Cultural basis for diabetes-related beliefs among low- and high-education African American, American Indian, and white older adults.

OBJECTIVES Racial and ethnic disparities in diabetes and subsequent complications are often attributed to culture; however, previous diabetes disparities research is restricted to in-depth ethnic-specific samples or to comparative study designs with limited belief assessment. The goal of our study was to improve understanding of the cultural basis for variation in diabetes beliefs. DESIGN Cross-sectional. SETTING Rural North Carolina. PARTICIPANTS Older adults (aged 60+) with diabetes, equally divided by ethnicity (White, African American, American Indian) and sex (N=593). INTERVENTIONS Guided by Explanatory Models of Illness and Cultural Consensus research traditions, trained interviewers collected data using 38 items in four diabetes belief domains: causes, symptoms, consequences, and medical management. Items were obtained from the Common Sense Model of Diabetes Inventory (CSMDI). MAIN OUTCOME Beliefs about diabetes. Response options for each diabetes belief item were "agree," "disagree" and "don't know." Collected data were analyzed using Anthropac (version 4.98) and Latent Gold (version 4.5) programs. RESULTS There is substantial similarity in diabetes beliefs among African Americans, American Indians and Whites. Diabetes beliefs were most similar in the symptoms and consequences domains compared to beliefs pertaining to causes and medical management. Although some discrete beliefs differed by ethnicity, systematic differences by ethnicity were observed for specific educational groups. CONCLUSIONS Socioeconomic conditions influence diabetes beliefs rather than ethnicity per se.