Emotional and Behavioral Aspects of Diabetes in American Indians/Alaska Natives

2016 ◽  
Vol 44 (1) ◽  
pp. 70-82 ◽  
Author(s):  
Lisa J. Scarton ◽  
Mary de Groot
Keyword(s):  
Type 2 Diabetes ◽  
Participatory Research ◽  
American Indians ◽  
Community Based Participatory Research ◽  
Alaska Natives ◽  
Self Management ◽  
Community Based ◽  
Behavioral Aspects

American Indians and Alaska Natives (AI/ANs) bear a disproportionate burden of diabetes and associated long-term complications. Behavioral interventions play a vital role in promoting diabetes medical and psychological outcomes, yet the development of interventions for AI/AN communities has been limited. A systematic review was conducted of studies focused on the psychosocial and behavioral aspects of diagnosed diabetes among AI/ANs. Ovid and PubMed databases and published reference lists were searched for articles published between 1987 and 2014 that related to the psychosocial and behavioral aspects of type 1 or type 2 diabetes in the AI/AN population. Twenty studies were identified that met the inclusion criteria. Nineteen studies were observational and one study was intervention based. Two of the studies used community-based participatory research methodology. Of the 20 studies, 2 discussed cultural influences associated with diabetes self-management and 10 identified the specific tribes that participated in the study. Tribal affiliations among the studies were broad with the number of AI/AN participants in each study ranging from 30 to 23,529 participants. Emotional and behavioral topics found in the literature were adherence ( n = 2), depression ( n = 9), physical activity ( n = 3), psychosocial barriers ( n = 1), social support ( n = 3), and stress ( n = 2). Relatively few studies were identified using AI/AN populations over a 27-year period. This is in stark contrast to what is known about the prevalence and burden that type 1 and type 2 diabetes mellitus place on AI/AN communities. Future research should promote community engagement through the use of community-based participatory research methodologies, seek to further understand and describe the emotional and behavioral context for diabetes self-management in this population, and develop and test innovative interventions to promote the best possible diabetes outcomes.

scholarly journals From Research to Practice: A Community-Based Participatory Research (CBPR) Approach to Develop an Education Session for People with Type 2 Diabetes (P16-055-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Soghra Jarvandi ◽  
Laurie Meschke ◽  
Bonnie Hinds
Keyword(s):  
Type 2 Diabetes ◽  
Focus Groups ◽  
Participatory Research ◽  
Community Based Participatory Research ◽  
Self Management ◽  
Education Session ◽  
Community Based ◽  
Meal Planning ◽  
Management Behaviors

Abstract Objectives Despite national efforts, type 2 diabetes continues to rise in the Appalachian region. With concerns about cultural competence and health literacy, we undertook a community-based participatory research (CBPR) approach to program development to maximize effectiveness and cultural relevance for people with type 2 diabetes in Appalachia. Methods We conducted a multi-stage project. First, we assessed the educational needs, using a survey measuring diabetes self-management behaviors (diet, exercise, glucose monitoring, foot care, and medication) and conducted six focus groups with people with type 2 diabetes living in East TN. Next, from the focus group participants, a Community Advisory Board (CAB) was formed to review the results and provide input on the design of the education tool. The CAB used a systematic prioritization method to select the education topic and delivery methods. Finally, we piloted the resulting single nutrition education session with the CAB members. Data were analyzed using descriptive analysis for quantitative data and thematic analysis for qualitative data. Results Forty-two people participated in this study (66% female; mean age 65.7 years, SD 12), with seven thereafter forming the CAB (57% female). Nutrition was the most raised topic in the focus groups. Comparing the five self-management behaviors, the lowest percentage of participants reported compliance with dietary self-management behaviors (32%). Using adapted Hanlon methodology, the CAB selected ‘nutrition’ as the topic for the education. In addition, CAB specified group interactions, opportunity for asking questions, presence of support person/family, and providing additional resources as critical program characteristics. Accordingly, we developed an interactive session, focused on food groups and meal planning, using social cognitive theory. The session includes basic information about diabetes, meal planning strategies, problem solving, scenarios, and individual action plan. The pilot testing of the session showed that all participants ‘strongly agree’[ed] that the session offers useable, practical information. Conclusions The CAB guided the development of a session to respond to the needs and concerns of people with type 2 diabetes in rural Appalachia. Funding Sources Humana Foundation.

