Wen Meng-Jung, Zou Tongtong, Bolt Daniel M, Shiyanbola Olayinka O
Division of Social and Administrative Sciences in Pharmacy, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Department of Educational Psychology, School of Education, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Br J Health Psychol. 2025 Feb;30(1):e12775. doi: 10.1111/bjhp.12775.
This study explores the structure of beliefs about type 2 diabetes among Black adults and informs potential targets to reframe negative beliefs and enhance diabetes self-management.
We applied network analysis to investigate the interrelated structure and clusters of beliefs about diabetes and identify specific items that could serve as behavioural targets. We obtained self-reported survey data from 170 Black adults with type 2 diabetes. Regularised partial correlation networks and a Gaussian graphical model were used to explore and visualise the interrelationship among 21 items of a culturally adapted Illness Perception Questionnaire-Revised.
Overwhelming negative emotions representing the current and long-term effects of diabetes were central to the illness perceptions network among Black adults, with feeling depressed having the highest node strength of centrality indices in the network. Four beliefs had a bridging effect with the central cluster: diabetes taking away the ability to enjoy food, diabetes keeping me away from the job I want, being poor contributed to my having diabetes, and I receive encouragement from friends and family.
In addition to highlighting the overwhelming feeling of diabetes, the illness perception network further differentiated the role of racial identity and social determinants of health as discrete, though both are related sociocultural influence constructs. To enhance self-management for Black adults with type 2 diabetes, this network informs promising intervention targets focused on culturally tailored education related to emotional regulation, internalised stigma and healthy food adaptation, and leveraging support to address social determinants of health.
本研究探讨了黑人成年人对2型糖尿病的信念结构，并为重塑消极信念和加强糖尿病自我管理的潜在目标提供信息。
我们应用网络分析来研究糖尿病相关信念的相互关联结构和聚类，并确定可作为行为目标的具体项目。我们从170名患有2型糖尿病的黑人成年人那里获得了自我报告的调查数据。使用正则化偏相关网络和高斯图形模型来探索和可视化一份文化适应性修订版疾病认知问卷中21个项目之间的相互关系。
代表糖尿病当前和长期影响的压倒性负面情绪是黑人成年人疾病认知网络的核心，其中感到沮丧在网络中心性指数中具有最高的节点强度。有四个信念与核心聚类有桥梁作用：糖尿病剥夺了享受食物的能力、糖尿病使我无法从事我想要的工作、贫穷导致我患糖尿病以及我从朋友和家人那里得到鼓励。
除了突出糖尿病带来的压倒性感受外，疾病认知网络进一步区分了种族认同和健康的社会决定因素作为离散因素的作用，尽管两者都是相关的社会文化影响结构。为了加强患有2型糖尿病的黑人成年人的自我管理，这个网络为有前景的干预目标提供了信息，这些目标集中在与情绪调节、内化耻辱感和健康食物适应相关的文化定制教育上，并利用支持来解决健康的社会决定因素。
