Heuristic Model Linking Contextual Processes to Self-Management in African American Adults With Type 2 Diabetes

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Abstract
PURPOSE This article examines the influence of various environmental factors on the diabetes self-care practices of African American adults with type 2 diabetes. METHODS A heuristic model was developed that considers how community barriers and supports, availability and use of insurance, diabetes education, medical provider-patient relationships, extended family processes, and psychological functioning may indirectly affect metabolic control through the patient's ability to regulate diabetes. RESULTS The proposed model offers a framework to demonstrate the complexity of diabetes management that may be unique to the African American experience. CONCLUSIONS A comprehensive view of the environmental context will lead to new and more effective approaches in diabetes education and counseling for African American adults with type 2 diabetes.