Type 2 diabetes is a significant health disparity for many American Indian (AI) communities. The goal of this competitive renewal research is to enhance, implement, and evaluate the effectiveness of a culturally tailored, intergenerational diabetes management and prevention intervention, ?Together on Diabetes.? The program activates family and cultural practices that encourage healthy diets and physical activities, promote stress- coping resources and responses, and reconnect families via a home-based intervention taught by AI paraprofessional Family Health Coaches. The proposed Community Based Participatory Research will enroll ?target? adult caregivers diagnosed with type 2 diabetes and their children, ages 10-16 years, with the goal of tapping into motivational reciprocity between the two generations. The work builds on an existing research collaboration with five Ojibwe tribal communities in the Midwest to implement a randomized controlled study (N = 280 families) with a wait-list design respectful of cultural norms of inclusion. The study will evaluate effectiveness of the intervention on adult physiological (primary outcome = HbA1c), behavioral, and mental health and children's psychosocial, familial, behavioral and physiological risk and protective factors for diabetes. The research will also identify stress-coping mechanisms that mediate the impact of the intervention on health. A novel collaborative, qualitative evaluation technique will map potential ?ripple effects? of the intervention within families and communities. If effective, the intervention will promote dissemination and scaling with tribal health coaches, community involvement, and stakeholder (health providers, health and human service agencies) input.
The goal of this research is to evaluate the impact of a culturally tailored, intergenerational, home-based type 2 diabetes intervention for American Indian adult diabetes-related health outcomes including HbA1c. We will also evaluate the impact of the program on enrolled adult's children in terms of diabetes risk and protective factors. If the intervention is effective, American Indian communities may benefit from an empirically supported, family-based model with promise to break the cycles of intergenerational diabetes.
| Sittner, Kelley J; Greenfield, Brenna L; Walls, Melissa L (2018) Microaggressions, diabetes distress, and self-care behaviors in a sample of American Indian adults with type 2 diabetes. J Behav Med 41:122-129 |
| Brockie, Teresa N; Elm, Jessica H L; Walls, Melissa L (2018) Examining protective and buffering associations between sociocultural factors and adverse childhood experiences among American Indian adults with type 2 diabetes: a quantitative, community-based participatory research approach. BMJ Open 8:e022265 |
| Walls, Melissa L; Sittner, Kelley J; Aronson, Benjamin D et al. (2017) Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes. Int J Environ Res Public Health 14: |
