RESEARCH CORE

本研究旨在建立妊娠期糖尿病的动物模型， 糖尿病患者（n=40）、60名妊娠非糖尿病患者（n=60）及其医疗保健提供者（n=60）， 病因、病程和治疗，以减少依从性障碍并改善糖尿病结局。 所有妊娠受试者均为AI。“卫生保健提供者”被定义为医生、有执照的护士， 认证糖尿病教育者（CDE）和部落社区卫生代表（CDE： 为家访、筛查、健康教育、社区资源培训准专业人员 识别和运送到卫生保健场所）。与乔托和Chicksaw的合作 俄克拉荷马州的国家将继续加强研究过程的所有阶段，并确保 将达到相应的研究目标。 具体目标1：与乔托族和契卡索族合作， 问卷的完善、研究的实施、研究结果的应用。 具体目标2：招募60名医疗保健提供者和100名妊娠患者作为受试者， 采访 具体目标#3：描述100名孕妇持有的避孕模型，其中10名孕妇将 30人会患妊娠糖尿病，60人不会患糖尿病。 假设：解释模型将因疾病经历类别而异。 具体目标#4：描述患者对母婴结局的解释模型 与妊娠期糖尿病有关。 假设：患者对母婴结局的解释模型可以预测求助和 坚持行为。 具体目标#5：描述提供者所持有的糖尿病诊断模型， 患者的糖尿病教育、求医行为和对治疗计划的依从性/不依从性。 假设：糖尿病的提供者解释模型可能与糖尿病的患者模型不一致， 造成沟通障碍。患者寻求帮助和依从性的感知可能 促进或阻碍最佳护理。 具体目标#6：描述提供者的护理模式。 假设：提供者的护理模式可能会促进或阻碍患者寻求帮助， adherence behaviors.. 具体目标7：描述受试者对传统人工智能文化或主流的认同程度 文化 假设：被试的文化认同可以预测其糖尿病诊断模式。 具体目标8：与乔托族和契卡索族合作， 两个部落的医疗保健提供者进行研究。

This research will elicit Explanatory Models of diabetes during pregnancy from pregnant diabetics (n=40), 60 pregnant non-diabetics (n=60), and their health care providers (n=60 ) regarding etiology, 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 resource identification, and transportation to health care sites). Collaboration with the Choctaw and Chicksaw Nations of Oklahoma will be continuous to strengthen all phases of the research process and assure that appropriate research goals will be met. Specific Aim # 1: Collaboration with Choctaw and Chickasaw Nations on decisions regarding questionnaire 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 for interviews. Specific Aim #3: Delineate the Explanatory Models held by 100 pregnant women of which 10 will have pre-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 outcomes relevant to diabetes during pregnancy. Hypothesis: Patient's Explanatory Models of maternal and infant outcomes may predict help-seeking and adherence behaviors. Specific Aim # 5: Delineate the Explanatory Models of diabetes held by providers regarding their patients' 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 either facilitate 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 and adherence behaviors.. Specific Aim #7: Delineate subjects' degree of identification with traditional AI culture or mainstream culture. 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 the research to health care providers in both tribes.