scholarly journals Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

2021 ◽  
Author(s):  
Justine Chan ◽  
Margaret De Melo ◽  
Jacqui Gingras ◽  
Enza Gucciardi
Keyword(s):  
Food Insecurity ◽  
Low Income ◽  
Local Community ◽  
Diabetes Education ◽  
Self Management ◽  
Semistructured Interview ◽  
Management Support ◽  
Urban Centre ◽  
Education Centre ◽  
Screening Questions

Objective. To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

scholarly journals Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Justine Chan ◽  
Margaret DeMelo ◽  
Jacqui Gingras ◽  
Enza Gucciardi
Keyword(s):  
Food Insecurity ◽  
Low Income ◽  
Local Community ◽  
Diabetes Education ◽  
Self Management ◽  
Semistructured Interview ◽  
Management Support ◽  
Urban Centre ◽  
Education Centre ◽  
Screening Questions

Objective.To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre.Design.Qualitative study comprising of in-depth interviews, using a semistructured interview guide.Setting.Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada.Participants.Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions).Method.Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews.Main Findings.Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience.Conclusion.Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

scholarly journals Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

2021 ◽  
Author(s):  
Justine Chan ◽  
Margaret De Melo ◽  
Jacqui Gingras ◽  
Enza Gucciardi
Keyword(s):  
Food Insecurity ◽  
Low Income ◽  
Local Community ◽  
Diabetes Education ◽  
Self Management ◽  
Semistructured Interview ◽  
Management Support ◽  
Urban Centre ◽  
Education Centre ◽  
Screening Questions

Objective. To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

scholarly journals Food Insecurity in Primary Care: Patient Perception and Preferences

2020 ◽  
Vol 52 (3) ◽  
pp. 202-205
Author(s):  
Anil Kopparapu ◽  
Greg Sketas ◽  
Taren Swindle
Keyword(s):  
Primary Care ◽  
Food Security ◽  
Food Insecurity ◽  
Care Setting ◽  
Local Community ◽  
Primary Care Setting ◽  
Primary Care Patient ◽  
Care Patient ◽  
Food Security Status ◽  
Screening Questions

Background and Objectives: Screening for and addressing food insecurity in primary care may improve associated comorbidities. The purpose of this study was to explore patient attitudes regarding screening for food insecurity and to elicit patient preferences for intervention in a primary care setting. Methods: Patients (N=284) completed a brief, voluntary survey in a university-based clinic and two community-based clinics over a 5-month period. Respondents were classified as either food-secure or food-insecure based on their responses to a validated food insecurity screener. Results: Participants stated that screening for food insecurity was valuable in the primary care setting (83.9%). Patients preferred having a nurse ask the screening questions (41.2%). The most popular intervention preference, regardless of food security status or clinic type, was to provide a list of food bank locations (76.4%) and local community organizations (71.6%) and to have referral to financial assistance programs (75.4%). There were no differences in preferences for screening or attitudes toward screening by food security status or clinic type (all P≥.05). Conclusions: Screening for food insecurity is not yet standard practice, partly due to concerns over potentially alienating patients with the screening questions. Based on our surveyed patient population and their indicated preferences, screening and providing resource referrals for food insecurity is not likely to damage the clinician-patient relationship.

scholarly journals Patients’ Experiences of Using Smartphone Apps to Support Self-Management and Improve Medication Adherence in Hypertension: Qualitative Study

10.2196/17470 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e17470
Author(s):  
Ciara M McBride ◽  
Eimear C Morrissey ◽  
Gerard J Molloy
Keyword(s):  
Medication Adherence ◽  
Personal Responsibility ◽  
Self Management ◽  
Antihypertensive Drug Therapy ◽  
Semistructured Interview ◽  
Management Support ◽  
Smartphone Apps ◽  
Improve Medication Adherence ◽  
Self Monitoring ◽  
Feasible Method

Background Worldwide, hypertension control rates remain suboptimal despite clinically effective antihypertensive drug therapy. Patient failure to take medication as prescribed (ie, nonadherence) is the most important factor contributing to poor control. Smartphone apps can facilitate the delivery of evidence-based behavior change techniques to improve adherence and may provide a scalable, usable, and feasible method to deliver self-management support. Objective The aim of this study is to explore patients’ experiences of the usability and feasibility of smartphone apps to support self-management and improve medication adherence in hypertension. Methods A qualitative descriptive study was conducted. A total of 11 people living with hypertension from the West of Ireland were sampled purposively and interviewed about their experience of using a self-management app for a 4-week period, which included two key functionalities: self-monitoring of blood pressure (BP) and medication reminders. Thematic analysis was carried out on the semistructured interview data. Results Participants’ age ranged from 43 to 74 years (mean 62 years, SD 9.13). Three themes were identified: digital empowerment of self-management, human versus digital systems, and digital sustainability. Although patients’ experience of using the technology to self-monitor BP was one of empowerment, characterized by an enhanced insight and understanding into their condition, control, and personal responsibility, the reminder function was only feasible for patients who reported unintentional nonadherence to treatment. Patients experienced the app as a sustainable tool to support self-management and found it easy to use, including those with limited technological competence. Conclusions The study’s findings provide new insights into the experience of using apps to support medication adherence in hypertension. Overall, the data support apps as a usable and feasible method to aid self-management of hypertension and highlight the need for personalized functionality, particularly with regard to medication adherence reminder strategies. The study’s findings challenge the perspective that the use of these technologies to support self-management can inevitably add to the burden of treatment experienced by patients.

