Behavioral and Psychosocial Dynamics in Diabetes Management

A Path Analysis to Examine the Influence of Acculturation in Arab Immigrant Communities

Bibliographic Data

ID7146769
AuthorsHamzah Alzubaidi (0000-0001-5122-271X, University of Sharjah), Vitor Hugo Oliveira (0000-0002-1998-8579, inED Centre for Research and Innovation in Education, School of Education, Polytechnic of Porto , Porto), Ward Saidawi (0000-0003-0558-4765, Research Institute for Medical and Health Sciences, University of Sharjah , Sharjah), Raya Aljobowry (Research Institute for Medical and Health Sciences, University of Sharjah , Sharjah), Jonathan E Shaw (0000-0002-6187-2203, Clinical and Population Health, Baker Heart and Diabetes Institute , Melbourne), Catarina Samorinha (0000-0002-6662-0347, Research Institute for Medical and Health Sciences, University of Sharjah , Sharjah)
Year2025
Volume59
Issue1
Publication date2025-01-04
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAnnals of Behavioral Medicine (JOURNAL)
Journal identifiersISSN: 0883-6612 • E-ISSN: 1532-4796
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/abm/kaae062
PMID39432836
OpenAlexW4403591155
LanguageEN
References cited50

BACKGROUND: Type 2 diabetes mellitus (T2DM) prevalence is rising globally. Arab immigrants with T2DM, one of the least studied ethnic minorities, have a higher diabetes prevalence and more prominent management-related challenges compared with mainstream host societies. Acculturation's impact on self-care activities and diabetes distress (DD) is understudied globally. PURPOSE: To examine how acculturation affects self-care practices and DD in first-generation Arab immigrants with T2DM and how health literacy, illness perceptions, and self-efficacy mediate these associations. METHODS: This multicenter cross-sectional study was conducted in Victoria, Australia. Eligible patients were invited while waiting for their appointments. The questionnaire included validated tools to assess DD, self-care activities, health literacy, self-efficacy, and acculturation. We tested mediation hypothesis using path analysis, with a maximum likelihood estimation to calculate total, direct, and indirect effects and bias-corrected accelerated 95% CI. RESULTS: Overall, 382 Arab immigrants with T2DM participated, with an average age of 57.9 years (SD = 8.0). Half were males, most had low education, and were married. Participants lived in Australia for a mean of 19.1 years (SD = 8.3) and had diabetes for 7.1 years (SD =4.7). Higher acculturation was directly associated with decreased DD. Illness perceptions (p = .002) and self-efficacy (p = .001) mediated the association of acculturation with self-care activities, while health literacy did not. Additionally, self-efficacy fully mediated the relationship between acculturation and DD (p = .001). CONCLUSIONS: This research provided valuable insights into the complex interplay between acculturation, diabetes management, and psychosocial factors. Interventions targeting self-efficacy and illness perceptions may improve self-care activities and reduce DD among Arab immigrants with T2DM.

Acculturation · Distress · Ethnic group · Health care · Health literacy · Health psychology · Immigration · Psychiatry · Psychosocial · Public health · Sociology · Chronic Disease Management Strategies · Clinical Psychology · Diabetes Management and Education · Diabetes, Cardiovascular Risks, and Lipoproteins · Medicine · Nursing · Psychology · Gerontology

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