Diabetes is reaching epidemic proportions in the United States with a record 25.8 million diagnosed in 2010 compared to 20.8 million in 2005. African Americans have the highest prevalence of diabetes in the United States. Social support related to medical conditions has been found effective in increasing treatment adherence. The purpose of this study is to gain a clearer understanding of diabetes support within African American couples’ relationships. This study explores the definition of support from the perspective of African American couples when at least one member has been diagnosed with diabetes. Couples were recruited from Riverside and San Bernardino counties in California. Ten couples participated; 9 married, 1 engaged and living together; 1 where the wife is diabetic, 7 where the man is diabetic, and 2 where both partners are diabetic. Semi-structured interviews were conducted via telephone using open ended questions. A grounded theory methodology was employed. Data were analyzed through a symbolic interaction lens to gain a clearer understanding of the meaning placed on verbal and nonverbal interactions perceived as supportive within the couple dyad. Participant couples identified behaviors as supportive or non-supportive and shared their experience of enacting and perceiving support related to diabetes. The four support themes that emerged from the data were awareness support, relational support, regimen support, and instrumental support. A step-by-step process was found that describes the unspoken method of how support is provided among African American couples. This study provides a framework for relationship oriented interventions for improving support and self-care behaviors with this population. As a result of this study, a relationally focused psychoeducation program was developed to improve the quality of partners’ attunement to each other about diabetes and its management. The Fighting Diabetes 2Gether program is designed to be a part of a comprehensive program that also includes education on dietary recommendations, self-care requirements, and knowledge about treatment of diabetes.

LLU Discipline

Marital and Family Therapy


Marital and Family Therapy


School of Science and Technology

First Advisor

Douglas Huenergardt

Second Advisor

Carmen Knudson-Martin

Third Advisor

John W. Rowe

Degree Name

Doctor of Marital and Family Therapy (DMFT)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Diabetes -- Prevention; African Americans -- Diseases; Diabetes Mellitus -- prevention and control; Diabetes Mellitus -- ethnology; African Americans; Family Health


Doctoral Project

Page Count

xiv; 148

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives