Strong Men, Strong Communities: Design of a Randomized Controlled Trial of a Diabetes Prevention Intervention for American Indian and Alaska Native Men

Abstract

Type 2 diabetes is a serious global epidemic that disproportionately affects disadvantaged populations. American Indians and Alaska Natives (AIs/ANs) have the highest rates of diabetes in the nation with a prevalence of 14.7% in 2018, more than twice that of non-Hispanic Whites. AI/AN men have the highest prevalence of diagnosed type 2 diabetes (14.5%) compared to non-Hispanic Black (11.4%), non-Hispanic Asian (10.0%), and non-Hispanic White (8.6%) men. Several landmark clinical trials have shown that lifestyle interventions can effectively prevent or delay the onset of diabetes among those at risk, including in AIs/ANs. Despite positive outcomes for AIs/ANs in these studies, very few were men. To date, there have been no concerted efforts to recruit and retain AI/AN men in interventions that promote weight loss and healthy lifestyles to prevent diabetes, and they remain underrepresented in these types of studies. This article describes the design and methods of the first randomized controlled trial of a diabetes prevention program with a study sample comprised entirely of AI/AN men. Research to date has demonstrated suboptimal patterns of recruitment and retention of AI/AN men, resulting in their virtual absence in health and intervention research. Effective methods to recruit and retain AI/AN men, and potential benefit gained from participation in diabetes prevention research, are unknown for this population who experience a high prevalence of type 2 diabetes. The study design presented in this article offers promising insights to help remedy these important shortcomings in the science of recruitment and retention of AI/AN men in research.

First Nation Peoples’ nutrition and exercise group programmes: transforming success through the lifeworld

“…Shared language that aimed to understand “what is valued” required a common dialect, including shared gesture and speech, such as traditional languages, words or phrases. The meaning and use of traditional words or phrases was shared by community members, who also helped others such as researchers to understand the significance to the community (Curtis et al, 2004 ; Janssen & Nelson, 2014 ; Sinclair et al, 2020 ; Tipene-Leach et al, 2013 ; Warbrick et al, 2020 ).…”

“…Invested key people developed and maintained strong connections and trust with community through repeatedly investing their time and “showing up” (Firth et al, 2012 ; Jernigan, 2010 ; Parmenter et al, 2020 ; Sinclair et al, 2020 ; Warbrick et al, 2020 ). They had a relational connection beyond the programme through family and friends, and reciprocally through these relationships, community members were invested in the programme (Bachar, 2006 ; Fredericks et al, 2005 ; Jernigan, 2010 ; Thompson et al, 2000 ).…”

“…The third quality, revitalizing First Nations Peoples’ knowledges, was identified as protective of health and well-being, and connected to identity and self-worth (Sinclair et al, 2020 ; Wicklum et al, 2019 ). This concept required those involved, including facilitators, researchers and health care workers to respect, recognize and remunerate cultural knowledge holders of languages, customs, and expertise, to enable a shared capability and understanding (Brown et al, 2020 ; Coppell et al, 2009 ; Curtis et al, 2004 ; Harris & Curtis, 2005 ; Tipene-Leach et al, 2013 ; Warbrick et al, 2020 ).…”

mHealth prompts within diabetes prevention programs: a scoping review

“…57,[77][78][79]. These studies used Social Cognitive Theory(57,77,79) and the Theory of Planned Behaviour(78).…”

“…57,[77][78][79]. These studies used Social Cognitive Theory(57,77,79) and the Theory of Planned Behaviour(78). Only six studies provided detailed explanations of how the theories were used to inform the prompt content(52,61,(70)(71)(72)74) corresponding to four theories: the Transtheoretical Model, Social Cognitive Theory, the Health Belief Model, and Control Theory which are described below.…”