Background: Diabetes is a prevalent chronic condition affecting more than 38 million individuals in the United States and contributing substantially to morbidity, mortality, and healthcare costs. Despite a higher prevalence of diabetes compared with non-Hispanic White populations, Arab Americans remain understudied and inadequately captured in national health datasets due to racial classification practices. Psychosocial and contextual factors influencing diabetes self-management in this population remain poorly understood.
Purpose/Aims: The purpose of this study was to examine relationships among sociodemographic and clinical factors, diabetes fatalism, self-efficacy, and diabetes self-management among Arab Americans. Guided by the Health Belief Model, the aims were to: describe participant characteristics and study variables in a community health setting; examine relationships among sociodemographic and clinical factors, fatalism, self-efficacy, and self-management; and determine the variance in self-management explained by sociodemographic factors, HbA1c, diabetes fatalism, and self-efficacy.
Methods: A descriptive cross-sectional design was used. A convenience sample of 101 Arab American adults with type 1 or type 2 diabetes was recruited from a Southern California community health center between July and November 2025. Participants completed validated English or Arabic instruments, including the Diabetes Fatalism Scale and Diabetes Self-Management Questionnaire, along with a demographic survey and self-reported HbA1c. Data were analyzed using descriptive statistics, bivariate analyses, and multiple regression.
Results: Participants were primarily older adults (84% aged ≥ 65), female (55.4%), and of Iraqi origin (98%). Knowledge gaps were evident: 35% did not know their diabetes type and 59% did not know their most recent HbA1c. Mean self-management was moderately high (M = 7.30, SD = 1.44), and fatalism was moderate (M = 39.33, SD = 6.52). Gender, employment status, income, diabetes type knowledge, and perceived HbA1c knowledge were significantly associated with self-management. The regression model was significant and explained 35% of the variance in self-management (R² = .350). Gender and perceived HbA1c knowledge remained significant predictors, with perceived HbA1c knowledge emerging as the strongest independent predictor; fatalism was not significant.
Implications:Findings suggest that perceived understanding and structural factors may influence diabetes self-management more strongly than fatalistic beliefs in this population. Results highlight the need for culturally responsive, language-concordant diabetes education that strengthens patient understanding of HbA1c and other key indicators. Interventions emphasizing health literacy, patient empowerment, and access to supportive resources may improve diabetes self-management among Arab Americans.
","abstract_html":"<p><strong>Background:</strong> Diabetes is a prevalent chronic condition affecting more than 38 million individuals in the United States and contributing substantially to morbidity, mortality, and healthcare costs. Despite a higher prevalence of diabetes compared with non-Hispanic White populations, Arab Americans remain understudied and inadequately captured in national health datasets due to racial classification practices. Psychosocial and contextual factors influencing diabetes self-management in this population remain poorly understood.</p> <p><strong>Purpose/Aims:</strong> The purpose of this study was to examine relationships among sociodemographic and clinical factors, diabetes fatalism, self-efficacy, and diabetes self-management among Arab Americans. Guided by the Health Belief Model, the aims were to: describe participant characteristics and study variables in a community health setting; examine relationships among sociodemographic and clinical factors, fatalism, self-efficacy, and self-management; and determine the variance in self-management explained by sociodemographic factors, HbA1c, diabetes fatalism, and self-efficacy.</p> <p><strong>Methods:</strong> A descriptive cross-sectional design was used. A convenience sample of 101 Arab American adults with type 1 or type 2 diabetes was recruited from a Southern California community health center between July and November 2025. Participants completed validated English or Arabic instruments, including the Diabetes Fatalism Scale and Diabetes Self-Management Questionnaire, along with a demographic survey and self-reported HbA1c. Data were analyzed using descriptive statistics, bivariate analyses, and multiple regression.</p> <p><strong>Results:</strong> Participants were primarily older adults (84% aged ≥ 65), female (55.4%), and of Iraqi origin (98%). Knowledge gaps were evident: 35% did not know their diabetes type and 59% did not know their most recent HbA1c. Mean self-management was moderately high (<em>M</em> = 7.30, <em>SD</em> = 1.44), and fatalism was moderate (<em>M</em> = 39.33, <em>SD</em> = 6.52). Gender, employment status, income, diabetes type knowledge, and perceived HbA1c knowledge were significantly associated with self-management. The regression model was significant and explained 35% of the variance in self-management (<em>R²</em> = .350). Gender and perceived HbA1c knowledge remained significant predictors, with perceived HbA1c knowledge emerging as the strongest independent predictor; fatalism was not significant.</p> <p><strong>Implications:</strong>Findings suggest that perceived understanding and structural factors may influence diabetes self-management more strongly than fatalistic beliefs in this population. Results highlight the need for culturally responsive, language-concordant diabetes education that strengthens patient understanding of HbA1c and other key indicators. Interventions emphasizing health literacy, patient empowerment, and access to supportive resources may improve diabetes self-management among Arab Americans.</p>","abstract_has_math":false,"creators":["Harter, Ani"],"institution":null,"degree_name":"PhD Nursing","degree_level":"Dissertation: USD Users Only","degree_discipline":"Nursing","degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2026,"date_issued":"2026-05-31T07:00:00Z","date_published":"2026-05-31T07:00:00Z","updated_at":"2026-07-24T05:41:55Z","subjects":["Arab Americans","diabetes self-management","diabetes fatalism","self-efficacy","Health Belief Model","Community Health and Preventive Medicine","Nursing","Public Health","Public Health and Community Nursing"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digital.sandiego.edu/dissertations/1100","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Harter, Ani"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2028-04-27T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation: USD Users Only"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD Nursing"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Arab Americans","diabetes self-management","diabetes fatalism","self-efficacy","Health Belief Model","Community Health and Preventive Medicine","Nursing","Public Health","Public Health and Community Nursing"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digital.sandiego.edu/dissertations/1100"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Diabetes is a prevalent chronic condition affecting more than 38 million individuals in the United States and contributing substantially to morbidity, mortality, and healthcare costs. Despite a higher prevalence of diabetes compared with non-Hispanic White populations, Arab Americans remain understudied and inadequately captured in national health datasets due to racial classification practices. Psychosocial and contextual factors influencing diabetes self-management in this population remain poorly understood.
