“A Touch of Sugar”: A Qualitative Study of the Impact of Health Beliefs on Type 1 and Type 2 Diabetes Self-Management Among Black Canadian Adults

Abstract

ObjectivesBlack Canadians have higher rates of diabetes and complications compared with White Canadians. However, research on diabetes self-management in this community is lacking. We conducted a qualitative study to explore diabetes self-management in the Black Canadian community using the lens of the Health Belief Model. MethodsForty-three individuals who identify as Black Canadians, living with or caring for a person with diabetes, were recruited. Data were collected through focus groups and interviews, and then analyzed using content analysis. ResultsWe found that participants appreciated they are susceptible to diabetes based on family or peer experiences. Perceived severity is variable for which some believe that diabetes is only a “sugar problem,” and the majority highlighted a perceived lack of knowledge about diabetes complications. Perceived benefits to treatment included prolonging life and cleansing one’s body. Perceived barriers included lack of culturally appropriate dietary advice, lack of shared decision-making driven by a language barrier and cultural mismatch between patient and provider, socioeconomic status and difficulty navigating and accessing the Canadian health-care system. Peers, family members, churches and online platforms served as the main information sources and cues to action, influencing each of the 4 aforementioned categories. A number of solutions were proposed by the participants to address the barriers from patient, health-care delivery and health advocacy perspectives. ConclusionsBlack Canadians face unique barriers to diabetes self-management, some of which are rooted within health belief systems. Avenues for intervention include peer education through narratives and a renewed focus on providing culturally appropriate care.