Explanatory models of diabetes in the U.S. and Mexico: The patient-provider gap and cultural competence

Susan Weller, Roberta D. Baer, Javier Garcia de Alba Garcia, Ana L. Salcedo Rocha

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Successful management of type 2 diabetes requires support and collaboration between diabetic patients, their health care providers, family and community. Using data collected in 1994-2001, we describe illness beliefs of physicians, patients, and representative samples of community members in the US and Mexico. We test whether differences in conceptualizations of diabetes are greater across national and linguistic boundaries or between physicians and lay groups. Interviews were conducted in southern Texas on the Mexican border and in Guadalajara, Mexico. Culturally appropriate interview materials were developed with a mixed-methods approach. Qualitative interviews elicited beliefs about causes, risks, symptoms, and treatments for diabetes and salient themes were incorporated into structured interviews. A cultural consensus analysis was used to verify salient themes within each of the six samples. The consistency in responses in each of the six samples indicated a shared core of beliefs that transcended individual variations. The greatest differences occurred between physician and lay samples; patient and community models were more similar to one another than to the physician models. Differences between physicians and patients may affect optimal management of diabetes, but these differences do not appear to be simply a function of differences in national culture and language, as the largest differences occurred in Mexico. This suggests that rather than cultural competence per se, formal educational levels and class differences may also play an important role in patient understanding and the gap in patient-provider understanding.

Original languageEnglish (US)
Pages (from-to)1088-1096
Number of pages9
JournalSocial Science and Medicine
Volume75
Issue number6
DOIs
StatePublished - Sep 2012

Fingerprint

Cultural Competency
Mexico
chronic illness
physician
Physicians
Interviews
interview
community
Patient Advocacy
national culture
Linguistics
qualitative interview
management
Health Personnel
Type 2 Diabetes Mellitus
Consensus
Language
illness
Cultural Competence
Diabetes

Keywords

  • Cultural consensus theory
  • Diabetes mellitus
  • Ethnicity
  • Explanatory models
  • Mexican-Americans
  • Mexicans
  • Mexico
  • USA

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

Cite this

Explanatory models of diabetes in the U.S. and Mexico : The patient-provider gap and cultural competence. / Weller, Susan; Baer, Roberta D.; Garcia de Alba Garcia, Javier; Salcedo Rocha, Ana L.

In: Social Science and Medicine, Vol. 75, No. 6, 09.2012, p. 1088-1096.

Research output: Contribution to journalArticle

Weller, Susan ; Baer, Roberta D. ; Garcia de Alba Garcia, Javier ; Salcedo Rocha, Ana L. / Explanatory models of diabetes in the U.S. and Mexico : The patient-provider gap and cultural competence. In: Social Science and Medicine. 2012 ; Vol. 75, No. 6. pp. 1088-1096.
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