Importantly, recent studies provide evidence that illness perceptions play a significant role in self-management behaviors and outcomes among African Americans with type 2 diabetes (Broadbent, Donkin, & Stroh, 2011 Rovner & Casten, 2018 Skelly et al., 2006). Studies have reported a higher medication adherence when healthcare providers discuss and address illness and medication beliefs with patients, subsequently leading to better disease self-management and improved health outcomes (Phillips et al., 2011 Sweileh et al., 2014). The ESRM (also called the Common Sense Model) is a theoretical framework useful in understanding the influence of illness perceptions on self-management behaviors. Based on the Extended Self-Regulatory Model (ESRM), patients’ illness perceptions influence self-management behaviors and in turn affect outcomes (Phillips, Leventhal, & Leventhal, 2011). One significant patient factor that affects medication adherence and diabetes self-management is illness and medication beliefs. The rate of medication adherence is 25% lower among African Americans with diabetes, compared to non-Hispanic whites after standardizing factors, such as insurance coverage, access to the care, and quality of care (García-Pérez, Alvarez, Dilla, Gil-Guillén, & Orozco-Beltrán, 2013 Patel et al., 2016). Optimal glycemic control and clinical outcomes among patients with type 2 diabetes are commonly associated with long-term use of therapeutic drugs and medication adherence (Aloudah et al., 2018). Compared to non-Hispanic whites, African Americans are twice as likely to have been diagnosed with diabetes and experience higher burden of diabetes-related complications, leading to increased morbidity and mortality (Spanakis & Golden, 2013). Diabetes is one of the leading causes of death in the United States.
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