Understanding diabetes self-management behaviors among Indigenous adults



 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.