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Comparing Patient Perspectives on Diabetes Management to the Deficit-Based Literature in an Ethnic Minority Population: A Mixed-Methods Study

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Listed:
  • Kathleen Abu-Saad

    (Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52621, Israel)

  • Nihaya Daoud

    (Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84015, Israel)

  • Giora Kaplan

    (Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52621, Israel)

  • Arnona Ziv

    (Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52621, Israel)

  • Arnon D. Cohen

    (Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84015, Israel)

  • Liraz Olmer

    (Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52621, Israel)

  • Daphna Pollack

    (Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52621, Israel)

  • Ofra Kalter-Leibovici

    (Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52621, Israel
    Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel)

Abstract

Marginalized racial/ethnic minorities have disproportionately high rates of type 2 diabetes prevalence, complications and mortality. Researchers and policymakers have typically addressed these disparities using a deficit-based discourse focused on individual/cultural deficiencies or failure. A mixed-methods study was used to compare the deficit discourse to the perspectives of adults with diabetes in the Arab minority in Israel, using data from 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Both qualitative and quantitative data were triangulated. In addition, multivariable regression models tested associations between diabetes management perspectives and participant characteristics. Contrary to the deficit-based characterizations of patients as fatalistic and unknowledgeable, participants viewed diabetes as a chronic disease with serious complications. They expressed more support for patient responsibility in diabetes management than for passive fatalism, and were less fatalistic as educational level and adequacy of diabetes self-care training increased. The impact of social/environmental barriers and changing cultural norms on lifestyle behaviors was highlighted. Over 95% used prescription medications for diabetes management, although 35% reported economic barriers. The deficit discourse is not well-aligned with Arab patients’ evolving perceptions and needs, and has deflected attention from the socioeconomic/structural determinants of health, and the healthcare system’s responsibility to provide effective, culturally-relevant diabetes services.

Suggested Citation

  • Kathleen Abu-Saad & Nihaya Daoud & Giora Kaplan & Arnona Ziv & Arnon D. Cohen & Liraz Olmer & Daphna Pollack & Ofra Kalter-Leibovici, 2022. "Comparing Patient Perspectives on Diabetes Management to the Deficit-Based Literature in an Ethnic Minority Population: A Mixed-Methods Study," IJERPH, MDPI, vol. 19(22), pages 1-17, November.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:22:p:14769-:d:968364
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    References listed on IDEAS

    as
    1. Nihaya Daoud & Varda Soskolne & Jennifer S. Mindell & Marilyn A. Roth & Orly Manor, 2018. "Ethnic inequalities in health between Arabs and Jews in Israel: the relative contribution of individual-level factors and the living environment," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(3), pages 313-323, April.
    2. Moskowitz, G.B. & Stone, J. & Childs, A., 2012. "Implicit stereotyping and medical decisions: Unconscious stereotype activation in practitioners' thoughts about African Americans," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 996-1001.
    3. Peek, Monica E. & Odoms-Young, Angela & Quinn, Michael T. & Gorawara-Bhat, Rita & Wilson, Shannon C. & Chin, Marshall H., 2010. "Race and shared decision-making: Perspectives of African-Americans with diabetes," Social Science & Medicine, Elsevier, vol. 71(1), pages 1-9, July.
    4. Anat Jaffe & Shmuel Giveon & Liat Wulffhart & Bernice Oberman & Maslama Baidousi & Arnona Ziv & Ofra Kalter-Leibovici, 2017. "Adult Arabs have higher risk for diabetes mellitus than Jews in Israel," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-9, May.
    5. Maya Maor & Moflah Ataika & Pesach Shvartzman & Maya Lavie Ajayi, 2021. "“I Had to Rediscover Our Healthy Food”: An Indigenous Perspective on Coping with Type 2 Diabetes Mellitus," IJERPH, MDPI, vol. 19(1), pages 1-16, December.
    Full references (including those not matched with items on IDEAS)

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