thank you for your unconditional love, for instilling in me the value of education and the willpower to accomplish my dreams. You are the quintessence of love, courage, and endurance! To my mother, Elizabeth P. Almonor, who has always supported me; I appreciate all you have done, thank you! To my brother, Jean Benoit Almonor, who has always encouraged me to pursue my dreams no matter how extraordinary they may have seemed, thank you! To all my friends, who have inspired and supported me through this major step of my life; thank you for your love, support, and most expressly for your prayers! You all have been instrumental in achieving this major milestone. I love you all and I dedicate this research to you! And finally, to all those who are at risk of diabetes or who are suffering with this chronic disease: I dedicate this research to you as a symbol of my contribution in bringing awareness to type 2 diabetes. Acknowledgments First, I would like to extend a special recognition to my doctoral team. I am very thankful to my mentor, Dr. Vasileios Margaritis, for his devoted attention, expertise, and guidance. Dr. Margaritis has been working diligently with me for the success of my research. His tireless attitude, guidance and keen interest in my work were instrumental in achieving this milestone. I am grateful to my committee member, Dr. Aaron Mendelsohn; and my University Research Reviewer, Dr. Patrick Tschida. Your expertise and critical evaluation of my work have been instrumental in achieving a valuable scholar document. I would like to acknowledge my dissertation buddy, Muinah Fowora, for her constant support, for cheering me when facing many challenges during this journey. Muinah, we did it and thank you from the bottom of my heart! My sincere thanks to my friend and classmate, Dr. Sonya Anyaka, for her support, encouragement, and mostly for her priceless insights and suggestions. Sonya, I could not have done it without you; thank you for your contribution! You have all contributed to the success of this research!