The influence of family function on dietary intake and glucose control in African American women with type 2 diabetes

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  • March 22, 2019
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  • Greene, Natasha
    • Affiliation: School of Nursing
Abstract
  • African American women disproportionately suffer from type 2 diabetes prevalence, morbidity, and mortality. Maintaining optimal nutrition for physiological function and normalizing body mass index in order to decrease glucose levels and insulin resistance prevents morbidity and mortality. Thus, following the recommended daily food allowances is the most important life-style modification for diabetes. Unfortunately, African American women with type 2 diabetes find dietary adherence difficult to maintain due to challenges with changing life-long dietary habits, lack of family and spousal support, multi-caregiver roles, and difficulty with portion control. Most of these factors occur in the family home, but there is still little information exploring how a spouse and the family influence dietary intake. Therefore, the overall purpose of this study was to explore the influence of family function on the quality of dietary intake and, ultimately, glucose control for African American women with type 2 diabetes. The conceptual model for the study was based on empirical evidence related to factors affecting dietary intake and glucose control and Turner's theory of family function. The specific aims were to: (a) explore whether family function (roles, problem solving, and communication) mediates the relationship between female and male characteristics (diabetes knowledge and health status) and dietary intake, (b) test a preliminary model for explaining how characteristics of the women and men, family function, and dietary intake related to glucose control, and (c) explore from the woman's perspective, other family factors affecting her dietary intake. Data were collected using self-report questionnaires and a brief semi-structured interview. The convenience sample consisted of 22 African American females with type 2 diabetes and 18 male spouses and 1 male cohabitating partner from rural counties in the Mid-Atlantic region of the U.S. Family function was not related to dietary intake and therefore, was not a mediator. Dietary intake was not related to fasting glucose. In the final model using stepwise multiple regression analyses, the woman's assessment of healthier family role behavior and her lower general health perceptions were associated with higher fasting glucose. Therefore, women have poorer glucose control when their general health is poorer and family role behaviors are clearly defined. Qualitative analyses suggested that women with normal glucose control obtained support in maintaining their diet from a variety of sources (family, God, spouse, and themselves), while women with poorer glucose control identified more challenges from a variety of sources (motherhood, themselves, spouse/partner, family, and work). Findings have implications for providing family focused education and interventions to African American women with type 2 diabetes.
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  • ... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Nursing.
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  • Miles, Margaret Shandor
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