Type 2 Diabetes Self-Management in Older African American Men: Piloting Cultural and Gender-Specific Interventions

Background: Older African American men are at increased risk of Type 2 Diabetes (T2D) but demonstrate high rates of poor illness management. They also participate in interventions targeting illness management at extremely low rates and are at high risk for dropout from clinical trials. One modifiable factor that has been identified in the literature that contributes to these disparities is health beliefs particular to men. Yet, despite the fact that illness management interventions have been developed to meet the needs of African Americans, none have followed recommendations to use gender-sensitive programming to meet the needs of men. The primary aim of this study was to advance our understanding of the intersection of age, race/ethnicity and gender on T2D self-management among older African American men with T2D and to explore their preferences for a peer-led T2D self-management intervention.

Methods and Analysis: Two focus groups were conducted with older African American men (n = 16) over a 6-month period. Sessions lasted 90 minutes, were audiotaped, and analyzed using thematic content analysis and a grounded theory approach. Participants were recruited from a Midwestern research volunteer registry can be accessed by scholars conducting research of African Americans, 55 years of age and older who meet their study criteria. Questions asked in the  focus group interview guide related to “Men’s Health Care Related Behaviors and Beliefs” and “Men’s Preferences for Community Health Worker Interventions.” 

Results: This exploratory study focused on increasing our knowledge of how a group of older Black men felt their gender-related beliefs and values influenced their diabetes-related health behaviors. This study went beyond discussing gender’s influence on T2D self-management to also collect men’s perspectives on a lay-helper diabetes self-management intervention model. Four themes arose from the data and included: 1) impact of gender in diabetes management; 2) self-management barriers and facilitators; 3) men’s preferences for T2D self-management interventions; and lastly, 4) health care services.

Conclusions and Implications: Results suggest that gender values and beliefs, patient-provider communication and social and structural barriers may have implications for T2D self-management in older African American men and that this population may be receptive to a peer-led T2D self-management intervention.