Type 2 diabetes prevention and self-management among Nicaraguan ethnic minorities: findings from phase 3 of a community-based participatory research study

2017 ◽  
Vol 10 (1) ◽  
pp. 28-42
Author(s):  
Kelley Newlin Lew ◽  
Yolanda McLean ◽  
Sylvia Byers ◽  
Helen Taylor ◽  
Karina Cayasso
Keyword(s):  
Type 2 Diabetes ◽  
At Risk ◽  
Participatory Research ◽  
Diabetes Education ◽  
Atlantic Coast ◽  
Community Based Participatory Research ◽  
Individual Factors ◽  
Community Based ◽  
Content Type

Purpose The purpose of this paper is to explore physical environmental, medical environmental, and individual factors in a sample of ethnic minority adults with or at-risk for type 2 diabetes (T2D) on the Atlantic Coast of Nicaragua. Design/methodology/approach The study used a cross-sectional descriptive design guided by a community-based participatory research framework. Three coastal communities in the South Atlantic Autonomous Region (RAAS) of Nicaragua were sampled. Inclusion criteria were: lay adult with or at-risk for T2D, ⩾21 years of age, self-identification as Creole or Miskito, and not pregnant. Convenience sampling procedures were followed. Data were collected via objective (A1C, height, and weight) and self-report (Pan American Health Organization surveys, Diabetes Care Profile subscales, and Medical Outcomes Survey Short Form-12 (MOS SF-12) measures. Univariate and bivariate statistics were computed according to level of measurement. Findings The sample (N=112) was predominately comprised of Creoles (72 percent), females (78 percent), and mid-age (M=54.9, SD±16.4) adults with T2D (63 percent). For participants with T2D, A1C levels, on average, tended to be elevated (M=10.6, SD±2.5). Those with or at-risk for T2D tended to be obese with elevated body mass indices (M=31.7, SD±8.1; M=30.2, SD±6.0, respectively). For many participants, fresh vegetables (63 percent) and fruit (65 percent) were reported as ordinarily available but difficult to afford (91 and 90 percent, respectively). A majority reported that prescribed medication(s) were available without difficulty (56 percent), although most indicated difficulty in affording them (73 percent). A minority of participants with T2D reported receipt of diabetes education (46 percent). A1C levels did not significantly vary according to diabetes education received or not (M=10.9, SD±2.9; M=10.4, SD±2.5; t=−0.4, p=0.71). Participants at-risk for T2D were infrequently instructed, by a provider, to follow an exercise program (4.8 percent) or meal plan (4.8 percent) and receive diabetes education (2.38 percent). MOS SF-12 findings revealed participants with T2D (M=41.84, SD=8.9; M=37.8, SD±8.5) had significantly poorer mental and physical health quality of life relative to at-risk participants (M=45.6, SD±8.4; M=48.1, SD±9.5) (t=−2.9, p<0.01; t=−2.5, p=0.01). Research limitations/implications Salient physical environmental, medical environmental, and individual factors were identified in a sample of adults with or at-risk for T2D on Nicaragua’s Atlantic Coast. Practical implications Findings informed the development of community-based clinics to address the problem of T2D locally. Social implications The community-based clinics, housed in trusted church settings, provide culturally competent care for underserved ethnic minority populations with or at-risk for T2D. Originality/value This is the first quantitative assessment of the T2D problem among diverse ethnic groups in Nicaragua’s underserved RAAS.

