Evaluation of Jamaican knowledge of diabetes and health beliefs

  • Melody L. Hartzler Cedarville University School of Pharmacy
  • Aleda M.H. Chen Cedarville University School of Pharmacy
  • Bethany L. Murphy Union University School of Pharmacy
  • Sarah J. Rodewald Cedarville University School of Nursing
Keywords: Jamaica, diabetes, health beliefs, knowledge

Abstract

Background & Aims: The International Diabetes Federation (IDF) estimated that over 382 million people worldwide were affected by diabetes in 2013. The Caribbean region consistently is above the global average in regards to diabetes prevalence.  Specifically in Jamaica, researchers have found that the management of diabetes is not consistent with international guidelines, and in Caribbean culture there are additional health beliefs that are different than typical US-based diabetes management practices and may need to be addressed. The purpose of this study is to (1) evaluate rural Jamaican patients’ diabetes-related knowledge and health beliefs, (2) determine the association between diabetes-related knowledge and health beliefs, and (3) identify diabetes-related educational needs in rural Jamaica. 

Methods:  Rural Jamaican patients with diabetes (N=48, mean age = 55.16±15.08) were asked to complete questionnaires for cross-sectional examination of knowledge and health beliefs during a medical mission trip to the St. Elizabeth parish of Jamaica.  Participants were asked to verbally complete the Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD, 10 items) and Health Belief Model-11 (HBM-11, 11 items), as well as a demographic instrument.  Analyses were performed in SPSS v. 19.0.  Frequencies were utilized for categorical variables, means for continuous variables, and medians for individual HBM items.  Spearman or Pearson correlations, as appropriate, were utilized to assess associations.

Results:  Participants had poor knowledge of diabetes, particularly regarding signs and symptoms of hyper/hypoglycemia, importance of foot and eye exams, fasting blood glucose levels, and long-term complications of diabetes.  Knowledge deficits were associated with educational attainment, as many participants had only completed primary school.  Most participants indicated they were ready to take action regarding their health.

Conclusions:  Among this population of rural Jamaican patients, general knowledge regarding diabetes remains low but patients want to take action regarding their diabetes.  These results indicate a continued need to develop programs to provide diabetes-related education to patients living in rural Jamaica, as patients are ready to improve their management of diabetes.

Author Biographies

Melody L. Hartzler, Cedarville University School of Pharmacy

Asisstant Professor of Pharmacy Practice

Dr. Hartzler earned her Doctor of Pharmacy degree from Ohio Northern University. After finishing her degree she completed her pharmacy practice residency at the Chalmers P. Wylie VA Ambulatory Care Center in Columbus, Ohio. During her residency she also obtained a teaching certificate from The Ohio State University College of Pharmacy. Her clinical specialization involves Medication Therapy Management Services (MTMS) including anticoagulation, diabetes, hypertension, and lipid management.

Dr. Hartzler's clinical practice involves a collaborative practice at the Victor J. Cassano Health Center in Dayton, a facility focused upon serving individuals with limited access to health care.  In this role she provides clinical pharmacy services in a physician teaching facility.

Aleda M.H. Chen, Cedarville University School of Pharmacy
Assistant Professor of Pharmacy Practice
Bethany L. Murphy, Union University School of Pharmacy
Assistant Professor of Pharmacy Practice
Sarah J. Rodewald, Cedarville University School of Nursing
Adjunct Instructor of Nursing

References

International diabetes federation (IDF) diabetes atlas-sixth edition [Internet]. Brussels (Belgium): International Diabetes Federation; [updated 2013 cited 3 March 2014]. Available from: http://www.idf.org/diabetesatlas (p. 9, 11, 62, 120)

International diabetes federation (IDF) diabetes atlas regional fact sheet [Internet]. Brussels (Belgium): International Diabetes Federation; [updated 2013 cited August 2014]. Available from: http://www.idf.org/sites/default/files/DA6_Regional_factsheets_0.pdf (p. 7-8)

Wilks RJ, Sergeant LA, Gulliford MC, Reid ME, Forrester TE. Management of diabetes mellitus in three settings in jamaica. Pan Am J Public Health 2001;9(2):65-72.

