Exploring the impact of cultural beliefs in the self-management of type 2 diabetes among Black sub-Saharan Africans in the UK – a qualitative study informed by the PEN-3 cultural model

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Omodara, D.A., Gibson, L. ORCID: 0000-0002-1220-8680 and Bowpitt, G. ORCID: 0000-0002-0554-9444, 2021. Exploring the impact of cultural beliefs in the self-management of type 2 diabetes among Black sub-Saharan Africans in the UK – a qualitative study informed by the PEN-3 cultural model. Ethnicity and Health. ISSN 1355-7858

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Official URL: https://doi.org/10.1080/13557858.2021.1881764

Abstract

Objective
The purpose of this study was to examine cultural beliefs, attitudes, and practices of Black sub-Saharan Africans (BsSAs) in the UK regarding their type 2 diabetes (T2D) self-management using the concepts of the PEN-3 cultural model.

Method
A qualitative study involved 36 semi-structured interviews with BsSAs living with T2D in the UK to examine relevant cultural practices and beliefs that have contributed to the uneven burden of self-management behaviours. A narrative thematic analysis of the data was then conducted for the study using NVivo software and guided by the PEN-3 cultural model, which moves beyond individualistic health behaviour models of diabetes but centralises culture in understanding health behaviours.

Results
Cultural perceptions and self-management behaviours of T2D varied among the BsSAs. Systems of self-management and treatment practices that were congruent with their cultural beliefs and personal priorities were seen as essential in the positive response to self-managing T2D. Knowledge and perceptions of non-conventional and alternative remedies linked to cultural beliefs reflected the existential health-seeking behaviours, and the significance attached to BsSAs negotiated cultural identities and collective practices within the communities. Social network supports were seen as enablers while advice and regimens from healthcare professionals (HCPs) were presented as medicalised and devoid of cultural sensitivities to respondents.

Conclusion
The study findings highlight the need to be not only aware of the negative impact of diabetes perceptions and health behaviours among the BsSA communities, but also be aware of the enabling factors and collective practices within the communities that are equally critical in influencing the self-management and health-seeking decisions of BsSAs living with T2D. PEN-3 model was significant with exploring not only how cultural context shapes health beliefs and practices, but also how social networks and systems play a critical role in enabling or nurturing positive health behaviours and health outcomes.

Item Type:

Journal article

Publication Title:

Ethnicity and Health

Creators:

Omodara, D.A., Gibson, L. and Bowpitt, G.

Publisher:

Routledge

Date:

5 February 2021

ISSN:

1355-7858