Date of Conferral

2019

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Jeanne Connors

Abstract

There are more than 3.4 million South Asians in the United States. Among this subgroup, Bangladeshis in New York have a high prevalence of Type 2 diabetes ranging from 15 to 24% compared to the general population. This study examined the effect of acculturation through length of stay in the United States and understanding of the English language, and the role of gender on self-efficacy (SE) and diabetes self-management among 336 New York Bangladeshi immigrants between the ages of 21 and 75 who had been diagnosed with type 2 diabetes with A1C -‰¥ 6.5%, as verified by their medical record for inclusion criteria in the original DREAM study. Health belief model was used as a theoretical framework. The key findings showed a significant relationship between gender and SE levels (p ¤ .0001). Bangladeshi women were 79% less likely to have high SE levels compared to their male counterparts (OR= .212; 95%CI: .099 -.453). Additionally, those who had low education attainment were 68% less likely to develop high SE levels (OR = .323, 95%; CI: .105 -.998). The findings demonstrate the need to understand the influence of social and contextual factors on SE and underscore the importance of integrating a systems approach and ontological lens in the implementation of gender-specific innovative strategies. Such an understanding might help destigmatize diabetes, improve medication adherence, and enhance SE and coping skills for Bangladeshi women across the life span. The findings of this study might provide knowledge to public health practitioners that would help create gender-specific diabetes education and lifestyle management for equity-centered capacity building to alleviate the disproportionate burden of diabetes in Bangladeshi minority women in the United States, ultimately improving health outcomes and reducing healthcare expenditures.

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