Date of Award
Winter 3-19-2023
Degree Type
Dissertation
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Roxanne Spurlark, DNP, APRN-FPA. FNP-C
Second Advisor
Shannon D. Simonovich, PhD, RN
Third Advisor
Ruth-Alma Turkson-Ocran, PhD, MPH, RN, FNP-C, CNE
Abstract
Background: Disparities in diabetes (DM) risk, care, and complications impact Black communities more than that of their White counterparts. While studies have thoroughly examined the impact discrimination and racism have on DM health disparities, no study has systematically reviewed the literature on the association between discrimination, racism, and DM care and outcomes in Black persons.
Purpose: The purpose of this study was to conduct a systematic review of the literature to examine the association between discrimination, racism, and DM care and outcomes in Black persons. The results of this systematic review will be utilized to guide best practices for this population. Research Question: What is the association between discrimination, racism, and DM care and outcomes in Black Americans?
Method: The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Databases used to identify studies include EBSCOhost (CINAHL, Academic Search Complete, PsycINFO, Nursing Academic Edition), PubMed, Science Direct, and Web of Science. Two reviewers assessed studies meeting eligibility criteria and study quality. Results: A total of six original research articles met the inclusion criteria, three quantitative and three qualitative studies. Overall, the systematic review findings revealed that among Black persons, perceived interpersonal discrimination and racism by healthcare professionals are associated with patients' behaviors that impact type 2 diabetes (T2DM) outcomes. The findings also revealed that provider-level factors such as communication, provider assumptions and attitudes, information sharing, shared decision-making, and disease management behaviors might influence T2DM outcomes in this population.
Discussion: Better DM-related outcomes depend on optimal DM control through adequate disease management. Building a therapeutic and culturally appropriate relationship free of discrimination or racism is vital to optimal disease management and decreasing health disparities in this patient population.
Conclusion: Perceived interpersonal racism and discrimination by healthcare providers, among other sociocultural factors, play a crucial role in some patient behaviors that influence T2DM health outcomes in this population. The efforts to decrease health disparities in this population should also focus interventions on addressing provider-level factors and behaviors perceived as racist or discriminatory.
Recommended Citation
Anim, Sandra B., "A Systematic Review of the Relationship Between Discrimination, Racism and Diabetes Care Outcomes for Black Americans" (2023). College of Science and Health Theses and Dissertations. 574.
https://via.library.depaul.edu/csh_etd/574
SLP Collection
yes