Diabetes Self-Management Education for African Americans: Using the PEN-3 Model to Assess Needs

Abstract

Background African Americans are 2.2 times more likely to die from diabetes than whites. Culturally sensitive diabetes self-management education (DSME) is an approach to respond to this problem. Purpose The purpose of this qualitative study is to assess African Americans' experiences managing type 2 diabetes. Results from this study will guide the development of a DSME intervention. Methods Two focus groups with African Americans over the age of 18 (N = 17) were conducted. Sessions were audio-recorded and transcribed. Data were analyzed using content analysis and comparative method. The thematic findings were applied to the PEN-3 Cultural Framework. Findings In the relationships and expectations domain, perceptions affecting disease management were feeling highly confident, fears about diabetes complications, and denial. Positive enablers were religion and social support. Negative enablers were disliking needles, time consumption, and cost of healthy foods. Nurturers consisted of family, friends, and health care providers. Cultural empowerment attributes were positive (spirituality and family), existential (faith healing), and negative (unhealthy traditional foods). For cultural identity, diabetes education was a need, especially family-focused intervention. Translation to Health Education Practice Qualitative research, such as focus groups, provides health educators with a useful tool to conduct needs assessments to plan culture-centered health programs.