scholarly journals Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes

2018 ◽  
Vol 3 (6) ◽  
pp. e001068 ◽  
Author(s):  
Josefien van Olmen ◽  
Peter Delobelle ◽  
David Guwatudde ◽  
Pilvikki Absetz ◽  
David Sanders ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Low Income ◽  
Income Country ◽  
Rural Setting ◽  
Self Management ◽  
Management Support ◽  
Reciprocal Learning ◽  
Stakeholder Interaction ◽  
Cross Site

This paper reports on the use of reciprocal learning for identifying, adopting and adapting a type 2 diabetes self-management support intervention in a multisite implementation trial conducted in a rural setting in a low-income country (Uganda), a periurban township in a middle-income country (South Africa) and socioeconomically disadvantaged suburbs in a high-income country (Sweden). The learning process was guided by a framework for knowledge translation and structured into three learning cycles, allowing for a balance between evidence, stakeholder interaction and contextual adaptation. Key factors included commitment, common goals, leadership and partnerships. Synergistic outcomes were the cocreation of knowledge, interventions and implementation methods, including reverse innovations such as adaption of community-linked models of care. Contextualisation was achieved by cross-site exchanges and local stakeholder interaction to balance intervention fidelity with local adaptation. Interdisciplinary and cross-site collaboration resulted in the establishment of learning networks. Limitations of reciprocal learning relate to the complexity of the process with unpredictable outcomes and the limited generalisability of results.

scholarly journals Automated Telephone Self-Management Support for Diabetes in a Low-Income Health Plan: A Health Care Utilization and Cost Analysis

2015 ◽  
Vol 18 (6) ◽  
pp. 412-420 ◽  
Author(s):  
Judy Quan ◽  
Alexandra K. Lee ◽  
Margaret A. Handley ◽  
Neda Ratanawongsa ◽  
Urmimala Sarkar ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Analysis ◽  
Health Care Utilization ◽  
Health Plan ◽  
Low Income ◽  
Self Management ◽  
Care Utilization ◽  
Management Support

scholarly journals Perspectives from Underserved African Americans and their Healthcare Providers on the Development of a Diabetes Self-Management Smartphone Application: Exploratory Study (Preprint)

2020 ◽  
Author(s):  
Tai Barber-Gumbs ◽  
Ylva Trolle Lagerros ◽  
Laura M. Sena ◽  
Joel Gittelsohn ◽  
Larry W. Chang ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Low Income ◽  
Diabetes Education ◽  
Healthcare Providers ◽  
Smartphone Application ◽  
Self Management ◽  
The Us ◽  
Management Recommendations ◽  
P Type

BACKGROUND Type 2 diabetes mellitus (T2DM) affects ~10% of the US population, disproportionately affecting African Americans. Smartphone applications (apps) have emerged as promising tools to improve diabetes self-management, yet little is known about the use of this approach in low-income minority communities. OBJECTIVE The goal of the study was to explore which features of an app were prioritized for people with T2DM in a low-income African-American community. METHODS Between February 2016 and May 2018, we conducted formative qualitative research with 78 participants to explore how a smartphone app could be used to improve diabetes self-management. Information was gathered on desired features and app mockups were presented to receive comments and suggestions of improvements from smartphone users with prediabetes/T2DM, their friends and family members, and healthcare providers (in 6 interactive forums, 1 focus group and 15 in-depth interviews). We carried out thematic data analysis using an inductive approach. RESULTS All three types of participants reported that difficulties with access to healthcare was a main problem and suggested that an app could help address this. Participants also indicated that an app could provide information for diabetes education and self-management. Other suggestions included that the app should allow people with T2DM to log and track diabetes care-related behaviors and receive feedback on their progress in a way that would increase a person with T2DM’s engagement in self-management. CONCLUSIONS We identified educational and tracking smartphone features that can guide development of diabetes self-management apps for a low-income African-American population. Considering those features in combination gives rise to opportunities for more advanced support, such as determining self-management recommendations based on data in user's logs. CLINICALTRIAL

Self-efficacy in disadvantaged communities: Perspectives of healthcare providers and clients

2021 ◽  
pp. 174239532110497
Author(s):  
Ruth Hardman ◽  
Stephen Begg ◽  
Evelien Spelten
Keyword(s):  
Behaviour Change ◽  
Low Income ◽  
Self Efficacy ◽  
Resource Constraints ◽  
Outcome Expectations ◽  
Self Management ◽  
Management Support ◽  
Health Providers ◽  
Management Interventions

Objective Most chronic disease self-management interventions emphasise the integral role of self-efficacy in achieving behaviour change. We explored the applicability of this model in a low-income setting, from the perspective of both patients and clinicians. Methods Interviews with multimorbid patients and their health providers at two rural community health centres in Victoria, Australia. We used a phenomenological methodology, exploring themes of confidence to manage health, outcome expectations and goals. Results Many assumptions in which the self-efficacy model is grounded did not apply to this population. Past experiences and resource constraints, especially poverty and healthcare access, influenced confidence, expectations and the ability to achieve desired outcomes. Discussion The focus of traditional self-management support on individual behaviour change disadvantages rural low-income patients, who face barriers related to life experience and resource constraints. For this group, self-management support needs to return to its roots, moving away from a narrow conception of behaviour change and reinstating the role of ‘support’ into ‘self-management support’ interventions. Health providers working in rural low-income settings should recognise the limits inherent in self-efficacy focussed interventions and think broadly about engaging with their clients in whatever way supports them to find a life with meaning and purpose.

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