Article Figures & Data
Tables
Characteristic n (%) Age, mean (SD) 38.4 (5.8) Gender Male 21 (51) Female 20 (49) Ethnicity/race* Latinx 10 (24) Black 12 (29) White 12 (29) Multiple/other 7 (17) Academic attainment Less than high school 2 (5) High school graduate or GED 8 (20) Some college 8 (20) 2-year college 10 (24) 4-year college 6 (15) Master's degree or higher 7 (17) At least one family member with diabetes 27 (66) At least one child <18 years at home (% yes) 24 (59) Diagnosis HbA1c, mean (SD) 8.1 (2.0) Pre-focus group HbA1c, mean (SD) 7 (1.7) Pre-focus group HbA1c <7% (% yes) 16 (39%) ↵* Self-reported on survey administered during focus group meeting
Abbreviations: SD, standard deviation; GED, General Education Development.
Themes Representative Quotes Mapping to COM-B Perceived facilitators 1. Knowledge about type 2 diabetes from observing or speaking with family members I guess I didn't feel overwhelmed because I've been around it so much with my parents and my siblings. So, a lot of the terminology, I was already familiar with. (Participant [P] 6)
[My dad] was telling me you need to do everything that you can to avoid getting full-blown diabetes…you need to get more exercise, overhaul your diet right now. (P38)Capability 2. The diabetes-related experiences of older relatives …my mom's the one who start telling me…she was about 40 years old when she had diabetes, so she's now 80…She never like, “Have to go to the hospital for this or need glasses, or need…” I mean, she's healthier than me. (P3)
…I have that in mind, my great-grandfather…He lived to be 97. Small, frequent meals walk two to three times a day…That's what I'm gonna keep doing until I die. (P12)
…I really thought about doing the weight loss surgery, you know, because once I hear “diabetes”—my dad died from diabetes and I kinda got scared. (P1)
[My mom] said that I was going to be fine, that I was young, that I could take control of it… she just told me to take care of myself so I wouldn't end up like her. (P4)Motivation Perceived barriers 3. Futility/inevitability related to family history of type 2 diabetes [My brother] said, “You knew this was coming, right?"…And I was like, “Yeah. I mean I knew, but, you know, I was trying to avoid it.” (P18)
[type 2 diabetes] runs on both sides. So, I'm screwed. (P34)Motivation Abbreviations: SD, standard deviation; GED, General Education Development.
Theme Representative Quotes Mapping to COM-B Perceived Facilitators 1. Children provide encouragement, directly support self-management activities, and easily adapt to household changes [My kids] they tell me, too, “Daddy…you need to take care of yourself because I want you to walk me down the aisle.” (Participant [P] 7)
…my daughter… “dad, you can't get that. You can't eat that.” (P25)
If I bring any kind of sweets in the house, [my son] call his self saving me by eating it up. (P26)
But like when I buy healthy stuff my daughter is like so into it…I'll buy like yogurts or fruit, or whatever, salads and she'll say, “Oh, mommy can you buy me some of that?” Like she's interested in eating that other than cookies or ice cream or doughnuts, or stuff like that. I think it's wonderful. (P9)Opportunity 2. Desire to be healthy and present for children …I need to be healthy for my kids…when I had kids it wasn't like oh, “I want to be the mom who sits in a park and lets my kids go off and play while I sit there and do nothing.” (P8)
Dude, I cannot let this take me down. I have two children, I gotta be there for both of them. I'm planning on seeing my grandchildren, I'm hoping my great-grans…so I gotta handle this myself. (P18)Motivation 3. Desire to model healthy behaviors for children and to prevent children from developing diabetes …we walk as a family because I like to teach them, you know, that exercise is – it's good, and it's okay to do it. And I just think it's better when they see me doing it. That way, they start doing it, too. (P4) …no candy…not in grandma's house. I'm going to give them broccoli, carrots, this and that. But no candy. No soda…I have done so many mistakes raising [my kids]…if someone would've came to me and explained to me…I would never gave [my kids] all that junk. (P39) Perceived Barriers 4. Children do not want to adapt/do not like healthier food They don't want oatmeal. Well they will, if they put sugar and a whole bunch of crap in there. (P8) Opportunity 5. Insufficient time for self-management And how do you still find time to exercise multiple times per week when you get home from work, you put the baby to sleep, and I'm ready to go to sleep, too…but I still have hours of work… (P31)
I'm gonna get home and [exercise]…And then it never happens…I've got the little one, who's running around the house…it's always the thought process and just not following through or not having time. (P19)
I have like a relax app…sometimes I do put that on and just try to de-stress, but it seems with kids when they see someone sitting and not doing anything… (P8)6. Prioritizing your children's needs over your own I'm spending all of my time watching out for them…I'm already done, that's the way that I see it. (P38)
I did make an appointment with a nutritionist, but then in typical mom fashion a kid got sick with asthma, and that becomes a priority… (P8)Motivation Abbreviation: Capability-Opportunity-Motivation-Behavior (COMB).
