Gender differences in self efficacy and behavior outcomes among diabetic Bangladeshis in New York City

Background/Significance: South-Asians have the highest prevalence of diabetes compared to other Asian subgroups. Self-efficacy plays a role in diabetes management, yet few studies have examined this concept among South-Asian diabetics, particularly among Bangladeshis. Objective/Purpose: To examine gender differences in health-related self-efficacy and diabetes outcomes among Bangladeshi individuals participating in a diabetes management community health worker (CHW) intervention. Methods: Eligible diabetic Bangladeshis were randomized into treatment and control groups. Treatment group participants received monthly group educational seminars and one-on-one visits from a CHW, while control group participants received an introductory seminar. Surveys were collected at baseline, midpoint, and endpoint (6-months). Chi-square tests were performed to reveal trends in self-efficacy overall, by gender, and by study group. Changes in clinical outcomes, including HbA1c and weight, were examined using paired sample t-tests and repeated measures ANOVA. Additionally, field notes collected by CHWs were examined to help understand and explain observed trends. Results: Preliminary analysis was conducted using two intervention rounds (n=84). A significant increase in overall self-efficacy among the intervention group was seen (p<0.10) while there was no significant change in the control group. Furthermore, results stratified by gender showed improvement in self-efficacy among females in the treatment group (p<0.05); females felt more comfortable going to the doctor alone at endpoint compared to baseline. No significant changes in self-efficacy were seen among males in either group, or among females in the control group. Moreover, females in the intervention group demonstrated a significant decrease in weight at 6-months (p<0.10). Further analysis will be performed with an additional round using repeated measures ANOVA to look at trends in clinical measures. Discussion/Conclusion: Results provide insight on the role of self-efficacy in diabetes management for Bangladeshis, especially among women. Further research is needed to help understand and address cultural and social norms to improve health care access.