Diabetes is a major health problem among Native American communities in New Mexico with estimated diabetes prevalence ranging from 10-28% and diabetes mortality increasing dramatically from 1958-1987. Although this is a trend noted nationwide, there has been little research to date in the area of diabetes interventions in Native American populations. diet and exercise are the cornerstones of diabetes care, however, long term behavior changes are difficult to achieve. Native American communities have special strengths which have not been fully explored to increase the likelihood of treatment success. The strong kinship ties within Pueblo communities make families an ideal target for diabetes treatment intervention. Previous work in Pueblo communities indicate families to be an appropriate target for diabetes intervention, but have also indicated the need for a multifaceted approach in order to effect change. thus, the aim of this project is to determine whether a diabetes lifestyle program delivered by a professional within the setting of family and friends meetings will have an impact on functional status, family functioning, nutrition and exercise habits, glycosylated hemoglobin, and medication and health care use among Native Americans with diabetes. A community-based, quasi-experimental research design will be used with three experimental groups: 1) diabetes lifestyle information delivered within family and friends meetings, 2) the same information delivered by a professional on a one-to-one basis or 3) usual care controls. IN addition to glucose control and exercise and nutrition behaviors, functional status will be measured using the Dartmouth COOP charts previously evaluated for use within Pueblo communities. Standard family functioning assessment tools will be evaluated and adapted for acceptability before use, and a nutrition and exercise behavior checklist specifically targeted to the intervention will be developed.
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