‘It is in our hands—Why wait until you are sick?’: Perceptions about diabetes prevention of Latina mothers in Mexico and the United States

• Type of Material: Article
• Authors: Ashley Mulcahy Toney, University of Texas, Houston; Maria Pineros-Leano, Boston College; Nancy Jacquelyn Pérez-Flores, Washington University, St. Louis; Diana Gomez, Boston College; Liliana Aguayo, Emory University
• Language: English
• Date: 2023-02-17
• Publisher: John Wiley and Sons
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2023 Diabetes UK.
• Final Published Version (URL): https://doi.org/10.1111/dme.15060
• Title of Journal or Parent Work: Diabetic Medicine
• Volume: 40
• Issue: 7
• Start Page: e15060
• Grant/Funding Information: This research study was supported by a seed grant awarded to LA and MPL through the training grant ‘Illinois Transdisciplinary Obesity Prevention Program (I-TOPP)’ funded by the National Institute of Food and Agriculture (USDA), under Award No. 2011-67001-30101. LA and this study were supported by the National Institute of Diabetes and Digestive and Kidney Diseases (17SFRN33660752 and 115937-03S2).
• Keywords: Health Belief Model (HBM); Latino/Hispanic; qualitative research; type 2 diabetes mellitus; diabetes
• Research Categories: Health Sciences, Public Health

Abstract

Aims: This study aimed to understand the perceptions driving type 2 diabetes mellitus prevention and management behaviours of Mexican and Latina mothers in Mexico and the United States. Methods: Low-income Mexican mothers in San Luis Potosí, Mexico and Latina mothers in Illinois, United States, were recruited by the Holistic Obesity Prevention Study (HOPS). Verbatim transcripts of the semistructured interviews conducted in Spanish (n = 24) and English (n = 1) were analysed using the Health Belief Model (HBM) framework. Results: Of the 25 participants, 22 (88%) indicated ‘knowing someone with diabetes’—specifically a father (n = 8), mother (n = 6) or grandparent (n = 7). Using the HBM, themes showed that mothers perceived: that Type 2 diabetes can happen to anyone, are attributable to genetic predisposition and may be driven by strong emotions (perceived susceptibility). Type 2 diabetes introduces severe comorbidities and emotional difficulties for people and their families (perceived severity). Adopting a healthier diet, exercising and staying in good spirits were recognized as benefits of Type 2 diabetes prevention (perceived benefits). The costs of food, challenges of exercising, dieting, modifying habits and time limitations were recognized as perceived costs. Cues to action included doctors’ recommendations (external) and fear (internal). Mothers acknowledged they could live a healthy life by controlling their weight, exercising, adhering to treatments/medications and having the determination to carry-on (self-efficacy). Conclusions: Mothers sought to prevent Type 2 diabetes and live healthy lives, particularly, after receiving a diagnosis of gestational diabetes or when learning about their children’s risks for Type 2 diabetes but perceived significant barriers to Type 2 diabetes prevention.