Access Type

Open Access Dissertation

Date of Award

January 2020

Degree Type


Degree Name




First Advisor

Nancy Hauff

Second Advisor

Joan Visger




August 2020 Advisor: Dr. Joan Visger & Dr. Nancy Hauff

Major: Nursing

Degree: Doctor of Philosophy

Introduction/Objectives: Individuals of Arabic descent who live in the United States are at increased risk of diabetes because the Middle Eastern and North African regions have the second highest global rate of the disease which, is also projected to increase by over 95% by 2035. Diabetes self-care involves seven essential behaviors, including: (1) eating a healthy diet, (2) being physically active, (3) being compliant with medication, (4) monitoring blood glucose, (5) having good coping skills, (6) being able to problem-solve, and (7) engaging in health risk reduction behaviors. Inadequate health literacy and poor social support have been associated with poor diabetes self-care. The link between diabetes self-care and health literacy among people of Arabic descent living in the United States remains unclear. No studies have been identified as featuring investigations of the level of health literacy among this group, nor have they clarified the links between health literacy and diabetes self-care behaviors. Such behaviors’ association with social support also merits further investigation. The overarching aim of this study is to investigate the level of health literacy among this population and to examine the relationship between perceived social support and health literacy, and diabetes self-care behaviors in individuals of Arabic descent who have diabetes (type 1 and type 2). For convenience, the study will be restricted to those living in Michigan. Method: Non-experimental descriptive correlational design comprised a convenience sample of 83 individuals of Arabic descent living in Michigan who have diabetes. Participants were older than 18, may be male or female. Data gathered using four questionnaires: Summary of Diabetes Self-Care Activities, Multidimensional Scale of Perceived Social Support, Short- Test of Functional Health Literacy in Adult. and demographic diabetes-related characteristics. SPSS version 25. Multiple linear regression and Spearman correlation performed to find the relationship between variables and identify whether social support and health literacy predict diabetes self-care, as well as to test the magnitude and direction of any such associations. Result: 48.1 % of participants had adequate health literacy, 32.5% had inadequate health literacy, and only 19.5% had marginal health literacy. Also, there was no evidance of statisticaly significant difference between health literacy and diabetes self care scale nor subscales ( general diet, specific diet, excerscise, blood glucose testing, and foot care). Also, Spearman correlation revealed no significant direct effect between social support and diabetes self care and subscales (specific diet, excersice, foot care and blood glucose testing). Only subscales general diet, in current study, associated with social support mainly family. Discussion/Implications: Studies emphasized the need for further studies in regards to health literacy among a minority group of Arab immigrants. Furthermore, while current study revealed no evidance of statisticaly significant difference between health literacy and diabetes self care, it was shown in some studies featuring investigations of health literacy have shown inconsistent results regarding diabetes self-care behaviors. According to a set of studies, higher health literacy is linked to better diabetes self-care activities while other studies found no link exists. Further studies needed in regard to test the association of health literacy to diabetes self-care among Arab. Future researchers may consider using a larger sample and examining the differences of health literacy and diabetes self-care among genders. In addition, future studies may explore the relationship of who is providing the social support and diabetes self-care behaviors.

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