scholarly journals Culture, Social Support, and Diabetes Empowerment Among American Indian Adults Living With Type 2 Diabetes

2020 ◽  
Vol 33 (2) ◽  
pp. 156-164
Author(s):  
Miigis B. Gonzalez ◽  
Kaley A. Herman ◽  
Melissa L. Walls
2017 ◽  
Vol 35 (5) ◽  
pp. 281-285 ◽  
Author(s):  
Nathan L. Ratner ◽  
Emily B. Davis ◽  
Laura L. Lhotka ◽  
Stephanie M. Wille ◽  
Melissa L. Walls

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022265 ◽  
Author(s):  
Teresa N Brockie ◽  
Jessica H L Elm ◽  
Melissa L Walls

ObjectivesThe purpose of this study was to determine the frequency of select adverse childhood experiences (ACEs) among a sample of American Indian (AI) adults living with type 2 diabetes (T2D) and the associations between ACEs and self-rated physical and mental health. We also examined associations between sociocultural factors and health, including possible buffering processes.DesignSurvey data for this observational study were collected using computer-assisted survey interviewing techniques between 2013 and 2015.SettingParticipants were randomly selected from AI tribal clinic facilities on five reservations in the upper Midwestern USA.ParticipantsInclusion criteria were a diagnosis of T2D, age 18 years or older and self-identified as AI. The sample includes n=192 adults (55.7% female; mean age=46.3 years).Primary measuresWe assessed nine ACEs related to household dysfunction and child maltreatment. Independent variables included social support, diabetes support and two cultural factors: spiritual activities and connectedness. Primary outcomes were self-rated physical and mental health.ResultsAn average of 3.05 ACEs were reported by participants and 81.9% (n=149) said they had experienced at least one ACE. Controlling for gender, age and income, ACEs were negatively associated with self-rated physical and mental health (p<0.05). Connectedness and social support were positively and significantly associated with physical and mental health. Involvement in spiritual activities was positively associated with mental health and diabetes-specific support was positively associated with physical health. Social support and diabetes-specific social support moderated associations between ACEs and physical health.ConclusionsThis research demonstrates inverse associations between ACEs and well-being of adult AI patients with diabetes. The findings further demonstrate the promise of social and cultural integration as a critical component of wellness, a point of relevance for all cultures. Health professionals can use findings from this study to augment their assessment of patients and guide them to health-promoting social support services and resources for cultural involvement.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Li Yang ◽  
Kun Li ◽  
Yan Liang ◽  
Qiuli Zhao ◽  
Dan Cui ◽  
...  

Abstract Background It has previously been established that patients who have strong barriers to their diet self-management are more likely to have weak social support; however, the key mechanisms underlying the association between these two variables have not yet been established. This study aims to examine the potential role that diet self-efficacy plays in the relationship between social support and diet behavior in patients with type 2 diabetes mellitus (T2DM). Methods It was a cross-sectional survey. Three hundred-eighty patients diagnosed with T2DM were recruited for this study from five community health centers in China. The Chronic Disease Resource Scale (CIRS), Cardiac Diet Self-efficacy Scale (CDSE), and Food Control Behavior Scale (FCBS) were used to estimate participants’ utilization of social resources, diet self-efficacy, and diet self-management, respectively. The data were analyzed utilizing structural equation modelling. Results The results suggest that both higher levels of social support and diet self-efficacy are related to higher levels of diet self-management. The mediating effect that diet self-efficacy has on the relationship between social support and diet self-management was significant (β = .30, p < .05), explaining 55.68% of the total effect of social support on diet self-management. Conclusions Diet self-efficacy plays a mediating role in the association between social support and diet behavior in patients with type 2 diabetes mellitus.


2020 ◽  
Vol 8 (1) ◽  
pp. e001018
Author(s):  
Qingping Yun ◽  
Ying Ji ◽  
Shenglan Liu ◽  
Yang Shen ◽  
Xuewen Jiang ◽  
...  

