Abstract

This research will elicit Explanatory Models of diabetes during pregnancy from pregnantdiabetics (n=40), 60 pregnant non-diabetics (n=60), and their health care providers (n=60 ) regardingetiology, course, and treatment in order to reduce barriers to adherence and improve diabetes outcomes.All pregnant subjects are AI's. 'Health Care Providers' are defined as physicians, licensed nurses,Certified Diabetes Educators (CDE's), and tribal Community Health Representatives (CHR's:paraprofessionals trained for home visits, screenings, health education, community resourceidentification, and transportation to health care sites). Collaboration with the Choctaw and ChicksawNations of Oklahoma will be continuous to strengthen all phases of the research process and assure thatappropriate research goals will be met.
Specific Aim # 1: Collaboration with Choctaw and Chickasaw Nations on decisions regardingquestionnaire refinement, research implementation, and application of the research findings.
Specific Aim # 2: Recruit 60 health care providers and 100 pregnant patients to serve as subjects forinterviews.
Specific Aim #3 : Delineate the Explanatory Models held by 100 pregnant women of which 10 will havepre-gestational diabetes, 30 will have gestational diabetes, and 60 will not have diabetes.Hypothesis: Explanatory Models will vary by category of disease experience.
Specific Aim # 4: Delineate the Explanatory Models held by patients about maternal and infant outcomesrelevant to diabetes during pregnancy.Hypothesis: Patient's Explanatory Models of maternal and infant outcomes may predict help-seeking andadherence behaviors.
Specific Aim # 5: Delineate the Explanatory Models of diabetes held by providers regarding theirpatients' diabetes education, care-seeking behaviors, and adherence/non-adherence to treatment plans.Hypothesis: Provider Explanatory Models of diabetes may be discordant with patient models of diabetes,contributing to communication barriers. Perceptions of patient help-seeking and adherence may eitherfacilitate or be a barrier to optimal care.
Specific Aim #6 : Delineate provider models of care delivery.Hypothesis: Provider models of care delivery may either facilitate or impede patients' help-seeking andadherence behaviors..
Specific Aim #7 : Delineate subjects' degree of identification with traditional AI culture or mainstreamculture.Hypothesis: Subjects' cultural identification may predict their Explanatory Model of diabetes.
Specific Aim # 8: In collaboration with Choctaw and Chickasaw Nations, disseminate the findings of theresearch to health care providers in both tribes.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Exploratory Grants (P20)
Project #
2P20MD000528-05
Application #
7305078
Study Section
Special Emphasis Panel (ZRG1-DIG-B (52))
Project Start
2007-10-01
Project End
2012-05-30
Budget Start
2007-09-30
Budget End
2008-05-31
Support Year
5
Fiscal Year
2007
Total Cost
$1,364
Indirect Cost

  Institution

Name
University of Oklahoma Health Sciences Center
Department
Type
DUNS #
878648294
City
Oklahoma City
State
OK
Country
United States
Zip Code
73117

  Publications

Short, Kevin R; Chadwick, Jennifer Q; Cannady, Tamela K et al. (2018) Using financial incentives to promote physical activity in American Indian adolescents: A randomized controlled trial. PLoS One 13:e0198390
Jiang, Shaoning; Teague, April M; Tryggestad, Jeanie B et al. (2017) Role of microRNA-130b in placental PGC-1?/TFAM mitochondrial biogenesis pathway. Biochem Biophys Res Commun 487:607-612
Jiang, Shaoning; Teague, April M; Tryggestad, Jeanie B et al. (2017) Effects of maternal diabetes and fetal sex on human placenta mitochondrial biogenesis. Placenta 57:26-32
Eichner, June E; Folorunso, Olakunle A; Moore, William E (2016) A Physical Activity Intervention and Changes in Body Mass Index at a Middle School With a Large American Indian Population, Oklahoma, 2004-2009. Prev Chronic Dis 13:E163
Short, Kevin R; Teague, April M; Fields, David A et al. (2015) Lower resting energy expenditure and fat oxidation in Native American and Hispanic infants born to mothers with diabetes. J Pediatr 166:884-9
Teague, April M; Fields, David A; Aston, Christopher E et al. (2015) Cord blood adipokines, neonatal anthropometrics and postnatal growth in offspring of Hispanic and Native American women with diabetes mellitus. Reprod Biol Endocrinol 13:68
Henderson, J Neil (2014) Introduction to the Special Issue. Care Manag J 15:158-159
Chou, Ann F; Page, Evaren E; Norris, Ann I et al. (2014) A Survey of Self-Management and Intrusiveness of Illness in Native Americans with Diabetes Mellitus. Care Manag J 15:170-183
Cuaderes, Elena; DeShea, Lise; Lamb, W Lyndon (2014) Weight-Bearing Exercise and Foot Health in Native Americans. Care Manag J 15:184-195
Hoffhines, Heather; Whaley, Kelleigh Dean; Blackett, Piers R et al. (2014) Early childhood nutrition in an American Indian community: educational strategy for obesity prevention. J Okla State Med Assoc 107:55-9

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