The role of cultural beliefs and distress in adherence to recommended physical activity among patients with type 2 diabetes mellitus.

The aim of this research was to examine the role of negative cultural beliefs about exercise and their relation to diabetes distress as determinants of exercise treatment adherence among culturally and socio-economically diverse patients with type 2 diabetes mellitus (T2DM). Participants included 193 Latin American (Latino) and non-Latino White patients with T2DM from a region of Southern California, with high rates of T2DM. The research was guided by Betancourt's Integrative Model of Culture, Psychology, and Behavior which specifies the structure of relations among socio-structural, cultural, and psychological factors as determinants of health behavior. As hypothesized, structural equation modeling revealed that negative cultural beliefs about exercise predicted higher levels of diabetes distress (ß = 0.32, p < 0.05), which in turn predicted lower exercise treatment adherence (ß = - 0.34, p < 0.05). Findings suggest a critical need for interventions that target both cultural and psychological factors in order to improve diabetes outcomes.

Health professional cultural competence reduces the psychological and behavioral impact of negative healthcare encounters.

OBJECTIVES: Negative health care encounters have psychological and behavioral consequences for patients, particularly for minority and low socioeconomic populations. Guided by an integrative model of culture, psychological processes, and health behavior, this study examined whether provider cultural competence reduces the emotional and behavioral consequences of negative health care encounters among Latina and non-Latino White American women in the United States. METHOD: A total of 335 women participated in the study, of which 236 (Latina = 112; non-Latino White = 124) reported at least one negative health care encounter during a preventive medical screening exam. Structural equation causal modeling was used to examine whether provider cultural competence, as perceived by the patient, influenced emotions associated with negative health care encounters and subsequent medical avoidance. RESULTS: When both Latina and non-Latino White American patients perceived their provider to be higher in cultural competence, they experienced less shame and embarrassment related to the negative encounter. Lower levels of shame and embarrassment in turn, predicted less medical avoidance for Latina, but not non-Latino White American women. CONCLUSIONS: Findings revealed that provider cultural competence reduces some of the consequences of negative health care encounters that are relevant to health behavior. These findings shed light on the complexity of how providers' cultural competence impacts patient behavior, highlighting the importance of including psychological variables when investigating the role of cultural competence in health behavior and outcome. (PsycInfo Database Record (c) 2020 APA, all rights reserved).