Family experience influences diabetes risk and management for African-Americans

Afro-American families not only share a higher risk of type 2 diabetes, but many myths and misconceptions about the disease are often pbaded on from one generation to the next.

To understand the influence of family experiences on risk and disease management, a team of researchers from Iowa State University interviewed parents and adult children of 20 African-American families with type 2 diabetes. Interviews focused on diagnosis, physical activity and nutrition, resources for disease management, family support and communication, and allowed researchers to deepen the family dynamics.

"We wanted to get into the meanings and nuances of family culture in order to identify some malleable targets with which we can work," said Tera Jordan, badociate professor of human development and family studies at the University of Toronto. UIP, which conducted the interviews. "By understanding the meaning people have about food and nutrition, we could find ways to change things."

The study, published in the journal Global Qualitative Research in Nursing, identified two main themes – family interactions and intergenerational openness – that shaped what the younger generations knew and did about the disease. Brianna Routh, senior author and badistant professor at Montana State University, was part of the research team when she was a postgraduate student in the state of Iowa. She says the findings provide information that can help doctors and nurses advise African American patients.

"Some family interactions may directly influence behaviors and the ability to manage one's diabetes, so it is important for health professionals to ask questions to better understand how these interactions can support or hinder the health goals of their family." individual, "said Routh.

For example, many members of the African-American community know that there is a genetic component, but are less aware of how physical activity and nutrition can prevent or mitigate the effects of the disease, Jordan said.

Importance of food and family

Previous studies have shown that family history – regardless of race, age or income – was a strong predictor of obesity and type 2 diabetes. In their article, researchers at ISU explained that cultural acceptance of a larger size and optimistic bias could limit the risk perceived by African Americans to contract the disease. Some are also skeptical about the medical system, which can have negative consequences.

As in many cultures, food plays a central role in African-American families. In the interviews, Jordan said that several parents and children had talked about special foods prepared for family vacations and meals. The parents explained that they were preparing the dishes for their children, but that they often did not realize the consequences for the health of their parents. For some families, the interviews were the first time they discussed these issues.

"I've really seen the information-sharing process unfold between the two generations, but also educate the public about misconceptions, such as how we treated diabetes a generation ago." "It's not the way we treat it right now." Families need to be diligent and open up new and updated information, "Jordan said.

Lessons for families, health professionals

Some parents have openly talked about diabetes with their children and models of healthy behaviors, but the study revealed the need to strengthen communication within families as well as with health professionals. The researchers noted gender differences – men were less likely to discuss their diagnosis – as well as concerns from parents reluctant to talk about it because they did not want to worry their children.

"Too often, we've heard of someone who has had a major medical event, unfortunately, maybe dead, just because he did not share information with his loved ones," he said. said Jordan.

The researchers offer the following recommendations to improve communication and education about type 2 diabetes:

• Open Communication: To provide support, family members should discuss the diagnosis and understand the course of management. Designate a designated person who can attend doctor's appointments and ensure that treatment and medication plans are followed.
• Notify a colleague or manager: a medical emergency can occur at any time. Tell someone at work that you have type 2 diabetes and how they should react if your blood sugar goes down and you stop reacting.
• Recognize potential barriers: Physicians and nurses must ensure that patients understand their diagnosis and feel comfortable asking questions. Awareness of cultural and family differences can help remove barriers to successful management.

"I would ask health care providers to do everything in their power to facilitate communication and build trust, while recognizing that they may not have done anything personally to violate this trust." but it's systemic, it's cultural, "Jordan said. "We have overcome a lot of things culturally and we simply recognize that it's probably in the room."