Self-management of type 2 diabetes among African Americans in the Arkansas Delta: a strengths perspective in social-cultural context.

This qualitative study explored underlying factors influencing the promotion of type 2 diabetes (T2D) self-management among adult African Americans diagnosed with T2D in the Arkansas Delta. Our narrative approach gathered insights in the participants' own voices and placed their T2D self-management experiences in social-cultural-historical contexts. Using purposive sampling, 31 participants (16 women and 15 men) were selected and interviewed. The participants showed low awareness of T2D's chronic nature because of its asymptomatic or nonspecific symptoms. They interpreted medically prescribed dietary and physical exercise guidelines as impractical and culturally irrelevant for them. Medication non-adherence was due to inadequate knowledge and awareness of T2D as a chronic disease, and suspicion and mistrust of the formal medical system. To develop culturally-targeted interventions to advance self-management outcomes, we must understand from and with African Americans the strengths of social-cultural contexts in which they live and make their health behavior choices. Engaging African Americans diagnosed with T2D in community-based programs may be a promising approach.