Psychosocial impacts of type 2 diabetes self-management in a rural African-American population.

This qualitative study explored the underlying psychosocial factors and conditions that may influence type 2 diabetes (T2D) self-management among adult T2D-diagnosed African Americans in the Arkansas Delta. Listening to participants' narratives in their own voices provided meaningful insights in their real-life experiences of T2D-related psychological and emotional challenges in African American social cultural contexts. Self-determination theory was used to conceptualize the participants' motivations for making health behavior changes. Using purposive sampling, 31 participants total (16 women and 15 men) were interviewed. The study participants described their (1) concern over prescribed dietary and physical exercise guidelines as impractical and culturally not relevant to them; (2) doubts over the availability of social supports necessary to implement T2D self-management; and (3) fatalistic expectations of negative outcomes that undermined their self-motivation to follow self-management guidelines. Specific strategies for developing culturally competent T2D self management guidelines and community-based communication outreach initiatives are discussed.