673-P: Food Insecurity and Intervention Opportunities for American Indians and Alaska Natives with Type 2 Diabetes: A Qualitative Analysis

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 673-P
Author(s):  
SARAH A. STOTZ ◽  
STEVEN LOCKHART ◽  
ANGELA G. BREGA ◽  
KELLY R. MOORE
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Analysis ◽  
Food Insecurity ◽  
American Indians ◽  
Alaska Natives

ORGANIZATION OF AMBULATORY CARE FOR TYPE 2 DIABETES MELLITUS

Vestnik ◽  
2021 ◽  
pp. 187-193
Author(s):  
З.К. Манатбекова ◽  
А. Озат ◽  
А.Е. Бектур ◽  
А.Р. Шаймерден ◽  
Д.А. Ахат ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Outpatient Care ◽  
Best Practice ◽  
Self Management ◽  
Order Sets ◽  
History Of ◽  
Insulin Use ◽  
Quality Assurance Standards

Качественная амбулаторная помощь при диабете требует как стандартов оказания амбулаторной помощи, часто обеспечиваемой структурированными наборами заказов, так и стандартов обеспечения качества для улучшения процессов. Протоколы, обзоры и руководства «передовой практики» непоследовательно применяются в больницах. Чтобы исправить это, в больницах установлены протоколы для структурированного ухода за пациентами и структурированные наборы заказов, которые включают компьютеризированный ввод заказов врача (CPOE). В первоначальных заказах должен быть указан тип диабета (например, диабет 1 или 2 типа) или отсутствие диабета в анамнезе. Поскольку стационарное использование инсулина и приказы о выписке могут быть более эффективными, если основаны на уровне A1C при поступлении, выполните тест A1C у всех пациентов с диабетом или гипергликемией, госпитализированных в больницу, если тест не был проведен. выполнено за предыдущие 3 месяца. Целью данной работы является рассмотрение стандартов амбулаторного лечения пациентов с диабетом 2 типа, составление рекомендации по поведению и формировании навыков в отношении самоконтроля при диабете. Quality ambulatory diabetes care requires both outpatient care standards, often provided by structured ordering, and quality assurance standards to improve processes. “Best practice” protocols, reviews and guidelines are inconsistently applied in hospitals. To remedy this, hospitals have established protocols for structured patient care and structured order sets that include computerized entry of physician orders (CPOE). Initial orders must indicate the type of diabetes (such as type 1 or 2 diabetes) or no history of diabetes. Because inpatient insulin use and discharge orders may be more effective if based on admission A1C levels, perform an A1C test on all diabetic or hyperglycemic patients admitted to the hospital if the test has not been performed. completed in the previous 3 months. The aim of this work is to review the standards of outpatient treatment of patients with type 2 diabetes, to draw up recommendations on behavior and skills formation in relation to self-management in diabetes.

Type 1 and Type 2 Diabetes

2019 ◽  
pp. 343-360
Author(s):  
Katherine A. S. Gallagher ◽  
Marisa E. Hilliard
Keyword(s):  
Type 2 Diabetes ◽  
Medical Condition ◽  
School Personnel ◽  
The United States ◽  
Self Management ◽  
Chronic Medical Condition ◽  
School Based ◽  
Support Students

Diabetes is a chronic medical condition that affects many children in the United States. The chapter provides an overview of type 1 and type 2 diabetes and focuses on the roles of school-based providers in helping students with diabetes, in collaboration with families and medical providers. Specific strategies, such as educating school personnel and peers about the conditions and treatments and recognizing and responding to symptoms of the conditions, are discussed. Providing assistance with, and supervision of, self-management tasks, monitoring symptoms, and identifying and implementing appropriate school-based accommodations are some key activities school-based professionals adopt to support students with diabetes. Additionally, addressing any learning or psychological concerns and assessing for possible diabetes-related contributors are critical. Included in the chapter are handouts with helpful resources for professionals, lists of measures for assessing concerns common to children with diabetes, and a tool to support student engagement in self-management activities related to diabetes care.

scholarly journals Association of health literacy and diabetes self-management: a systematic review

2019 ◽  
Vol 25 (6) ◽  
pp. 526 ◽  
Author(s):  
Padam K. Dahal ◽  
Hassan Hosseinzadeh
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Literacy ◽  
Self Management ◽  
Foot Care ◽  
Community Based Interventions ◽  
Community Based ◽  
Randomised Control Trials

The purpose of this review is to summarise the existing evidence about the association of health literacy (HL) with type 2 diabetes mellitus self-management. The PubMed, Medline, CINHAL, Scopus and Web of Science databases were searched for randomised control trials of type 2 diabetes mellitus (T2DM) self-management and HL published between 2009 and 2018. Fourteen randomised control trials were included in this review. Our findings showed that HL was instrumental in improving diabetes knowledge, physical activity, self-efficacy and quality of life; however, its associations with glycaemic control, self-monitoring of blood glucose, foot care and medication adherence was inconclusive. Customized and community-based HL interventions were more efficient compared to patient-focused HL interventions. This review concludes that HL is key for T2DM self-management, but customised, structured and community-based interventions are more likely to yield better outcomes.

