Online Program

American Indian talking circles and diabetes self-management-a qualitative study

Monday, November 4, 2013

Marlene Wilken, RN, PhD, Dept. of Preventive Medicine and Public Health, Creighton University, Omaha, NE
The culturally appropriate Talking Circle (TC) was used as one intervention to improve diabetes self-management behaviors for American Indian study participants with HbA1c's of 7 or greater. Each of the two groups of study participants met once a week for 12 weeks. The TC was facilitated by a tribal elder with well controlled DM2 and experience as a TC leader. Cultural themes significant to the TC participants were spirituality which included prayers, relationship to God (Wakonda) and blessings for those who were objects of the prayers. Additional themes or characteristics of the culture that were evident throughout the TC sessions were gratitude, sharing, and humor. The major topics of the discussions were the experiences of living with DM2. The subcategories of themes expressed included the challenges of having DM2. These challenges were: fatalism, denial, difficulties related to medication adherence and regimen compliance, achieving acceptance and the effects of DM2 on families. Another category was coping with DM2. Coping included reasons for participating in the TC, motivators for adherence to medication and dietary regimens, specific behaviors that promoted adherence, and the effects of adherence. Study participants consistently identified that what they liked best about the TC was the sharing, hearing others' stories, and knowing they were not alone. Suggestions for what health care providers should know are given.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the key components of an American Indian Talking Circle Discuss the major diabetes self-management themes identified by Talking Circle particpants

Keyword(s): Self-Management, Community Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principle Investigator of this qualitative study which is part of an NIDDK grant awared to me. I attended and audio-taped all 24 Talking Circles on an American Indian reservation. The qualitative findings have been coded and analyzed.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.