Browsing by Author "Bradley, Vickie"

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Dietary Beliefs and Management of Older American Indians With Type 2 Diabetes
(2019-07) Shure, Mark B.; Turner Goins, Ruth; Jones, Jacqueline; Winchester, Blythe; Bradley, Vickie
Objectives This qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM). Design Semistructured in-person interviews were conducted and digitally recorded. Setting Southeastern American Indian tribal community. Participants A total of 28 noninstitutionalized older tribal members aged >60 years. Phenomenon of Interest Study participants’ beliefs and experiences with dietary practices and management related to T2DM. Analysis Transcribed qualitative interviews were coded using an inductive content analysis approach. Results Four themes regarding T2DM dietary beliefs and T2DM dietary management emerged from the analyses: diet changes, portion control, health care professional and family influence, and barriers to healthy eating. Study participants described how their beliefs, practices, and experiences in these 4 areas related to T2DM. Conclusions and Implications American Indian older adults face a variety of challenges to dietary management of T2DM. Future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM. Clinicians and diabetes educators and Native communities have an instrumental role in identifying culturally appropriate messages and programs to help persons effectively manage T2DM.
Type 2 diabetes management among older American Indians: Beliefs, attitudes, and practices
(2018-07) Goins, R. Turner; Jones, Jacqueline; Schure, Mark B.; Winchester, Blythe; Bradley, Vickie
Objective: The purpose of this study was to examine beliefs, attitudes, and practices of older American Indians regarding their type 2 diabetes mellitus (T2DM) management. T2DM is one of the leading causes of morbidity and mortality among American Indians. American Indians are more than twice as likely to have T2DM and have over three times a T2DM mortality rate as Whites. Design: Study participants were older members of a federally recognized tribe who had T2DM. A low-inference qualitative descriptive design was used. Data were collected through semi-structured in-depth qualitative interviews with a mixed inductive, deductive, and reflexive analytic team process. Results: Our study sample included 28 participants with a mean age of 73.0 ± 6.4 years of whom 16 (57%) were women. Participants’ mean self-confidence score of successful T2DM management was 8.0 ± 1.7 on a scale from 1 to 10 with 10 representing the greatest amount of confidence. Participants’ mean HbA1c was 7.3% ± 1.5%. Overall, participants discussed T2DM management within five themes: 1) sociocultural factors, 2) causes and consequences, 3) cognitive and affective assessment, 4) diet and exercise, and 5) medical management. Conclusions: It is important to be aware of the beliefs and attitudes of patients. Lay understandings can help identify factors underlying health and illness behaviors including motivations to maintain healthy behaviors or to change unhealthy behaviors. Such information can be helpful for health educators and health promotion program staff to ensure their efforts are effective and in alignment with patients’ realities.