COVID-19 stressors for Hispanic/Latino patients living with type 2 diabetes: a qualitative study

Frontiers in Clinical Diabetes and Healthcare

Clinical Diabetes and Healthcare

Lawrence M. Murray¹  Amgad N. Makaryus²  Roman Zeltser²  Alyson K. Myers³  Yael T. Harris⁴  Edgardo Cigaran⁵  Jose Marino⁵  Sabrina Martinez⁵  Jennifer Polo⁵  Valeria Correa Gomez⁵  Nicole Goris⁵  Vidhi H. Patel⁶  Renee Pekmezaris⁶  Myia S. Williams⁶  Ralph J. DiClemente⁷  Dilcia Granville⁷  Samy I. McFarlane⁸  Martin L. Lesser⁹  Myriam Kline^1,10  Josephine Guzman^1,11  Paulina Barbero^1,11 

[1] Annie E. Casey Foundation Children and Family Fellowship, Baltimore, MD, United States;Department of Cardiology, Nassau University Medical Center, East Meadow, NY, United States;Department of Medicine, Division of Endocrinology, Albert Einstein/Montefiore, Bronx, NY, United States;Department of Medicine, Division of Endocrinology, North Shore University Hospital, Manhasset, NY, United States;Department of Medicine, Division of Health Services Research, Northwell Health, Manhasset, NY, United States;Department of Medicine, Division of Health Services Research, Northwell Health, Manhasset, NY, United States;Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States;Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, United States;Department of Social and Behavioral Sciences, New York University (NYU) School of Global Public Health, New York, NY, United States;Hispanic Counseling Center, Hempstead, NY, United States;Division of Infectious Disease, College of Medicine, SUNY-Downstate Health Sciences University, Brooklyn, NY, United States;Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States;Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, United States;Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, United States;Northwell Health, Manhasset, NY, United States;

关键词: health disparities;    COVID-19, telemonitoring;    racial/ethnic minorities;    health equity;    stakeholder engagement;   

DOI  :  10.3389/fcdhc.2023.1070547

 received in 2022-10-15, accepted in 2023-03-16,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background and aimDuring the early stages of the COVID-19 pandemic, nationwide lockdowns caused disruption in the diets, physical activities, and lifestyles of patients with type 2 diabetes. Previous reports on the possible association between race/ethnicity, COVID-19, and mortality have shown that Hispanic/Latino patients with type 2 diabetes who are socioeconomically disadvantaged are disproportionately affected by this novel virus. The aim of this study was to explore stressors associated with changes in diabetes self-management behaviors. Our goal was to highlight the health disparities in these vulnerable racial/ethnic minority communities and underscore the need for effective interventions.Methods and participantsParticipants were enrolled in part of a larger randomized controlled trial to compare diabetes telehealth management (DTM) with comprehensive outpatient management (COM) in terms of critical patient-centered outcomes among Hispanic/Latino patients with type 2 diabetes. We conducted a thematic analysis using patient notes collected from two research nurses between March 2020 and March 2021. Two authors read through the transcripts independently to identify overarching themes. Once the themes had been identified, both authors convened to compare themes and ensure that similar themes were identified within the transcripts. Any discrepancies were discussed by the larger study team until a consensus was reached.ResultsSix themes emerged, each of which can be categorized as either a source or an outcome of stress. Sources of stress associated with the COVID-19 pandemic were (1) fear of contracting COVID-19, (2) disruptions from lockdowns, and (3) financial stressors (e.g., loss of income). Outcomes of COVID-19 stressors were (1) reduced diabetes management (e.g., reduced diabetes monitoring and physical activity), (2) suboptimal mental health outcomes (e.g., anxiety and depression), and (3) outcomes of financial stressors.ConclusionThe findings indicated that underserved Hispanic/Latino patients with type 2 diabetes encountered a number of stressors that led to the deterioration of diabetes self-management behaviors during the pandemic.

【 授权许可】

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Copyright © 2023 Williams, Cigaran, Martinez, Marino, Barbero, Myers, DiClemente, Goris, Gomez, Granville, Guzman, Harris, Kline, Lesser, Makaryus, Murray, McFarlane, Patel, Polo, Zeltser and Pekmezaris