The Johns Hopkins Center for American Indian Health is enhancing the previously developed Together on Diabetes program (implemented 2011-2015 in the southwestern United States) for implementation with Midwestern tribes and evaluating its effect through a wait-list randomized control trial. The enhancement of this project will build off of the Gathering for Health project’s findings that historical trauma and contemporary stressors are associated with worse type 2 diabetes risks and management among American Indian adults.
The project curriculum will be taught to American Indian caregiver/adolescent dyads in their homes by local paraprofessional Family Health Coaches. Lessons will cover topics such as diabetes management, historical trauma, life skills, goal setting, managing stress, nutrition, and physical activity. This project will involve 280 families across five communities and will evaluate effectiveness of the intervention on adult physiological, behavioral, and mental health and adolescents’ psychosocial, familial, behavioral, and physiological risk and protective factors for diabetes. Intervention delivery will begin Summer of 2020.
Type 2 diabetes has become an epidemic across American Indian communities, and American Indian people experience the highest rates of type 2 diabetes related morbidity and mortality of any racial/ethnic group. Particularly troubling, type 2 diabetes is increasingly impacting American Indian children and parents, calling for family-based intervention.
If this intervention is effective, American Indian communities may benefit from an empirically supported, family-based model with promise to break cycles of intergenerational diabetes.