This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Prior CANHR research has found that the incidence of strong risk factors for diabetes (i.e. overweight, obesity, and impaired glucose tolerance) is increasing dramatically among Yup'ik Eskimos. Moreover, data from COBRE I suggest that Yup'ik cultural perceptions of body weight identify overweight and obesity as indicators of a healthy and strong individual, as opposed to a strong risk factor for diabetes. If such perceptions are culturally prevalent, overweight and obese individuals may feel removed from risk and believe there is no need to monitor diabetes risk or modify health behaviors. Therefore, the overall purpose of this study is to conduct vital formative research to elucidate Yup'ik beliefs about body weight and diabetes in the context of remote village life. Such an understanding will move us toward future intervention research and prevention planning that can be tailored to the strengths and constraints of the village lifeworld and respectful to the values and local knowledge of Yup'ik peoples. We will identify Yup'ik cultural models of diabetes through an application of the Kleinman Explanatory Model (EM) of illness questionnaire administered via in-depth, semi-structured interviews. We will identify Yup'ik cultural perceptions of body weight and body image via specific probing questions embedded within the in-depth interviews and via administration of a standard pile sort task of pre-tested culturally sensitive body image cards. Finally, we will investigate structural factors via key informant interviews and participant observation in two villages. We expect compelling findings with direct health relevance for creating culturally appropriate and viable diabetes prevention programs in remote villages, provider training in cultural competency, and improving adherence among those already receiving medical treatment. There are no expected changes in the gender/minority composition of research subjects for this project.
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