Newman Sara, Cheng Terri, Ghahate Donica M, Bobelu Jeanette, Sandy Phillip, Faber Thomas, Shah Vallabh O
Health and Behavioral Sciences, University of Colorado, Denver, Colorado, United States of America.
School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America.
PLoS One. 2014 Jun 11;9(6):e99614. doi: 10.1371/journal.pone.0099614. eCollection 2014.
The Zuni Pueblo, in collaboration with the University of New Mexico, have formed the Zuni Health Initiative (ZHI) engaged in community-based participatory research to plan and implement educational interventions to reduce health disparities. We conducted the first phase of ZHI study and identified barriers to healthcare. We concluded that the burden presented by these barriers ultimately translates into a lack of patient activation and engagement in their health care including for diabetes, effectively hindering adoption of healthy behaviors.
Community health representatives (CHRs) led 10 one-hour focus group sessions to elicit information on diabetes knowledge and self-management strategies at which a total of 84 people participated. Audiotapes were translated and transcribed by bilingual ZHI staff. We reduced the text to thematic categories, constructed a coding dictionary and inserted the text into NVivo 9 program.
The focus groups revealed that despite extensive personal or family experiences with diabetes or complications, participants identified knowledge gaps in the disease progression and disease management. However, we gained insight into how many Zunis conceptualize the etiology of diabetes, risk factors associated with diabetes, sources of knowledge and self-management practices.
We concluded that many of the Zuni diabetics experience significant impacts on their life when they were diagnosed with diabetes and suffered the plight of stigmatization. We further concluded that developing Zuni culture specific diabetes care should focus on family involvement with continued education.
祖尼部落与新墨西哥大学合作，发起了祖尼健康倡议（ZHI），致力于开展基于社区的参与性研究，以规划和实施教育干预措施，减少健康差距。我们开展了祖尼健康倡议研究的第一阶段，确定了医疗保健方面的障碍。我们得出结论，这些障碍带来的负担最终导致患者缺乏对自身医疗保健的积极性和参与度，包括糖尿病方面，这有效地阻碍了健康行为的养成。
社区健康代表（CHRs）主持了10次为时1小时的焦点小组会议，以获取有关糖尿病知识和自我管理策略的信息，共有84人参与。祖尼健康倡议的双语工作人员对录音带进行了翻译和转录。我们将文本归纳为主题类别，构建了一个编码词典，并将文本录入NVivo 9程序。
焦点小组表明，尽管参与者个人或其家庭有丰富的糖尿病或并发症经历，但他们在疾病进展和疾病管理方面仍存在知识差距。然而，我们深入了解了许多祖尼人对糖尿病病因、与糖尿病相关的风险因素、知识来源和自我管理做法的概念。
我们得出结论，许多祖尼糖尿病患者在被诊断出患有糖尿病时，其生活受到重大影响，并遭受了被污名化的困境。我们进一步得出结论，制定针对祖尼文化的糖尿病护理应注重家庭参与和持续教育。
