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Objectives: Native Americans have higher rates of mental health symptoms and chronic disease compared to the general population, partly due to historical loss (eg, land, language, culture). Few studies have examined strength-based characteristics that enable Native populations to cope with loss and reduce loss-related emotional symptoms (eg, anxiety, anger). Methods: We recruited 81 participants (mean age 47.9 years; 61% female) in a midwestern Anishinaabe community using convenience sampling. Participants completed questionnaires assessing historical loss, loss-related emotional symptoms, psychological resilience, and maladaptive and adaptive coping strategies. Hierarchical regression analyses examined associations of historical loss, psychological resilience, and coping strategies with loss-related emotional symptoms after controlling for demographics. Results: Historical loss ( β = .56, p < .001) and maladaptive coping strategies ( β = .23, p < .05) were positively associated with loss-related symptoms among Anishinaabe community members; psychological resilience was inversely associated with loss-related symptoms ( β = -.21, p < .05). Adaptive coping strategies ( β = .02, p > .05) were not associated with loss-related symptoms. Conclusions: Findings suggest that historical loss is associated with loss-related emotional symptoms in the Anishinaabe population. Public health programs that foster psychological resilience and reduce maladaptive coping strategies are needed to address these loss-related symptoms.

Purpose: The purpose of the study was to determine the feasibility of implementing A1C self-testing at home using the A1CNow® Self Check and to compare the accuracy of the A1CNow to a reference standard in African Americans with type 2 diabetes (T2D). Methods: African American adults with T2D were recruited from 13 different churches (N = 123). Phase 1, conducted during the early phase of the COVID-19 pandemic, examined the feasibility of A1C assessment using the A1CNow performed at home by untrained participants. Phase 2, conducted when in-person research resumed, compared A1C values concurrently measured using the A1CNow and the DCA Vantage™ Analyzer (reference standard) collected by research staff at church testing sites. Results: In Phase 1, 98.8% of participants successfully completed at least 1 at-home A1C test; the overall failure rate was 24.7%. In Phase 2, the failure rate of staff-performed A1CNow testing was 4.4%. The Bland-Altman plot reveals that A1CNow values were 0.68% lower than DCA values, and the mean differences (A1CNow minus DCA) ranged from −2.6% to 1.2% with a limit of agreement between −1.9% to 0.5%. Conclusions: A1C self-testing is feasible for use in community settings involving African American adults with T2D. The A1CNow Self-Check underestimated A1C values when compared with the reference standard. Ongoing improvements in point-of-care devices have the potential to expand research and clinical care, especially in underserved communities.

Purpose The purpose of this substudy was to determine the most acceptable way to restart the Texas Strength Through Resilience in Diabetes Education (TX STRIDE) study safely using remote technologies. Following the emergence of COVID-19, all in-person TX STRIDE intervention and data collection sessions were paused. Methods Qualitative descriptive methods using telephone interviews were conducted during the research pause. A structured interview guide was developed to facilitate data collection and coding. Forty-seven of 59 Cohort 1 participants were interviewed (mean age = 60.7 years; 79% female; mean time diagnosed with type 2 diabetes = 11 years). Results Data categories and subcategories were generated from the interview responses and included: personal experiences with COVID-19, effects of COVID-19 on diabetes self-management, psychosocial and financial effects of COVID-19, and recommendations for program restart. Although some participants lacked technological knowledge, they expressed eagerness to learn how to use remote meeting platforms to resume intervention and at-home data-collection sessions. Six months after the in-person intervention was paused, TX STRIDE restarted remotely with data collection and class sessions held via Zoom. A majority of participants (72.9%) transitioned to the virtual platform restart. Conclusions Qualitative findings guided the appropriate implementation of technology for the study, which facilitated a successful restart. High retention of participants through the study transition provides evidence that participants are invested in learning how to manage their diabetes despite the challenges and distractions imposed by COVID-19.