Sub-Saharan African Immigrant's Health-Illness Transition Experiences with Type 2 Diabetes Self-Management in the United States

Abstract

Sub-Saharan African immigrants represent a rapidly growing racial subgroup in the United States. These immigrants have an increased Type 2 diabetes mellitus (T2DM) prevalence as well as diabetes complications occurring after they have lived in the U.S. for three years or more. Diabetes self-management among Sub-Saharan African immigrants with T2DM is poorly understood; diabetes data for Sub-Saharan Africa immigrants are interspersed among data of Blacks or African-Americans. The purpose of this qualitative descriptive study was to describe Sub-Saharan African immigrants' health-illness transition experiences associated with T2DM self-management. The framework for the study was the middle-range nursing theory of transitions. Purposive and snowball sampling were used to recruit participants. The primary investigator conducted face-to-face semi-structured in-depth interviews with 10 Sub-Saharan African immigrant men and women with T2DM, and used qualitative content analysis to analyze the data. Domains were selected apriori to respond to each research question, and categories and subcategories were elicited through the immersion and crystallization of thematic units. Four overarching domains selected apriori describing the health-illness transition experiences the participants had with T2DM self-management: 1) Knowledge of T2DM Self-Management Behaviors 2) Current T2DM Self-Management Behaviors 3) Inhibitors of T2DM Self-Management 4) Facilitators of T2DM Self-Management. Health professionals should be equipped with an understanding of the properties and conditions of health-illness transition necessary to build a foundation that facilitates healthy adaptation to the T2DM transition. The knowledge from this study will lead to the development of culturally tailored interventions to decrease inhibitors of and encourage self-management in daily diabetes care for Sub-Saharan African immigrants with T2DM.