Making sense of diabetes: cultural models, gender and individual adjustment to type 2 diabetes in a Mexican community

This study was conducted among Type 2 diabetes patients attending Social Security clinics in Guadalajara, Mexico. The goals were to describe cultural models of diabetes causation, assess gender-related differences, and analyze the relationship between cultural knowledge and the status of diabetes control. In the first stage, open-ended interviews were conducted with 28 participants. On the basis of the themes elicited, a series of scenarios describing the causes of diabetes were constructed. In the second stage of the study, 46 individuals were asked to rate each of the scenarios on a 3-point scale. A cultural consensus model was used to analyze the scenario interviews to evaluate the level of cultural sharing, estimate each individual's level of cultural knowledge, and validate cultural themes about the causes of diabetes. Multiple regression analysis was used to estimate the relationship between cultural knowledge and the status of diabetes control. The results demonstrated that participants shared a single cultural model of diabetes causality that emphasized emotional and environmental explanations of diabetes. Women shared more knowledge than men. Better diabetes control was related to a higher level of cultural knowledge. The results suggest that diabetes prevention and care efforts should include community participation. It is important to increase male participation in health care. Psychological assistance and stress management education should become a part of health care services for individuals with Type 2 diabetes. (C) 2004 Elsevier Ltd. All rights reserved.