Diabetes Fatalism, Self-Efficacy, and Self-Management Among Arab Americans

<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>

Name thesis:degree_name

PhD Nursing

Level thesis:degree_level

Dissertation: USD Users Only

Discipline thesis:degree_discipline

Nursing

Year dc:date.available

2026

Author dc:creator

• Harter, Ani

• 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

Repository record dc:identifier

https://digital.sandiego.edu/dissertations/1100

OAI identifier oai:identifier

oai:digital.sandiego.edu:dissertations-2111