Cultural orientation and diabetes self-care in low-income African Americans with type 2 diabetes mellitus

Objectives: The purpose of the study was to examine the relationships between cultural variables and diabetes self-care behaviors and glycemic control among African Americans with type 2 diabetes. Design: Cross-sectional survey. Methods: Questionnaires assessing traditional African-American cultural orientation, ethnic identity, self-identification, and diabetes self-care were administered to a sample of 94 low-income, African-American, inner-city hospital outpatients with type 2 diabetes. Participants were predominantly female (64%), with an average age of 53 years, and most had attained less than or equal to a high school education (66%). Results: No significant relationships were found among ethnic identity, self-identification, glycemic control, and diabetes self-care behaviors. Traditional African-American cultural orientation was significantly associated with decreased dietary adherence scores (P<.03). Increased scores on cultural mistrust were related to decreased dietary adherence scores (P<.002). Traditional food practices showed a non-significant trend toward decreased dietary adherence in conjunction with number of dependents and income (P<.055). Conclusions: Traditional African-American cultural orientation was found to be associated with decreased dietary adherence scores in a sample of urban African Americans with type 2 diabetes. Assessment of the cultural orientation of African-American patients has the potential to assist providers in designing culturally tailored, diabetes-specific dietary interventions.