Diabetes Prevention Strategies for the Diné: Cultural Learning to Implement change. A Qualitative Study
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Diabetes Prevention Strategies for the Diné: Cultural Learning to Implement change. A Qualitative Study

Abstract

Diabetes Prevention Strategies for the Diné

The purpose of this qualitative study was to explore Diné stories as a culturally appropriate educational method in the active implementation of diabetes prevention strategies among Native Americans. Native Americans are 2.3 times more likely than European Americans to be diagnosed with diabetes and die from this disease. In fact, Native people die at a rate that is 200% higher than the U.S. population (Indian Health Service, 2007; Office of Minority Health, 2011). As of 2020 Partners in Health (PIH) has reported that one in three Navajo individuals are diagnosed as diabetic or pre-diabetic. This high rate of disease warrants immediate intervention. A foundational assumption of this study is the critical importance of a culturally appropriate educational method which will inform decision-making about individual and communal health and well-being. This study will build on research about Indigenous education (Battiste, 2013; Brayboy, 2005; Reyhner, 2013; Ritskes & Sium, 2013) and public health (Grace, 2011; Lombard et al., 2012), which demonstrates the value of stories as an effective means of “transformative learning,” with the potential to influence behavioral change. The focus of this qualitative study was on the stories of the Diné as a means for positive change in health outcomes for their community. The overarching focus of the study was what we would be able to learn from Diné participants’ stories that show us ways in which they have been able to implement diabetes prevention strategies in their own lives. Using a method based on Seidman’s (2013) phenomenological interview process, I have given voice to testimonies rooted in traditional Diné values and practices. I learned about the lived experiences of participants related to diabetes, and from their own diagnosis or that of a family member. I also engaged in a form of reciprocal interviewing, in which I shared with participant current effective prevention strategies, such as an improved diet, which is a proven factor in mediating the risk of diabetes (Center for Disease Control, 2011). I then developed narrative profiles for each participant (Seidman, 2013) which present their unique experiences. This approach constituted the first stage of data analysis and also allowed me to ultimately present the data in a form that is a true representation of each participant’s stories. Keywords: phenomenology, culturally appropriate education, storytelling, diabetes interventions

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