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Presentation2
1. Hispanic Americans Perceived Barriers to Lifestyles Changes In Type 2
Diabetics: Partial Literature Review
Nahomy Marrero
Maryville University Online
2. Hispanic Americans Perceived Barriers to Lifestyles Changes In Type 2
Diabetics
Purpose Statement
• The purpose of this comprehensive review is to
analyze the broad question of what are the
perceived barriers to lifestyle changes among
Hispanic Americans that affect glycemic control
and positive health outcomes in this population.
Additionally, are there differences in perceived
barriers to change among subgroups of
Hispanics? Lastly, are there differences or
similarities in gender regarding perceived
barriers to lifestyle modification in Latinos?
Understanding the perceived barriers of
Hispanic Americans to improved glycemic
control will provide insight in tailoring effective
diabetes intervention strategies for this
population of Americans.
PICO Question
• How do adult Hispanics
with diagnosed type 2
diabetes perceive barriers
to implementing dietary
and lifestyle changes to
reduce A1C levels in the
first 3 months after
diagnosis?
3. Key Findings
90-95% of Diabetics are Type 2 Diabetics
In Hispanic Americans type 2 diabetes is diagnosed at younger ages 3.2% compared to non-Hispanics 1.3%
Cross- sectionally 9.8% of Hispanics have diabetes compared to 5% of non-Hispanics
By 2031 20% of Hispanics will be diagnosed with diabetes.
Introduction
• Diabetes Mellitus compromises a group of disorders that have
the common feature of having abnormally elevated blood
glucose levels. According to the Centers for Disease Control
and Prevention the most common form is type 2 Diabetes that
affects 90-95% of diabetics (Centers for Disease Control and
Prevention, 2004). Key findings indicate that Diabetes affects
Hispanic Americans at a younger age and with diagnosed
cases at 3.2 % compared to 1.3 % in non-Hispanics whites.
Cross sectionally 9.8% of Latinos have diabetes compared to
5% of non-Hispanic Whites (Centers for Disease Control and
Prevention, 2004).
• Additionally, there is a corresponding increase in the number
of complications associated with diabetes including
cardiovascular and end-stage renal disease, microalbuminuria,
micro and macrovascular complications, and amputation
(Sullivan, Hicks, Salazar, & Robinson, 2010, p. 384). Despite
the evidence that self-management interventions such as diet,
exercise and medical management improve glycemic control
and health outcomes these strategies are less effective among
Hispanics, which indicates, that other factors may affect
glycemic control in this population (Cherrington, Ayala,
Scarinci, & Corbie-Smith, 2011, p. 280).
Search History
• A literature review found that perceived barriers of
Hispanics to lifestyle modifications have been analyzed
in the domains of health, socioeconomics, behavioral
psychology, and culture, and emphasizes the significance
of these factors on influencing diabetes management
among this population. MEDLINE and CINAHL
databases were searched with limiters of full-text and
peer reviewed from the period of 1990 to 2013.
Keywords used were: 1.) Diabetes OR Type 2 OR non-
insulin dependent diabetes mellitus/niddm; 2.) Perceived
barriers OR barriers OR obstacles; 3.) Hispanics OR
Latinos OR Hispanic Americans OR Latino Americans;
4.) Implementing Or Dietary Or Lifestyle. Searches
were based on (1), (2), (3), and (4) with Boolean phrase
AND in combination. Inclusion criteria were adults,
Hispanics residing in the United States, and type 2
diabetes. Articles that had as the sample population
pregnant Latinas or Hispanics residing outside the
United States were excluded. Bibliographic data and
abstracts were scanned for additional articles and
relevance, respectively.
6. Conclusion
• In Hispanic Americans diabetes is an epidemic and by 2031 is predicted to be
diagnosed in 20% of Latinos in the U.S. However, it is estimated that only
50% on diabetics in general attain glycemic control and even less is evidenced
in Hispanic populations (as cited in Cherrington et al., 2011, p. 280). The
devastating consequences of this disease and its implications personally
sparked the question of how perceived barriers to lifestyle modifications in
this population of Americans affects glycemic control. The literature
reviewed evaluated perceived barriers in context of behavioral psychology and
found that cognitive behavioral frameworks and concepts were often studied
in relation to lifestyle modification in Hispanics. However, as some
researchers stated, self-efficacy, and sense of control are limited in describing
the full experience of Hispanic Americans on self-management behaviors.
• Diabetes self-management in Hispanic adults also entails an understanding of
diabetes knowledge, diet and exercise barriers, social support, cost, and access
to care. In addition, perceptions of language, health literacy and provider
interactions should be considered. Finally, variations in and among Hispanic
sub-groups and gender differences offer insight into perceived barriers to
diabetes self-management strategies. Interventions for this population must be
targeted and culturally sensitive to the needs of Latino’s in order to attain
positive outcomes.
• Lastly, future areas of research should evaluate discrimination as a barrier to
health care and its subsequent negative effect on self-management behaviors.
References
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