Table 2.

Essential Themes and Representative Quotes

Essential themes	Representative quotes
Enduring financial hardship	Susan: “Lack of money, money to pay for healthy food, good health care is not enough.” John: “Money is never enough. I have my car insurance, family members in Haiti are included on my monthly bill, and I have a lot of my own bills. The medicines are pricey, and I have to spend $20–$25 when visiting the doctor.” Evelyne: “For many other older people like me in the church, it is very difficult for them to buy good food, you know, like vegetable, fruits, paying for their expensive insulin.” Veronica: “I am frustrated with all my medical issues and lack of resources to help. I have more money to pay for my medications because of my newly added MassHealth insurance. Six months ago, there were months in which I was only able to pick up some of the meds when my kids could not help paying.” Pierre: “Lack of resources for people like me make it hard to manage T2DM.”
Facing isolation outside Haitian community	Joseph: “We are isolated. Even more now. Our neighbors do not really talk to us because we are different.” Marie: “I am beyond frustrated. I feel neglected, isolated by all of this. English, not enough English, no neighbor friends. Many of us are the same age. I think because I am Haitian, most of them are White, they do not want to talk or invite me to some of their fun stuff.” Pierre: “I feel alone at times. You know, I do not speak good English, my kids cannot always come and stay with me, my neighbors do not know me, and I do not know enough English to reach out to them.” Previlon: “I used to be very frustrated and isolated given the culture is different. I am used to French or Haitian Creole languages. When I came here, for a good period of time, I did not have a voice. Without the language you feel isolated and like a man with his head cut off. You know, no one respects you, they think you are not educated at all and that is frustrating.” Berly: “I feel sad, frustrated, and isolated; sad from losing my wife, frustrated with all my medical issues and lack of resources, and finally, my neighborhood. I do not know what it is; older people who are different get isolated. They do not like to have us around and socialize with us much.”
Creating and maintaining a good community	Previlon: “When diabetes bothers me, I pray and ask my sisters from the church to pray with me and for me, and it works. I do not know where I would be without God.” Berly: “I do not know what I would do without the support from the church and my kids. They check on me, call, pray for me and my family.” Evelyne: “The nurse at the church helped me make some changes to the food I eat, and I started feeling better. They also connected me with another dietician who had worked with Haitians before.” Odette: “To tell you the truth, without my family and my sisters from the church, I do not know where I would be with this disease. I am glad I was able to create this support network and happy I have a good family to help me manage my diabetes.” Julene: “Make sure you have people to support you.”

Abbreviation: T2DM, type 2 diabetes mellitus.