Researcher tackles new approach to diabetes management for American Indians

LAWRENCE — American Indians have the highest prevalence of diabetes, at 17 percent, of all racial and ethnic groups in the United States, according to the Centers for Disease Control and Prevention. Yet fighting the problem is not as simple as a doctor telling an individual to have a better diet and take medication. A University of Kansas professor is harnessing the collective wisdom of tribes and combining it with theory-based approaches for health messages delivery to research new ways to empower individuals and communities to work together to fight diabetes.

Mugur Geana, associate professor of journalism and director of the Center for Excellence in Health Communication to Underserved Populations, known as CEHCUP, is the principal investigator of a grant funded by the Center for Diabetes Translation Research from the Washington University in St. Louis. The study will use a web application developed by Geana to deliver tailored health information about best practices in diabetes management to two American Indian communities in Kansas. The entire approach to the study focuses on the culture, customs and input of community members. CEHCUP representatives have been meeting with community leaders and residents of the Prairie Band Potawatomi Nation in Kansas and the Iowa Tribe of Kansas and Nebraska to gather input for the program and its application, as well as to better understand the cultural dimensions that can be leveraged to address diabetes.

“We’re in the process of learning about the culture and how we need to tailor the information to be relevant to people in the community,” Geana said. “This will hopefully help community members improve their quality of life and assist them better manage their diabetes.”

Research has shown that misunderstanding or minimal knowledge of diabetes is very common in American Indian communities, and Geana and his colleagues have often encountered fatalistic attitudes on individuals who have learned they have diabetes. Considering that most of diabetes’ outcomes depend on an individual’s self care and lifestyle, the need to do something to improve one’s control is even more important.

“We’re working to empower the individual,” Geana said. “We’re not saying, ‘You have to do what we tell you to do, rather, it’s up to you, here are the options you have and the benefits and risks for each option.’ Patients can learn to have better control of their diabetes. Diabetes doesn’t have to control them.”

Each version of the web app will be unique to the tribe it is designed for. They will be developed based on input from the communities and continue to be available for use after the initial research has ended. They will be open to all community members, not just those currently dealing with diabetes. Others who may be concerned about it, have a family member dealing with the disease and those who simply want more information will all be able to use the application.

By providing individually tailored, relevant information on diabetes management and health, and a community forum to talk about the disease, the project aims to modify beliefs, attitudes and behaviors regarding diabetes in individuals and throughout the community.

“We want to stimulate an information exchange within the tribe,” Geana said. “We hope to empower everyone to better manage their diabetes by being able to learn from us and from the collective wisdom.”