Diabetes Prevention and Care Capacity at Urban Indian Health Organizations.
Front Public Health
; 9: 740946, 2021.
Article
in English
| MEDLINE | ID: covidwho-1775895
ABSTRACT
American Indian and Alaska Native (AI/AN) people suffer a disproportionate burden of diabetes and cardiovascular disease. Urban Indian Health Organizations (UIHOs) are an important source of diabetes services for urban AI/AN people. Two evidence-based interventions-diabetes prevention (DP) and healthy heart (HH)-have been implemented and evaluated primarily in rural, reservation settings. This work examines the capacity, challenges and strengths of UIHOs in implementing diabetes programs. Methods:
We applied an original survey, supplemented with publicly-available data, to assess eight organizational capacity domains, strengths and challenges of UIHOs with respect to diabetes prevention and care. We summarized and compared (Fisher's and Kruskal-Wallis exact tests) items in each organizational capacity domain for DP and HH implementers vs. non-implementers and conducted a thematic analysis of strengths and challenges.Results:
Of the 33 UIHOs providing services in 2017, individuals from 30 sites (91% of UIHOs) replied to the survey. Eight UIHOs (27%) had participated in either DP (n = 6) or HH (n = 2). Implementers reported having more staff than non-implementers (117.0 vs. 53.5; p = 0.02). Implementers had larger budgets, ~$10 million of total revenue compared to $2.5 million for non-implementers (p = 0.01). UIHO strengths included physical infrastructure, dedicated leadership and staff, and community relationships. Areas to strengthen included staff training and retention, ensuring sufficient and consistent funding, and data infrastructure.Conclusions:
Strengthening UIHOs across organizational capacity domains will be important for implementing evidence-based diabetes interventions, increasing their uptake, and sustaining these interventions for AI/AN people living in urban areas of the U.S.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Indians, North American
/
Diabetes Mellitus
Type of study:
Experimental Studies
/
Observational study
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Front Public Health
Year:
2021
Document Type:
Article
Affiliation country:
Fpubh.2021.740946
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