Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Frazier Beatty


According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when delivering culturally appropriate diabetes care, so a focus on cultural knowledge, intercultural patient-provider communication skills, and cultural assessment were key to this case study. One pilot study was conducted to test the focus group questions with 3 diabetes providers (i.e., certified nurse diabetes educator [CDE], registered nutritionist, and dietitian) who help patients to self-manage their diabetes. The second pilot study was conducted with 5 African immigrant patients who had been diagnosed with Type 2 diabetes. The primary focus groups were conducted with 5 CDEs and 10 patients. The transcribed responses were analyzed and categorized to identify the 17 themes that emerged (9 from the CDEs and 8 from the patients). One implication for social change is that a patient-centered approach to patient-provider communication will mean better health outcomes. To ensure culturally appropriate patient-provider communication, a change in health care delivery is required to incorporate cultural constructs as part of diabetes care and education to accommodate various ethnic and racial groups.