Theses Doctoral

Self-management Practices and Perspectives of Spanish-speaking Older Dominican Adults with Type 2 Diabetes

Diaz Roman, Yessica

Background. Type 2 diabetes is the fifth-leading cause of death in Latinos in the United States. Diabetes is a commonly occurring health condition in older adults, leading to complications that can severely impact quality of life and hasten death. The burden of diabetes is considerable in the older adult population; almost four-fifths of adults with diabetes are older than 59 years. Diabetes mortality can be reduced or delayed with effective management of the illness. Older minority adults are more likely to have higher rates of adult-onset diabetes than non-Hispanic Whites, yet few studies have examined the diabetes self-management practices of this group. These issues are particularly important to investigate in older Dominican adults in Washington Heights/Inwood, New York City, because this group has unique cultural beliefs and practices, is rapidly increasing in population, and has a variety of unmet health-related needs. This study explored specific barriers encountered (cultural and structural) and the extent to which external factors are associated with self-management practices among older Dominican community residents living in mainland US with type 2 diabetes. After 20 years of health disparities research and intervention older adults continue to have problems accessing health care due to structural and socio-cultural barriers. Methods. This investigation utilized qualitative in-depth interviews to examine the cultural and structural barriers to health care and self-management practices existing in this group. Results. Thirty Dominicans 55 years and older were recruited through a community-based senior resource center from the mainland US. Self-management practices for type 2 diabetes vary and are represented by commonly known factors, including: 1) diet modifications; 2) glucose monitoring; 3) medication adherence; 4) exercise, and 5) diabetes classes. Findings from this study illustrate that male and female participants have mixed self-management practices that assist them in managing their diabetes. In addition, participants are interested in “learning” how to manage their diabetes through their participation in classes and diabetes-related workshops. Home remedies (remedies caseros) for type 2 diabetes were identified in this study. Conclusions. Programs and services that promote healthy self-management practices of older Latino adults need to include a focus on the unique cultural beliefs and behaviors of the individual as well as the broader situational context that impacts their diabetes self-management. Such information is invaluable for researchers and health practitioners interested in diabetes self-management practices of older minority adults.


  • thumnail for DiazRoman_cumc.columbia_0054E_10066.pdf DiazRoman_cumc.columbia_0054E_10066.pdf application/pdf 1.45 MB Download File

More About This Work

Academic Units
Sociomedical Sciences
Thesis Advisors
Raveis, Victoria H.
Dr.P.H., Mailman School of Public Health, Columbia University
Published Here
December 28, 2020