Crabtree Krysia, Sherrer Nathan, Rushton Tullia, Willig Amanda, Agne April, Shelton Tanya, Cherrington Andrea
Eastern Virginia Medical School, Norfolk, Virginia (Ms Crabtree)
School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Mr Sherrer)
Diabetes Educ. 2015 Feb;41(1):118-26. doi: 10.1177/0145721714557043. Epub 2014 Nov 3.
The purpose of the study is to explore African American men's perceptions of how community-based, community-health worker (CHW)-delivered diabetes interventions might best be implemented.
Four 90-minute focus groups were guided by a trained moderator with a written guide to facilitate discussion on the topic of diabetes management and preferences for community-based programs. Participants were recruited from the diabetes education database at a safety-net health system in Jefferson County, AL. Two independent reviewers performed content analysis to identify major themes using an iterative, combined deductive and inductive approach.
There were 25 male participants. Mean years living with diabetes was 9.6 (range, 1-20). Participants demonstrated knowledge of self-management strategies and identified various hardships including emotional and physical manifestations of diabetes, dietary restrictions, and institutional frustrations with the health system that contributed to self-management barriers. Their preferred CHW responsibilities were to educate, hold support groups, help track daily activities, and help find resources. Potential concerns included the need for confidentiality and fears of being stereotyped.
Participants identified critical self-management strategies but endure hardships that present barriers to daily diabetes management. Preferences for community-based programs and suggested CHW responsibilities could help to overcome many of those barriers by increasing access and providing support.
本研究旨在探讨非裔美国男性对于如何以最佳方式实施基于社区的、由社区卫生工作者(CHW)提供的糖尿病干预措施的看法。
四个90分钟的焦点小组由一名经过培训的主持人主持,并依据一份书面指南来推动关于糖尿病管理主题以及对基于社区项目的偏好的讨论。参与者从阿拉巴马州杰斐逊县一个安全网医疗系统的糖尿病教育数据库中招募。两名独立评审员采用迭代的、演绎与归纳相结合的方法进行内容分析,以确定主要主题。
共有25名男性参与者。糖尿病患病平均时长为9.6年(范围为1至20年)。参与者展示了自我管理策略方面的知识,并指出了各种困难,包括糖尿病的情绪和身体表现、饮食限制以及对医疗系统的制度性不满,这些都构成了自我管理障碍。他们对社区卫生工作者职责的偏好是进行教育、举办支持小组、帮助跟踪日常活动以及帮助寻找资源。潜在担忧包括对保密性的需求以及对被刻板化的恐惧。
参与者确定了关键的自我管理策略,但面临着阻碍日常糖尿病管理的困难。对基于社区项目的偏好以及建议的社区卫生工作者职责,可通过增加可及性和提供支持来帮助克服其中许多障碍。