Diabetes detachment: How cultural, contextual, and personal barriers influence low-income young women with diabetes in Appalachia

This study explored the experiences of young low-income women with type 2 diabetes (T2D) in Appalachia, Tennessee. Diabetes care remains suboptimal across the United States particularly in underserved communities. The study employed a descriptive qualitative case study collecting data using in-depth interview of a group of low-income women in their 20s with T2D. Data was analyzed using qualitative content analysis. The findings identified three themes: “frustration and stigma lead to detachment care,” “frozen by fear and unable to overcome resource limitations” and “social support and an empowered perspective lead to a positive outlook.” Cultural barriers combined with contextual and personal barriers resulted in detachment from diabetes care among study participants. Within Appalachia, leveraging the existing familism values along with culturally congruent education and support can help alleviating the burden of diabetes care.