Care. Lead. Inspire.

Conclusion: • T2D is often considered a family disease due to

genetic and cultural factors as well as shared environmental factors

• Findings of this study indicate the participants’ desire for diabetes programs that include family members

• A multi-generational T2D intervention may be the most effective way to decrease the burden of diabetes diagnosis in this minority population

Acknowledgments:Research reported in this poster was supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR001427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

This research was funded by the University of Florida, College of Nursing and Diabetes Institute

Thank you to Choctaw Nation of Oklahoma including the Diabetes Educators and community participants who were kind enough to share their time and wisdom with us.

Challenges to Managing Diabetes Among American Indians: Preliminary Findings From a Focus Group StudyVelazquez, I.E.1, Scarton, L.J.1, O’Neal, L2, Wilkie, D.J.1

1University of Florida College of Nursing, 2University of Florida IFAS

Problem: The incidence rate of diabetes diagnoses among

American Indians (AI) surpasses all other racial/ethnic

minority groups and is double the rate of non-Hispanic

Whites. Failure to address the healthcare of AIs through

culturally competent lenses, as well as address the role

of the entire family in management and prevention of the

disease, has led not only to the disparity in diagnosis

rates, but also to barriers in managing their diabetes.

Furthermore, the barriers to and facilitators of diabetes

prevention and management within a family context are

virtually unknown.

14.90%

9.00%

12.20%12.60%

15.30%

7.30%

13.20%

11.70%

0.00%

5.00%

10.00%

15.00%

20.00%

AI/AN Asian Black, Non-Hispanic Hispanic

Prevalence of DIagnosed Diabetes by race/ethnicity and Sex

Male

Female

Data Source: 2013-2015 National Health Interview Survey, except American

Indian/Alaska Native data, which are from the 2015 Indian Health Service National

Data Warehouse.

Methods: Design/Setting:

• Exploratory Study

• Focus groups were held in local community centers

convenient for most participants

Measures:

• Discussion guide using open-ended questions developed

with guidance from tribal diabetes educators

Methods (cont.):Analysis:

o Descriptive statistics used to summarize demographic data

o Lead author conducted initial analysis and identified

potential themes found in de-identified data

o Three independent research team members compared

themes and discussed discrepancies

Sample:

• Conducted a total of seven focus groups with 62 AI

participants in Florida and rural Oklahoma

• Mean age of participants was 55.3 (SD 11.4) years and the

mean duration of diabetes diagnosis was 10.4 (SD 9.1)

years

Results: Preliminary findings revealed 4 themes:

• Intervention components

o Include family members

o Focus material topics on needs of family and person with

T2D

o Meet monthly for 2 hours at community center

o Hands on activities that are culturally appropriate

• Barriers to T2D-Prevention and Management (T2D-PM)

o Lack of time and safe location to engage in physical activity

o Limited access to fresh produce and distance to store

o Forgetting to take medication and negative side effects

Aim: To understand the diabetes-related practices, needs, and

challenges of AIs with Type 2 Diabetes (T2D) and their

families, as well as the characteristics of interventions

they would find most relevant and beneficial.

Results (cont.):• Personal experiences with T2D

o Feelings of panic, fear, and depression

o Self-blame for not taking action when first

diagnosed with pre-diabetes

• Impact of family behaviors on T2D-PM

o Eat similar foods together as family

o Only keep healthy foods in the home

o Encourage person with T2D without ‘nagging’