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Neighborhood Influences on Physical Activity Among Low-Income African American Adults With Type 2 Diabetes Mellitus
The Science of Diabetes Self-Management and Care ( IF 3.9 ) Pub Date : 2020-02-26 , DOI: 10.1177/0145721720906082
Soim Park 1 , Wayne W Zachary 2 , Joel Gittelsohn 1 , Charlene C Quinn 3 , Pamela J Surkan 1
Affiliation  

Purpose The purpose of the study was to explore the influences of the neighborhood environment on physical activity (PA) among people living with type 2 diabetes mellitus (T2DM) in a community with limited resources. Methods Participants were adults with T2DM and their family members or friends who help in the management of T2DM and who were living in a low-income African American (AA) community. Health care providers working in the neighborhood were also included. Using an emergent design, qualitative data were collected through 7 focus group discussions (N = 63) and 13 in-depth interviews. Verbatim transcriptions were analyzed via thematic coding to explore contextual factors that limit PA and meaning around neighborhood features that promote or discourage PA. Results Levels of PA were strongly limited by neighborhood insecurity and a lack of recreational facilities in the neighborhood. People with T2DM and physical/mobility disabilities were more affected by the neighborhood environment than those without disabilities, particularly due to perceived safety concerns and social stigma. Despite socioeconomic inequalities within neighborhoods, participants showed resilience and made efforts to overcome social-environmental barriers to PA, applied various coping strategies, and received social support. Conclusions Results suggested that in an underserved neighborhood, individual barriers to physical activity were amplified by neighborhood-level factors such as crime, especially among individuals who have T2DM and disabilities. Socioeconomic inequalities should be addressed further to improve management of T2DM and its complications.

中文翻译:

社区对患有 2 型糖尿病的低收入非洲裔美国成年人身体活动的影响

目的 本研究的目的是探讨社区环境对资源有限社区中 2 型糖尿病 (T2DM) 患者身体活动 (PA) 的影响。方法 参与者是患有 T2DM 的成年人及其家人或朋友,他们帮助管理 T2DM,并且生活在低收入的非裔美国人 (AA) 社区。在附近工作的医疗保健提供者也包括在内。使用紧急设计,通过 7 次焦点小组讨论(N = 63)和 13 次深度访谈收集定性数据。通过主题编码分析逐字转录,以探索限制 PA 的上下文因素以及围绕促进或阻止 PA 的邻里特征的意义。结果 PA 水平受到邻里不安全感和邻里缺乏娱乐设施的强烈限制。患有 T2DM 和身体/行动障碍的人比没有残疾的人更受邻里环境的影响,特别是由于感知到的安全问题和社会污名。尽管社区内存在社会经济不平等,但参与者表现出韧性,并努力克服 PA 的社会环境障碍,应用各种应对策略,并获得社会支持。结论 结果表明,在服务不足的社区中,社区层面的因素(例如犯罪)放大了个人身体活动障碍,尤其是在患有 T2DM 和残疾的个体中。
更新日期:2020-02-26
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