Gherman A, Schnur J, Montgomery G, Sassu R, Veresiu I, David D. How are adherent people more likely to think? A meta-analysis of health beliefs and diabetes self-care. Diabetes Educ 2011;37(3):392-408.

Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: Patient and provider factors. Diabetes Res Clin Pract 2011;93(1):1-9.

Barrier Analysis Model. [Internet]. Washington DC (United States): Food for the Hungry; [updated 2004 cited August 2014] Available from: http://barrieranalysis.fhi.net/

Rosenstock IM. Historical origins of the health belief model. Health Educ Behav 1974;2(4):328-335.

Wint YB, Duff EM, McFarlane-Anderson N, O'Connor A, Bailey EY, Wright-Pascoe RA. Knowledge, motivation and barriers to diabetes control in adults in jamaica. West Indian Med J 2006;55(5):330-333.

Moss MC, McDowell JRS. Rural vincentians' (caribbean) beliefs about the usage of non-prescribable medicines for treating type 2 diabetes. Diabet Med 2005;22(11):1492-1496.

Less LA, Ragoobirsingh D, Morrison EY, Boyne MS, Anderson-Johnson P. The jamaican lay facilitators program: a positive impact on glycemic control. Diabetes Manage 2011;1(2):167-173.

Rothman RL, Malone R, Bryant B, et al. The spoken knowledge in low literacy in diabetes scale. Diabetes Educ 2005; 31(2):215-224.

Hurley AC. The health belief model: evaluation of a diabetes scale. Diabetes Educ 1990;16(1):44-48.

Standards of medical care in diabetes—2012. Diabetes Care 2012; 35(Supplement 1):S11-S63.

Powell CK, Hill EG, Clancy DE. The relationship between health literacy and diabetes knowledge and readiness to take health actions. Diabetes Educ 2007; 33(1):144-151.

Berkman ND, Sheridan SL, Donahue KE, et al. Executive summary: Health literacy interventions and outcomes: An updated systematic review. Rockville, MD: Agency for Healthcare Research and Quality;2011.

Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of Functional Health Literacy to Patients' Knowledge of Their Chronic Disease: A Study of Patients With Hypertension and Diabetes. Arch Intern Med. 1998;158(2):166-172.

Institute of Medicine. Health literacy: A prescription to end confusion. National Academy of Sciences; 2004.

Aljasem LI, Peyrot M, Wissow L, Rubin RR. The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes. Diabetes Educ 2001;27(3):393-404

Ayele K, Tesfa B, Abebe L, Tilahun T, Girma E (2012) Self Care Behavior among Patients with Diabetes in Harari, Eastern Ethiopia: The Health Belief Model Perspective. PLoS ONE 7(4): e35515. doi:10.1371/journal.pone.0035515

Global guidelines for type 2 diabetes [Internet]. Brussels (Belgium): International Diabetes Federation; 2012 [cited 24 Jan 2013]. Available from: http://www.idf.org/global-guideline-type-2-diabetes-2012

Duff E, O’Connor A, McFarlane-Anderson N, Wint Y, Bailey E, Wright-Pascoe R. Self-care, compliance and glycaemic control in jamaican adults with diabetes mellitus. W Indian Med J 2006; 55(4):232-236.

Bailey C, Day C, Turner S, Leatherdale B. Cerasee, a traditional treatment for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetes Res 1985;2(2): 81-84.

Allen D. 'Bush' tea danger: Cerassie, ganja tea, aloe vera among potentially harmful home remedies [Internet]. Kingston (Jamaica): Jamaica Observer; 2012 Mar 29 [updated 2012 Mar 29, cited 29 Jan 13]. Available from: http://www.jamaicaobserver.com/news/-Bush-tea--danger_11141393

Published
2014-11-06