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Frontiers in public health
2021;9 788285.

Centering the Strengths of American Indian Culture, Families and Communities to Overcome Type 2 Diabetes.

Melissa Walls, Rachel Chambers, Marissa Begay, Kristin Masten, Kevalin Aulandez, Jennifer Richards, Miigis Gonzalez, Angie Forsberg, Leonela Nelson, Francene Larzelere, Cindy McDougall, Megan Lhotka, Ryan Grass, Sidnee Kellar, Raymond Reid, Allison Barlow
Author Information
  1. Melissa Walls: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  2. Rachel Chambers: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  3. Marissa Begay: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  4. Kristin Masten: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  5. Kevalin Aulandez: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  6. Jennifer Richards: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  7. Miigis Gonzalez: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  8. Angie Forsberg: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  9. Leonela Nelson: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  10. Francene Larzelere: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  11. Cindy McDougall: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  12. Megan Lhotka: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  13. Ryan Grass: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  14. Sidnee Kellar: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  15. Raymond Reid: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
  16. Allison Barlow: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
PMID: 35368509 DOI: 10.3389/fpubh.2021.788285

Abstract

Type 2 diabetes (T2D) is a critical Indigenous health inequity rooted in experiences of colonization and marginalization including disproportionate exposure to stressors, disruption of traditional family and food systems, and attacks on cultural practices that have led to more sedentary lifestyles. Thus, an important step in redressing inequities is building awareness of and interventions attuned to unique Indigenous contexts influencing T2D and Indigenous culture as a pathway to community wellbeing. Using a dynamic, stage-based model of intervention development and evaluation, we detail the creation and evolution of a family-based, culturally centered T2D preventive intervention: Together on Diabetes (later Together Overcoming Diabetes) (TOD). The TOD program was built by and for Indigenous communities via community-based participatory research and has been implemented across diverse cultural contexts. The TOD curriculum approaches health through a holistic lens of spiritual, mental, physical and emotional wellness. Preliminary evidence suggests TOD is effective in reducing diabetes risk factors including lowering BMI and depressive symptoms, and the program is viewed favorably by participants and community members. We discuss lessons learned regarding collaborative intervention development and adaptation across Indigenous cultures, as well as future directions for TOD.

Keywords

American Indian/Alaska Native CBPR Native American diabetes intervention���behavioral prevention

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Grants

  1. P30 DK092950/NIDDK NIH HHS
  2. R01 DK091250/NIDDK NIH HHS

MeSH Term

Community-Based Participatory Research
Diabetes Mellitus, Type 2
Humans
Risk Factors
American Indian or Alaska Native
Journal Article
Article has an altmetric score of 10

Word Cloud

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