Reimagining Empowerment: A Critical Review of Empowerment Theory in Diabetes Research

Abstract

Diabetes, well documented as a complicated condition, has been the focus of self-management studies for over three decades. Empowerment theory has co-developed within diabetes literature at the same time. However, this literature lacks a core and standard definition, which has led to incongruencies in theory and relative terminology. In this critical review, the construct of empowerment in diabetes literature is dissected and examined. Prominent measures and methods are problematized to highlight their overreliance on individual behavior rather than systemic social change. Current interventions targeting empowerment focus almost exclusively on individual behavior-change, inadvertently suggesting that the location of the problem of poor management lies within the abilities, attitudes, and beliefs of individuals. This paper argues that there has to be a socially-based power-related shift from one group to another in the process of empowerment for its construct to be complete, and that the ultimate agent of change must shift from the patient to systemic barriers in their way. Examples of online patient community-generated definitions, resources, and practices of empowerment are highlighted, leading to an argument that researchers and healthcare providers ought to add nuance to the construct of empowerment by weaving in community and systems levels change goals.