Evidence map›Paper›PMID 39353695›Full record

ArticleBMJ open2024

Applying the theoretical domains framework to identify determinants to mental healthcare use among older African Americans with type 2 diabetes: a qualitative study.

Jaclynn Hawkins, Srijani Sengupta, Katherine A Kloss, Claudia Schwenzer, Fonda N Smith, Lenette M Jones, Jamie Mitchell, Robin Nwankwo, Gretchen A Piatt

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Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Jaclynn HawkinsUniversity of Michigan School of Social Work, Ann Arbor, Michigan, USA jachawk@umich.edu.ORCID 0000-0001-8132-790X
Srijani SenguptaUniversity of Michigan School of Social Work, Ann Arbor, Michigan, USA.
Katherine A KlossUniversity of Michigan School of Social Work, Ann Arbor, Michigan, USA.
Claudia SchwenzerUniversity of Michigan School of Social Work, Ann Arbor, Michigan, USA.
Fonda N SmithUniversity of Michigan School of Social Work, Ann Arbor, Michigan, USA.
Lenette M JonesSchool of Nursing, University of Michigan, Ann Arbor, Michigan, USA.
Jamie MitchellUniversity of Michigan School of Social Work, Ann Arbor, Michigan, USA.
Robin NwankwoDepartment of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA.
Gretchen A PiattDepartment of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA.

Funding

Regional Pilot And Feasibility Study Grants ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Mehboob A Hussain · 2013 to 2026
$24.3M
Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
NIDDK NIH HHS P30 DK020572NIDDK NIH HHS P30 DK092926
6 · The paper itself

Abstract

objectivesThere is a paucity of research focused on enhancing access to mental healthcare for older African Americans with type 2 diabetes (T2D), who may be at risk for or living with comorbid depression. This study aims to identify barriers and facilitators to mental healthcare utilisation among this population, guided by the theoretical domains framework (TDF).

designThis qualitative study involved 30 interviews with older African American adults diagnosed with T2D. The interview questions were aligned with TDF domains to capture participant perspectives on barriers and facilitators to mental healthcare use.

settingInterviews were conducted via telephone by a licensed clinician trained in social work. Each session lasted 60-90 min and was transcribed and analysed.

participantsThe study included 30 African American adults (15 males and 15 females), aged 60 and above, living in an urban area in the Midwest. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was the identification of themes from participant responses, analysed using thematic content techniques and categorised into TDF constructs. Demographic data served as the secondary outcome.

resultsNine key themes were identified, categorised under major TDF domains and constructs. Significant barriers included (1) systemic racism ('knowledge'), (2) normalisation of depressive symptoms ('beliefs about consequences'), (3) perceived stigma ('beliefs about consequences') and 4) costs of medications and healthcare ('environmental context and resources'). Facilitators to seeking mental healthcare included (1) empowerment ('beliefs about capabilities'), (2) perceived benefits of mental health exams ('beliefs about consequences'), (3) positive provider experiences ('reinforcement'), (4) recognition of depressive symptoms as a motivator ('goals') and (5) support networks ('social influences'). CONCLUSION AND IMPLICATIONS: Key findings highlight that fostering positive patient-provider relationships and enhancing self-recognition of depressive symptoms can significantly encourage mental healthcare utilisation among older African Americans with T2D. These findings suggest that future interventions should focus on strengthening these relationships and improving self-awareness to better mental health outcomes.

Indexed as

Black or African AmericanDiabetes Mellitus, Type 2Mental Health ServicesQualitative ResearchAgedDepressionFemaleHealth Services AccessibilityHumansInterviews as TopicMaleMiddle AgedPatient Acceptance of Health CareSocial Stigmadepression & mood disordersdiabetes & endocrinologyhealth equitymental health

Identifiers

PMID39353695
PMCPMC11448234

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.