Social Ecology and Diabetes Self-Management among Pacific Islanders in Arkansas.

Autor:	McElfish PA; Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, USA., Moore R; Department of Anthropology, University of Arkansas, USA., Woodring D; Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, USA., Purvis RS; Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, USA., Maskarinec GG; Family Medicine and Community Health, University of Hawai'i at Manoa, USA., Bing WI; Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, USA., Hudson J; Pharmacy Practice, University of Arkansas for Medical Sciences Northwest, USA., Kohler PO; University of Arkansas for Medical Sciences Northwest, USA., Goulden PA; College of Medicine, University of Arkansas for Medical Sciences, USA.
Jazyk:	angličtina
Zdroj:	Journal of family medicine and disease prevention [J Fam Med Dis Prev] 2016; Vol. 2 (1). Date of Electronic Publication: 2016 Mar 14.
DOI:	10.23937/2469-5793/1510026
Abstrakt:	Chronic diseases disproportionately affect ethnic and racial minorities. Pacific Islanders, including the Marshallese, experience some of the highest documented rates of type 2 diabetes. Northwest Arkansas is home to the largest population of Marshallese outside of the Republic of the Marshall Islands, and many migrants are employed by the local poultry industry. This migrant population continues to increase because of climate change, limited health care and educational infrastructure in the Marshall Islands, and the ongoing health effects of US nuclear testing. The US nuclear weapons testing program had extensive social, economic, and ecological consequences for the Marshallese and many of the health disparities they face are related to the nuclear fallout. Beginning in 2013, researchers using a community-based participatory (CBPR) approach began working with the local Marshallese community to address diabetes through the development and implementation of culturally appropriate diabetes self-management education in a family setting. Preliminary research captured numerous and significant environmental barriers that constrain self-management behaviors. At the request of our CBPR stakeholders, researchers have documented the ecological barriers faced by the Marshallese living in Arkansas through a series of qualitative research projects. Using the Social Ecological Model as a framework, this research provides an analysis of Marshallese health that expands the traditional diabetes self-management perspective. Participants identified barriers at the organizational, community, and policy levels that constrain their efforts to achieve diabetes self-management. We offer practice and policy recommendations to address barriers at the community, organizational, and policy level. Competing Interests: Conflicts of Interest The authors have no conflict of interest to disclose.
Databáze:	MEDLINE
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