Putting Self-Management in the Context of Community-Dwelling American Indians Living With Type 2 Diabetes

2019 ◽  
Vol 46 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Jacqueline Jones ◽  
R. Turner Goins ◽  
Mark Schure ◽  
Blythe Winchester ◽  
Vickie Bradley
Keyword(s):  
Type 2 Diabetes ◽  
American Indians ◽  
Management Education ◽  
Self Care ◽  
Community Support ◽  
Community Dwelling ◽  
National Standards ◽  
Self Management ◽  
Community Food Security

Purpose The purpose of this qualitative descriptive study was to examine the National Standards for Diabetes Self-Management Education and Support (DSMES) defined diabetes self-care behaviors (healthy eating, being active, taking medication, monitoring, problem solving, reducing risk, and healthy coping) in the context of older community-dwelling American Indians (AIs). Methods Secondary theme analysis of transcribed semistructured qualitative interview data from 28 participants in the Native Elder Care Study aged >60 years identified factors that influence the DSMES self-care behaviors in the context of community-dwelling AIs. Results Four themes that characterized barriers, facilitators, and opportunities for DSMES to support self-care behaviors included community food security, care partners in self-care, community opportunities for diabetes support, and blending of both health worlds. Conclusion Tribal communities have contemporary strengths and cultural traditions that can be activated to enhance diabetes self-management education and support. Diabetes educators can work in tandem with community health representatives to strengthen the social and community support within which individual AIs with type 2 diabetes mellitus live. Community-based participatory research with AI caregivers, dyads, families, youth, and Indian Health Service clinicians may help to improve tribal food policy and school health initiatives, as well as develop intergenerational interventions for modeling effective diabetes self-management.

scholarly journals Participation of Patients With Type 2 Diabetes in Online Support Groups is Correlated to Lower Levels of Diabetes Self-Management

2020 ◽  
Vol 15 (1) ◽  
pp. 121-126
Author(s):  
Noelia Herrero ◽  
Frederic Guerrero-Solé ◽  
Lluís Mas-Manchón
Keyword(s):  
Type 2 Diabetes ◽  
Support Groups ◽  
Care Management ◽  
Online Survey ◽  
Self Care ◽  
Self Management ◽  
Online Support ◽  
Online Support Groups

Background: Support groups play an important role in diabetes understanding and education. This study aims to find connections between participating in diabetes-related online communities (groups and forums) and the self-reported degree of self-care management and health problems associated with type 1 and 2 diabetes. Methods: A cross-sectional study using an online survey was conducted and 307 participants were recruited. Participants were asked about diabetes self-care management (glucose management, healthcare, dietary restrictions, and physical activity) and complications related to the disease, as well as their participation in online social groups and forums (duration, time, and intensity). Results: Belonging to diabetes-related online support groups (OSGs) was associated with lower scores in healthcare and self-management of diabetes ( M = 2.98, SD = 1.07, n = 207, for belonging to OSGs; and M = 4.22, SD = 0.59, n = 97, for not belonging to OSGs). These differences were not statistically significant for type 1 diabetes individuals ( M = 4.33, SD = 0.47, n = 28, for belonging to OSGs, and M = 4.29, SD = 0.48, n = 52, for not belonging to OSGs), but were highly significant for type 2 diabetes (T2D) individuals ( M = 2.41, SD = 0.68, n = 144, for belonging to OSGs; and M = 4.14, SD = 0.64, n = 61, for not belonging to OSGs). People with both type 1 and 2 diabetes reported to have suffered more complications derived from diabetes when they belonged to an OSG, but greater statistically significant differences were found in type 2 individuals. Conclusion: Patients with T2D who participate in OSGs show a higher correlation with having lower levels of diabetes self-care management as well as health complications related to the disease.

Sign in / Sign up

Export Citation Format

Share Document