Racial Disparities in Adherence to Diabetes Management Guidelines: The Impact of Immigration Status Among Asian Populations in the U.S.

Author Type

Faculty

Presentation Date

2025

Document Type

PowerPoint

Abstract

Background/Purpose

 

Asian populations in the U.S. demonstrate lower adherence to diabetes management guidelines compared to other racial groups. The American Diabetes Association (ADA) recommends a minimum of two annual A1C tests to manage diabetes effectively. This study examines racial disparities in adherence to these guidelines, focusing on the impact of immigration-related factors and patient perceptions of provider communication. The findings aim to identify barriers and inform strategies to enhance diabetes management and improve patient-provider interactions in underserved communities.

Theoretical/Conceptual Framework

 

This study employs a modified patient-provider communication model as its theoretical framework, emphasizing how effective communication can influence adherence to diabetes management guidelines. By integrating immigration-related factors and cultural contexts, the framework explores how communication dynamics impact patient engagement and adherence within diverse populations.

 

Methods (Design, Sample, Setting, Measures, Analysis)

This retrospective secondary data analysis utilizes multiple years of nationally representative Medical Expenditure Panel Survey Household Component (MEPS-HC) data. The sample includes adults aged 18 and older with a diabetes diagnosis by a healthcare professional. We conducted multiple bivariate and stratified analyses by racial categories to explore adherence differences across groups.

Results

The study analyzed a sample of 1,640 individuals, of whom 17.9% were foreign-born and 22.4% spoke a language other than English at home. Overall, 35.9% of participants did not meet the ADA recommendation for at least two A1C tests in the past year, with the highest non-adherence rate observed among Asians at 45.5%. Foreign-born Asians were particularly less likely to adhere to the guidelines. Among non-adherent Asians, 57.1% reported that their healthcare providers “always” explained things clearly, compared to 80.8% among adherent individuals.

Conclusions & Implications

Findings highlight racial disparities in adherence to ADA A1C guidelines, with Asian populations showing the highest non-adherence rates. Immigration-related factors and provider communication perceptions influenced adherence. Asians adhering to guidelines more often reported clear provider communication, suggesting enhanced communication may improve adherence. These insights underscore the need for culturally tailored interventions to improve diabetes management in underserved populations and support equitable healthcare outcomes.

Conference Title

37th Annual Scientific Sessions of the Eastern Nursing Research Society (ENRS)

Sponsorship or Institution

Eastern Nursing Research Society

Location

Philadelphia, Pennsylvania

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Open Access publication, upload allowed

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