Purpose/Aims: The purpose of this study was to examine relationships among sociodemographic and clinical factors, diabetes fatalism, self-efficacy, and diabetes self-management among Arab Americans. Guided by the Health Belief Model, the aims were to: describe participant characteristics and study variables in a community health setting; examine relationships among sociodemographic and clinical factors, fatalism, self-efficacy, and self-management; and determine the variance in self-management explained by sociodemographic factors, HbA1c, diabetes fatalism, and self-efficacy.
Methods: A descriptive cross-sectional design was used. A convenience sample of 101 Arab American adults with type 1 or type 2 diabetes was recruited from a Southern California community health center between July and November 2025. Participants completed validated English or Arabic instruments, including the Diabetes Fatalism Scale and Diabetes Self-Management Questionnaire, along with a demographic survey and self-reported HbA1c. Data were analyzed using descriptive statistics, bivariate analyses, and multiple regression.
Results: Participants were primarily older adults (84% aged ≥ 65), female (55.4%), and of Iraqi origin (98%). Knowledge gaps were evident: 35% did not know their diabetes type and 59% did not know their most recent HbA1c. Mean self-management was moderately high (M = 7.30, SD = 1.44), and fatalism was moderate (M = 39.33, SD = 6.52). Gender, employment status, income, diabetes type knowledge, and perceived HbA1c knowledge were significantly associated with self-management. The regression model was significant and explained 35% of the variance in self-management (R² = .350). Gender and perceived HbA1c knowledge remained significant predictors, with perceived HbA1c knowledge emerging as the strongest independent predictor; fatalism was not significant.
Implications:Findings suggest that perceived understanding and structural factors may influence diabetes self-management more strongly than fatalistic beliefs in this population. Results highlight the need for culturally responsive, language-concordant diabetes education that strengthens patient understanding of HbA1c and other key indicators. Interventions emphasizing health literacy, patient empowerment, and access to supportive resources may improve diabetes self-management among Arab Americans.
"]},{"key":"dc:title","label":"Title","values":["Diabetes Fatalism, Self-Efficacy, and Self-Management Among Arab Americans"]}]}],"canonical_facts":{"dc:creator":["Harter, Ani"],"dc:date.available":["2028-04-27T07:00:00Z"],"dc:description.abstract":["Background: Diabetes is a prevalent chronic condition affecting more than 38 million individuals in the United States and contributing substantially to morbidity, mortality, and healthcare costs. Despite a higher prevalence of diabetes compared with non-Hispanic White populations, Arab Americans remain understudied and inadequately captured in national health datasets due to racial classification practices. Psychosocial and contextual factors influencing diabetes self-management in this population remain poorly understood.
Purpose/Aims: The purpose of this study was to examine relationships among sociodemographic and clinical factors, diabetes fatalism, self-efficacy, and diabetes self-management among Arab Americans. Guided by the Health Belief Model, the aims were to: describe participant characteristics and study variables in a community health setting; examine relationships among sociodemographic and clinical factors, fatalism, self-efficacy, and self-management; and determine the variance in self-management explained by sociodemographic factors, HbA1c, diabetes fatalism, and self-efficacy.
Methods: A descriptive cross-sectional design was used. A convenience sample of 101 Arab American adults with type 1 or type 2 diabetes was recruited from a Southern California community health center between July and November 2025. Participants completed validated English or Arabic instruments, including the Diabetes Fatalism Scale and Diabetes Self-Management Questionnaire, along with a demographic survey and self-reported HbA1c. Data were analyzed using descriptive statistics, bivariate analyses, and multiple regression.
Results: Participants were primarily older adults (84% aged ≥ 65), female (55.4%), and of Iraqi origin (98%). Knowledge gaps were evident: 35% did not know their diabetes type and 59% did not know their most recent HbA1c. Mean self-management was moderately high (M = 7.30, SD = 1.44), and fatalism was moderate (M = 39.33, SD = 6.52). Gender, employment status, income, diabetes type knowledge, and perceived HbA1c knowledge were significantly associated with self-management. The regression model was significant and explained 35% of the variance in self-management (R² = .350). Gender and perceived HbA1c knowledge remained significant predictors, with perceived HbA1c knowledge emerging as the strongest independent predictor; fatalism was not significant.
Implications:Findings suggest that perceived understanding and structural factors may influence diabetes self-management more strongly than fatalistic beliefs in this population. Results highlight the need for culturally responsive, language-concordant diabetes education that strengthens patient understanding of HbA1c and other key indicators. Interventions emphasizing health literacy, patient empowerment, and access to supportive resources may improve diabetes self-management among Arab Americans.
"],"dc:identifier":["https://digital.sandiego.edu/dissertations/1100"],"dc:subject":["Arab Americans","diabetes self-management","diabetes fatalism","self-efficacy","Health Belief Model","Community Health and Preventive Medicine","Nursing","Public Health","Public Health and Community Nursing"],"dc:title":["Diabetes Fatalism, Self-Efficacy, and Self-Management Among Arab Americans"],"thesis:degree_discipline":["Nursing"],"thesis:degree_level":["Dissertation: USD Users Only"],"thesis:degree_name":["PhD Nursing"]},"updated_at":"2026-07-24T05:41:55Z"}