ObjectivesTo assess whether social support or autonomy support intervention for patients with type 2 diabetes can achieve glycemic control at the end of intervention, and to test whether the glycemic control effect can be maintained for a long time.Research design and methodsIn this cluster randomized controlled trial, 18 community healthcare stations (CHSs) were randomized to the following: (1) usual care group (UCG) offering regular public health management services, (2) social support group (SSG) providing 3-month social support intervention based on problem solving principles, and (3) autonomy support group (ASG) offering 3-month autonomy support intervention based on self-determination theory. A total of 364 patients registered in the CHSs were enrolled into either of the three groups. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were diabetes self-management (DSM) behaviors. Assessment was conducted at baseline and at 3 and 6 months.ResultsPatients in ASG achieved better HbA1c reduction at the end of intervention (0.53% or 7.23 mmol/mol, p<0.001) than those in the UCG and successfully maintained it up to 6 months (0.42% or 5.41 mmol/mol, p<0.001). However, patients in SSG did not experience significant change in HbA1c at 3 or 6 months when compared with patients in UCG. Besides, patients in both the SSG (0.12, p<0.05) and ASG (0.22, p<0.001) experienced improvement in exercise at 3 months. Patients in ASG sustained improvement in exercise up to 6 months (0.21, p<0.001), but those in the SSG did not.ConclusionsAutonomy support for patients with type 2 diabetes could help achieve glycemic control at the end of intervention and successfully maintain it up to 6 months. These findings indicate that autonomy support has positive long-term effects on DSM behaviors and glycemic control and can be recommended in future diabetes intervention programs.Trial registration numberChiCTR1900024354.


Diabetes Care ◽  
2010 ◽  
Vol 33 (11) ◽  
pp. 2383-2389 ◽  
Author(s):  
H. C. Looker ◽  
J. Krakoff ◽  
V. Andre ◽  
K. Kobus ◽  
R. G. Nelson ◽  
...  

Diabetologia ◽  
2021 ◽  
Author(s):  
Miranda T. Schram ◽  
Willem J. J. Assendelft ◽  
Theo G. van Tilburg ◽  
Nicole H. T. M. Dukers-Muijrers

AbstractIt has been known for decades that social networks are causally related to disease and mortality risk. However, this field of research and its potential for implementation into diabetes care is still in its infancy. In this narrative review, we aim to address the state-of-the-art of social network research in type 2 diabetes prevention and care. Despite the diverse nature and heterogeneity of social network assessments, we can draw valuable lessons from the available studies. First, the structural network variable ‘living alone’ and the functional network variable ‘lack of social support’ have been associated with increased type 2 diabetes risk. The latter association may be modified by lifestyle risk factors, such as obesity, low level of physical activity and unhealthy diet. Second, smaller network size and less social support is associated with increased risk of diabetes complications, particularly chronic kidney disease and CHD. Third, current evidence shows a beneficial impact of social support on diabetes self-management. In addition, social support interventions were found to have a small, favourable effect on HbA1c values in the short-term. However, harmonisation and more detailed assessment of social network measurements are needed to utilise social network characteristics for more effective prevention and disease management in type 2 diabetes. Graphical abstract


2020 ◽  
Author(s):  
Carlos A Pérez-Aldana ◽  
Allison A Lewinski ◽  
Constance M Johnson ◽  
Allison Vorderstrasse ◽  
Sahiti Myneni

BACKGROUND Diabetes remains a major health problem in the US affecting an estimated 10.5% of the population. Diabetes self-management interventions improve diabetes knowledge, self-management behaviors, and metabolic control. Widespread Internet connectivity facilitates the use of eHealth interventions, which positively impacts knowledge, social support, clinical, and behavioral outcomes. Particularly, diabetes interventions based in virtual environments have the potential to improve diabetes self-efficacy and support while being highly feasible and usable. However, little is known about the pattern of social interactions and support taking place within type 2 diabetes-specific virtual communities. OBJECTIVE The objective of this study was to examine social support exchanges from a type 2 diabetes self-management education and support intervention that was delivered via a virtual environment (VE). METHODS Data comprised VE-meditated synchronous interactions among participants and between participants and providers from an intervention for type 2 diabetes self-management education and support. Network data derived from such social interactions were used to create networks to analyze patterns of social support exchange with the lens of social network analysis. Additionally, network correlations were used to explore associations between social support networks. RESULTS Findings reveal structural differences between support networks as well as key network characteristics of supportive interactions facilitated by the intervention. Emotional and appraisal support networks are the larger, most centralized, and most active networks, suggesting that virtual communities can be good sources for these types of support. In addition, appraisal and instrumental support networks are more connected, suggesting that members of virtual communities are more likely to engage in larger group interactions where these types of support can be exchanged. Lastly, network correlations suggest participants that exchanged emotional support are likely to exchange appraisal or instrumental support, and participants that exchanged appraisal support are likely to exchange instrumental support. CONCLUSIONS Social interaction patterns from disease-specific virtual environments can be studied using a social network analysis approach to better understand the exchange of social support. Network data can provide valuable insights into the design of novel and effective eHealth interventions given the unique opportunity virtual environments have facilitating realistic environments that are effective and sustainable where social interactions can be leveraged to achieve diverse health goals.


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