Date of Conferral

2-10-2025

Degree

Ph.D.

School

Public Health

Advisor

Patrick Dunn

Abstract

African Americans in rural Appalachian West Virginia experience disproportionate rates of diabetes, with limited research examining their unique challenges in managing this chronic condition. This qualitative study aimed to explore how African Americans in rural Appalachia develop and utilize diabetes management skills, examining the intersections of cultural influence, healthcare access, and technological adoption. Using a hermeneutic phenomenological approach grounded in the Social Determinants of Health theory, Health Belief Model, and Social Ecological Model, semi-structured interviews were conducted with nine African American adults diagnosed with pre-diabetes or Type 2 diabetes in Kanawha County. Thematic analysis revealed four main themes: Cultural and Community Influence, Access to Resources, Technological Assistance, and Health Literacy and Education. The findings showed that participants faced significant barriers to healthcare access, including transportation and provider availability issues. Technology adoption varied widely, with some participants effectively utilizing digital tools for self-monitoring while others struggled with access and literacy barriers. Health literacy development was often hindered by limited educational resources and cultural disconnects in healthcare communication. Healthcare access challenges were exacerbated by rural infrastructure limitations and socioeconomic factors. These insights can inform healthcare providers, policymakers, and community leaders in developing culturally sensitive interventions and policies to address the unique challenges of diabetes management in rural settings.

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