Diabetes Self-Management Behaviors among American Indians in the Midwestern United States.

The purpose of this study was to understand if American Indian adults with diabetes in the Midwest are similar to American Indian adults nationally in their self-management behaviors. This cross-sectional survey was conducted from May 2009 to April 2010 at powwows, health fairs, and other community events. The convenience sample self-selected into the study and answered questions via touch screen computer about diabetes self-management. Participants were significantly below the national average for American Indians in their adherence to self-management recommendations in daily foot checks (p=0.0035) and having had a dilated eye exam in the previous year (p=0.0002), despite being significantly more likely to have taken a diabetes self-management class (p<0.0001). They were similar to the national average for daily glucose checks and having had one or more hemoglobin A1C tests in the previous year. Participants were less likely to eat 5 or more servings of fruits or vegetables per day (p=0.0001), but more likely to achieve 150 minutes or more of physical activity per week (p=0.0001). Programs addressing self-care issues should be developed to help improve the self-management habits of American Indian adults with diabetes, with particular attention to activities outside of monitoring blood glucose and hemoglobin A1C levels.

Health Is Life in Balance: Students and Communities Explore Healthy Lifestyles in a Culturally Based Curriculum.

From exploring knowledge from wise members of the community to investigating the science of homeostasis, students learn healthy ways of living through a new hands-on curriculum, Diabetes Education in Tribal Schools: Health Is Life in Balance. The curriculum integrates science and Native American traditions to educate students about science, diabetes and its risk factors, and the importance of nutrition and physical activity in maintaining health and balance in life. Applying an inquiry-based approach to learning, the curriculum builds skills in observation, measurement, prediction, experimentation, and communication, and provides healthy lifestyle messages and innovative science activities for all students. The curriculum is now available to teachers and health educators at no cost through a federal grant.Health Is life in Balance incorporates interdisciplinary standards as well as storytelling to help children understand important messages. Implementation evaluation of the curriculum indicated improved knowledge and attitudes about science and health, positive teacher and student comments, and culturally relevant content. The lessons highlighted in this article give a glimpse into this hands-on curriculum which integrates science and Native American traditions, looking to our past and listening to the wisdom of our Elders, to gain powerful information for healthy, holistic living. The circle of balance is a theme in many indigenous belief systems and is woven into the lessons, providing enduring understandings of health behaviours that can prevent type 2 diabetes in the context of Native American cultural themes.