Understanding diabetes self-management behaviors among Indigenous adults

 描述(申请人提供)：背景：美洲印第安人(以下简称：土著)的糖尿病和糖尿病相关并发症的发病率高于普通人群。糖尿病患者进行糖尿病自我管理行为对预防并发症和改善预后非常重要，许多不同的社会和个人决定因素影响着实施这些行为的可能性。尽管研究影响糖尿病行为的因素的文献很多，但很少有信息描述患有2型糖尿病(T2D)的土著个体的这些行为，也没有发现关于影响他们的特定文化因素的数据。目的：本研究的目的是确定影响新近被诊断为T2D的土著个体的DSMB的因素。方法：这项横断面研究将利用安徒生行为模型的改编形式，检查影响中西部五个上部土著部落社区的易患和使能特征。参与者将从临床记录中随机选择，如果他们认为自己是美国印第安人，年龄在18岁以上，并且在过去两年内被诊断为T2D。共有256名个人将被邀请参加。参与者将完成计算机辅助个人面试(CAPI)。数据分析将包括描述性统计、双变量相关、回归模型和结构方程建模。预期结果：这项研究将提高人们对动态医疗行为参与率的认识，并阐明影响这些行为的因素。结果将有助于未来规划以提供者和社区为基础的干预措施，以解决DSMB的障碍和促进者。了解个人和社区一级因素之间的复杂关系将为针对多种决定因素的社会生态干预提供动力。

 DESCRIPTION (provided by applicant): Background: American Indians (hereafter: Indigenous) have higher rates of diabetes and diabetes-related complications than the general population. It is important for individuals with diabetes to engage in diabetes self-management behaviors (DSMB) to prevent complications and enhance outcomes, and many different social and individual determinants impact the likelihood of performing these behaviors. Despite the breadth of literature investigating factors influencing DSMB, little information describes these behaviors among Indigenous individuals with type 2 diabetes (T2D), and no data were found regarding culturally specific factors impacting them. Aims: The purpose of this study is to determine factors influencing DSMB of Indigenous individuals who are recently diagnosed with T2D. Methods: This cross-sectional study will utilize an adapted form of Andersen's Behavioral Model to examine the predisposing and enabling characteristics impacting DSMB in five upper Midwest Indigenous tribal communities. Participants will be randomly selected from clinic records if they identify as American Indian, are over the age of 18, and have been diagnosed within the past two years with T2D. A total of 256 individuals will be invited to participate. Participants will complete computer-assisted personal interviews (CAPI). Data analysis will include descriptive statistics, bivariate correlations, regression models, and structural equation modeling. Expected Outcomes: This research will enhance the knowledge of rates of engagement in DSMB, and elucidate the factors influencing these behaviors. Results will facilitate future planning of both provider- and community-based interventions to address barriers and facilitators of DSMB. Understanding the complex relationship between individual and community level factors will provide impetus for socio-ecological interventions aimed at multiple levels of determinants.