Date of Conferral





Public Health


Michael G. Schwab


Type 2 diabetes mellitus (T2DM) is a global epidemic, impacting the economy and quality of life of affected individuals. The treatment and management of the disease often rely heavily on self-efficacy and provider guidance. Adherence to provider treatment regimens can help to prevent T2DM-related complications. However, non-adherence to T2DM regimens is a growing concern among minority populations, where T2DM is highly prevalent. Limited research is available for the Afro-Caribbean migrant farmworker (ACMF) with high rates of diabetes and an alarmingly high rate of non-adherence to treatment recommendations which is further complicated by low literacy, common cultural practices, and poor diets. The main objective of this phenomenological study was to examine the lived experience of this population, to determine the causes of treatment non-adherence. The Health Belief Model was used as a theoretical framework to collect data from 15 participants then analyzed using hand coding. Results showed that: ‘perceived susceptibility’ to diabetes and acceptance of diagnosis was high; ‘perceived severity’ and ‘diabetes health literacy’ were low ‘perceived benefits’ included medication side-effects and a cultural preference for folk medicines; and ‘perceived barriers’ were many, most notably decreased access due to distance from care. Adherence to medication was reduced by the need for time-off to travel to centers, or (if the job carried no health insurance) the cost of health care. Understanding these factors will help to promote social change by empowering health care professionals’ to be cognizant of previously unknown factors that decrease medication adherence in the ACMF population.