Provides rationales from the literature, including relevant statistical data, for selecting this topic.Presents current literature from U.S. professional journals & books (primary sources within the last 5 years).
(10 Points)
Review of Literature:
Cites 10 sources (minimum) of literature related to selected issue in minority health.
***Strictly use provided 10 research articles for references/sources***
Include:
-Incidence/Morbidity/Mortality
-Risk Factors
-Social Aspects
-Cultural Aspects
-Economic Aspects
-Prevention
-Community Models of Intervention
(50 points)
Presents current literature from U.S. professional journals & books (primary sources within the last 5 years).
(5 Points)
Summary:
Summarizes major points of literature review.
(5 Points)
Conclusion:
Includes personal belief of issue
(5 Points)
Recommendation:
Makes a recommendation for potential, creative intervention(s)
(15 Points)
Composition, spelling, grammar, APA format
(10 Points)
TOTAL
(100 Points)
State of the Science: A Cultural View of Native Americans and
Diabetes Prevention
Karethy (Kay) Edwards, DrPH, FNP, BC and
Professor and Co-Director of the Center for Cultural Competency & Healthcare Excellence at the
University of Oklahoma Health Sciences Center
Beverly Patchell, MS, CNS
Assistant Professor & Co-Director of the Center for Cultural Competency & Healthcare
Excellence at the University of Oklahoma Health Sciences Center
Abstract
The purpose of this article is to present a review of the literature on diabetes type 2 prevention
interventions for Native American populations. The interrelation of the cultural role of food in
Native American diets, educational policies related to food, outcomes of federal policies, and the
historical background of diabetes are addressed. In addition, published studies of diabetes
prevention interventions with Native American populations are examined. Lastly, exemplars of
programs that represent best practices in the prevention of diabetes are described.
Keywords
Native America; Type 2 Diabetes; Prevention Programs; Cultural
Introduction
Much has been written about American Indians and Type 2 diabetes. Search engines bring
up hundreds of articles and internet sites on this topic. How do these published reports really
impact diabetes prevention for Native Americans? Has what is known gone from awareness
to intervention to success in preventing diabetes? The purpose of this article is to present a
review of the pertinent published literature about the prevention of Type 2 diabetes
(hereafter called diabetes) among Native Americans and to highlight exemplar programs and
empirically tested interventions in the literature that could make a difference. The impetus
for this process is the authors’ work as Co-Directors for the nursing research training core of
the American Indian Diabetes Prevention Center. The mission of the American Indian
Diabetes Prevention Center is to prevent or delay the onset of diabetes in American Indians
and Alaska Natives. The goal of this project is to teach tribal nurses, who work with Native
Americans, about research methods, the process of implementing evidence-based practice,
and the ethical conduct of research in the practice setting. In learning about any issue, it is
important to review its historical background.
History of American Indian Health in America
Native Americans have a rich history of healthy food systems and prosperous agricultural
economies. By 800 A.D., North American Indian farmers from Florida to Ontario, Canada
were cultivating several crops and developing varieties that were appropriate for the
growing season where they lived (Keoke & Porterfield, 2002). Explorers landing in the so
called new world marveled at the abundance of agricultural crops and the advanced
NIH Public Access
Author Manuscript
J Cult Divers. Author manuscript; available in PMC 2010 July 16.
Published in final edited form as:
J Cult Divers. 2009 ; 16(1): 3235.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
agricultural technology. As a result, many explorers and settlers were aided by Indian
farmers’ bounty (Keoke & Porterfield, 2002).
This changed as colonization was established and the Indigenous people were pushed out of
their traditional homelands, subject to war and disease and finally, containment on
reservations or city slums. Surveys of Native American diets from the 1920s into the 1950s
found staples of canned meat and fish, bread, beans, sugar, and coffee or tea (Prucha, 1986).
On many reservations, malnutrition and nutritional deficiencies were endemic. Despite
recommendations to improve Native American diets, food aid provided to the tribes was
usually insufficient and of low quality. Also, the food aid did not include traditional foods,
leading to further deterioration in health. The history of food insecurity for Native
Americans that began with the establishment of reservations continues today. Until the
1950s, malnutrition and hunger were the primary food issues facing tribes (Prucha, 1986).
After the 1950s, Native American dietary patterns were increasingly dictated by the arrival
of welfare checks and the distribution of government commodities (Bass, 1974 p.37). To
the contrary, despite the increase in federal food aid, Native American diets remained
inadequate to their needs.
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