African American families not only share a higher risk for Type 2 diabetes, but many myths and misconceptions about the disease are often passed on from one generation to the next.
To understand how family experiences influence risk and management of the disease, a team of Iowa State University (ISU) researchers interviewed parents and adult children of 20 African American families with strong histories of Type 2 diabetes. The interviews focused on diagnosis, physical activity and nutrition, resources for managing the disease, family support and communication, and allowed researchers to dig deeper into family dynamics.
“We wanted to get into the meanings and nuances within the family culture to identify some malleable targets we can work with,” said Tera Jordan, an ISU associate professor of human development and family studies who conducted the interviews.
The study, published in the journal Global Qualitative Nursing Research, identified two primary themes—family interactions and intergenerational openness—that shaped what younger generations knew and did about the disease. Brianna Routh, lead author and assistant professor at Montana State University, was part of the research team while a graduate student at Iowa State. She says the results provide insight that may help doctors and nurses counsel African American patients.
For example, many in the African American community know there is a genetic component but are less aware of how physical activity and nutrition can prevent or mitigate effects of the disease, Jordan said.
Previous studies have shown family history—regardless of race, age, or income—is a strong predictor of obesity and type 2 diabetes. In their paper, ISU researchers explained that cultural acceptance of larger body size and optimistic bias may limit African Americans’ perceived risk for the disease. Some are also skeptical of the medical system, which can have negative consequences.
As with many cultures, food plays a central role in African American families. In the interviews, Jordan says several parents and children talked about special foods prepared for holidays and family meals. Parents explained that they made the dishes for their children, but the children often did not realize the health consequences for their parents. For some families, the interviews were the first time they had talked about these issues.
Some parents openly talked about diabetes with their children and modeled healthy behaviors, but the study revealed a need for greater communication within families as well as with medical professionals. The researchers noted gender differences—men were less likely to discuss their diagnosis—as well as concerns from parents reluctant to talk about it because they did not want to worry their children.