The Arab American experience with diabetes: Perceptions, myths and implications for culturally-specific interventions.

Culturally-specific lifestyle diabetes prevention programs require an assessment of population disease perceptions and cultural influences on health beliefs and behaviors. The primary objectives were to assess Arab Americans' knowledge and perceptions of diabetes and their preferences for a lifestyle intervention. Sixty-nine self-identified Arab or Arab Americans ≥30 years of age and without diabetes participated in 8 focus groups. Emerging themes from the data included myths about diabetes etiology, folk remedies, and social stigma. The main barrier to healthcare was lack of health insurance and/or cost of care. Intervention preferences included gender-specific exercise, group-delivered education featuring religious ideology, inclusion of the family, and utilization of community facilities. Lifestyle interventions for Arab Americans need to address cultural preferences, diabetes myths, and folk remedies. Interventions should incorporate Arabic cultural content and gender-specific group education and exercise. Utilization of family support and religious centers will enable culturally-acceptable and cost-effective interventions.

Bertran EA ，Pinelli NR ，Sills SJ ，Jaber LA ... -  《-》

A culturally adapted lifestyle intervention addressing a Middle Eastern immigrant population at risk of diabetes, the MEDIM (impact of Migration and Ethnicity on Diabetes In Malmö): study protocol for a randomized controlled trial.

Saha S ，Leijon M ，Gerdtham U ，Sundquist K ，Sundquist J ，Arvidsson D ，Bennet L ... -  《-》

Challenges in insulin initiation among Hispanics/Latinos with diabetes in the United States.

The prevalence of diagnosed diabetes in the United States (U.S.) is particularly high among people of Hispanic/Latino ethnicity, placing this population at risk of developing diabetes-related complications. We conducted a systematic literature review to understand and communicate the current gaps and disparities, including myths and misconceptions, regarding insulin initiation among the Hispanic/Latino population in the U.S. We searched MEDLINE and MEDLINE In-process, e-pubs ahead of print (OvidSP), EMBASE (OvidSP), and the Cochrane Central Register of Controlled Trials (CENTRAL). The search strategy combined free text and controlled vocabulary terms and was developed to identify challenges associated with insulin use and initiation, as well as myths/misconceptions associated with insulin use. The quality of included studies was assessed using the National Institutes of Health (NIH) quality assessment tool. In total, 777 articles were identified, with 13 articles included for data synthesis. Frequently reported barriers to initiating diabetes treatment among the Hispanic/Latino community related to socioeconomic and sociocultural factors. In particular, limited health literacy and access to health care, as well as low education and economic status, were common factors preventing treatment initiation for diabetes. Cultural factors, including language, food preferences, and lack of family support were also evident, with misconceptions and fears concerning insulin being commonly reported. Patients also described barriers concerning health care providers, including interpersonal issues and difficulties with communication and language. Overall, the current literature highlights many obstacles facing Hispanic/Latino patients in initiating insulin treatment for diabetes. Although limited research was identified, we describe common barriers and themes among this minority population. Awareness of these barriers is important for health care providers, enabling them to identify and address insulin-related fears and misconceptions and to be mindful of their cultural competency. Additionally, knowledge of current barriers will guide further research aimed at developing tailored strategies and tools to improve long-term health outcomes and quality of life in this population.

Kaushik P ，Reed B ，Kalirai S ，Perez-Nieves M ... -  《-》

The Impact of Arab American Culture on Diabetes Self-management Education.

The purpose of this study was to better understand barriers and facilitators of diabetes self-management education (DSME) among Arab American patients with diabetes. Little is known about the impact of Arab culture on DSME. Arab American adults (N = 23) with medically managed diabetes participated in 1 of 3 focus groups. An Arabic-speaking, trained moderator conducted video-recorded sessions. Verbatim Arabic transcripts were translated into English. Transcripts underwent a qualitative content analysis approach. Arab American cultural traditions such as food sharing, religious beliefs, and gender roles both facilitated and at times impeded DSME. Patients also held conflicting views about their interactions with their providers; some participants praised the authoritative patient-physician relationship style while others perceived the gaps in communication to be a product of Arab culture. Participants expressed that lack of available educational and supportive resources are key barriers to DSME. Arab American culture affects DSM activities, and culturally sensitive educational resources are lacking. Development of DSME programs tailored to address relevant aspects of Arab culture might improve DSME outcomes in Arab American population.

Bertran EA ，Fritz H ，Abbas M ，Tarakji S ，DiZazzo-Miller R ，Pociask FD ，Lysack CL ，Arnetz J ，Jaber LA ... -  《-》

Diabetes self-management among Arab Americans: patient and provider perspectives.

Fritz H ，DiZazzo-Miller R ，Bertran EA ，Pociask FD ，Tarakji S ，Arnetz J ，Lysack CL ，Jaber LA ... -  《-》