Browsing by Author "Turner Goins, Ruth"

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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.
Frailty in Older American Indians: The Native Elder Care Study
(2019-06) Turner Goins, Ruth; Schure, Mark B.; Winchester, Blythe
Introduction Frailty is often described as a reduction in energy reserves, especially with respect to physical ability and endurance, and it has not been examined in American Indians. The goals of this study were to estimate the prevalence of frailty and identify its correlates in a sample of American Indians. Methods We examined data from 411 community-dwelling American Indians aged ≥55 years. Frailty was measured with weight loss, exhaustion, low energy expenditure, slowness, and weakness characteristics. Results Slightly over 44% of participants were classified as pre-frail and 2.9% as frail. Significant correlates of a combined pre-frail and frail status identified in the fully adjusted analyses were younger age, female gender, lower levels of education, increased number of chronic medical conditions, and increased number of activities of daily living limitations. Marital status, chronic pain, and social support were not associated with pre-frail/frail status. Conclusions Our findings point to specific areas in need of further research, including use of frailty measures that also capture psychosocial components and examining constructs of physical resilience. Targeting those with multiple chronic medical conditions may be an important area in which to intervene, with the goal of reducing risk factors and preventing frailty onset.