Native Diabetes Wellness Program, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA 30341 (
Native Diabetes Wellness Program, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
Prev Chronic Dis. 2023 Apr 13;20:E26. doi: 10.5888/pcd20.220315.
We aimed to determine why the Eagle Books, an illustrated series for American Indian and Alaska Native (AIAN) children to address type 2 diabetes, remain viable long after their release. We sought to answer 2 questions: Why did the books maintain popularity? What factors have sustained them?
Type 2 diabetes burgeoned in the US after World War II, compounding a long legacy of injustices for AIAN peoples. By the 1980s, their rates soared above those of White people. Concerned for future generations, Tribal Leaders suggested that the Centers for Disease Control and Prevention and Indian Health Service use traditional storytelling to teach children about staying healthy. Public health interventions are most effective when culture and history are integrated into health education, particularly stories to address a relatively new disease for AIAN peoples.
From 2008 through 2013, we conducted a case study among 8 tribal communities to evaluate the uptake of the Eagle Books across Indian Country. To understand the Eagle Books' sustained appeal, in 2022 we reanalyzed the original case study themes and analyzed for the first time themes that emerged from evaluation results in the Eagle Books' program literature. These were programs that had independently evaluated their use of the Eagle Books and published their findings.
Outcomes demonstrated continuous application of the Eagle Books in diverse community interventions, influencing children's healthy choices. Community implementers described sustainability components, such as the books' versatility, flexibility of use, and availability online and in print.
Historical, social, economic, and environmental health determinants intersect with biological and behavioral factors to weave a complex web of causation for type 2 diabetes, beginning early in life. Compelling, colorful stories reflecting traditional wisdom and respect for Western and Indigenous science - through the eyes of a wise eagle, a clever rabbit, a tricky coyote, and kids in T-shirts and sneakers - can positively influence community health.
我们旨在确定为什么《Eagle Books》系列书籍，这一系列为美洲印第安人和阿拉斯加原住民（AIAN）儿童绘制的插图书籍，用于解决 2 型糖尿病问题，在发布多年后仍然具有生命力。我们试图回答两个问题：为什么这些书籍保持受欢迎？哪些因素支撑着它们？
20 世纪二战后，2 型糖尿病在美国迅速蔓延，这加剧了美洲印第安人长期以来的不公正待遇。到 20 世纪 80 年代，他们的发病率已经超过了白人。出于对后代的担忧，部落领袖建议疾病控制与预防中心和印第安卫生服务机构利用传统故事来教育儿童保持健康。当文化和历史融入健康教育，特别是针对美洲印第安人相对较新的疾病的故事时，公共卫生干预措施最为有效。
从 2008 年到 2013 年，我们在 8 个部落社区中进行了一项案例研究，评估《Eagle Books》在整个印第安国家的采用情况。为了了解《Eagle Books》持续受欢迎的原因，我们在 2022 年重新分析了原始案例研究的主题，并首次分析了《Eagle Books》项目文献中从评估结果中出现的主题。这些都是独立评估其使用《Eagle Books》并公布其发现的项目。
研究结果表明，《Eagle Books》在各种社区干预措施中持续应用，影响了儿童的健康选择。社区实施者描述了可持续性的组成部分，例如书籍的多功能性、使用的灵活性，以及在线和印刷版的可用性。
历史、社会、经济和环境健康决定因素与生物和行为因素交织在一起，形成了 2 型糖尿病的复杂因果关系网络，从生命早期开始。引人入胜、丰富多彩的故事反映了传统智慧和对西方及本土科学的尊重——通过一只聪明的鹰、一只狡猾的兔子、一只狡猾的郊狼和穿着 t 恤和运动鞋的孩子们的视角——可以对社区健康产生积极影响。
