Recipient Organization
UNIV OF MINNESOTA
(N/A)
ST PAUL,MN 55108
Performing Department
Family Social Science
Non Technical Summary
The Family Education Diabetes Series (FEDS) is a health promotion initiative that was created through the collaborative efforts of providers affiliated with the University of Minnesota and local leaders in the Saint Paul/Minneapolis American Indian community. The program engages low-income, urban-dwelling American Indians and their families in an active forum of education, fellowship, and support. Its mission is to improve the health and well-being of Indigenous people through diabetes education and fellowship in manners that embrace their heritage, values, and culture(s).In March 2020, the FEDS was put on-hold secondary to the COVID-19 pandemic. Many of the program's participants are elderly, obese, diabetic, and/or have co-morbid health conditions that place them at higher risk of virus contraction. As public health messages got worse (not better), it became clear that in-person programming necessitated an adaptation to something else. Concerted efforts followed to explore what we could do. Without meeting in-person, sharing meals together, and otherwise engaging in active forums of education and support, how could we foster the social connectedness that the FEDS used to offer? How could we continue to facilitate community education / resources about diabetes (narrowly) and health (broadly)? How could we do this in light of the fact that many FEDS participants cannot afford consistent access to video conferencing technologies and/or means (internet connections, cell phone minutes)? After several unsuccessful and clumsy starts during the Summer, we began having virtual FEDS meetings in the Fall.The principal goal of the proposed project is to integrate an interview-based investigation into our current efforts. Specifically, we will ask participants to share their perceptions about what efforts - of the many attempted - were the most helpful and effective in modifying this conventionally in-person intervention to a virtual one. We will also inquire about how their COVID-19 experiences (e.g., social isolation, reduced access to outside activities) have influenced their physical health (e.g., weight/BMI, metabolic control). Asking these questions is important because current participants' wisdom can inform future FEDS participants' successful engagement with the program, and in making sense of how outcome data were (or are) influenced by doing the FEDS on-line.We will coordinate and conduct five group interviews (divided across adults and elderly). The interviews will follow a semi-structured format; they will be audio-recorded and later transcribed word-for-word. Qualitative analyses of transcripts will be organized and presented across major categories and themes that emerge from the gross data base. Results will be shared back to, discussed, and interpreted with participants - and then integrated into ongoing FEDS programming. We will also present our work across local-, national-, lay/community-, and professional/academic conferences and forums.Knowledge gained through this research will inform our local work in refining and adapting the FEDS to its contemporary (and evolving) challenges, alongside others' efforts to create similar programs in comparable low-income, urban-dwelling American Indian communities.
Animal Health Component
(N/A)
Research Effort Categories
Basic
100%
Applied
(N/A)
Developmental
(N/A)
Goals / Objectives
The Family Education Diabetes Series (FEDS) is a health promotion initiative that was created through the collaborative efforts of providers affiliated with the University of Minnesota and local leaders in the Saint Paul/Minneapolis American Indian community. Using guiding principles of Citizen Health Care (CHC) and Community-based Participatory Research (CBPR), the program engages low-income, urban-dwelling American Indians and their families in an active forum of education, fellowship, and support. Its mission is to improve the health and well-being of Indigenous people through diabetes education and fellowship in manners that embrace their heritage, values, and culture(s).In March 2020, the FEDS was put on-hold secondary to the COVID-19 pandemic. Many of the program's participants are elderly, obese, diabetic, and/or have co-morbid health conditions that place them at higher risk of virus contraction. As public health messages got worse (not better), it became clear that in-person programming necessitated an adaptation to something else. Concerted efforts followed to explore what we could do. Without meeting in-person, sharing meals together, and otherwise engaging in active forums of education and support, how could we foster the social connectedness that the FEDS used to offer? How could we continue to facilitate community education / resources about diabetes (narrowly) and health (broadly)? How could we do this in light of the fact that many FEDS participants cannot afford consistent access to video conferencing technologies and/or means (internet connections, cell phone minutes)? After several unsuccessful and clumsy starts during the Summer, we began having virtual FEDS meetings in the Fall.The principal aim of the proposed project is to integrate a qualitative investigation into our current efforts. Specifically, we will inquire about participants' perceptions regarding (a) what efforts - of the many attempted - were the most helpful and effective in modifying this conventionally in-person intervention to a virtual one, and (b) how their COVID-19 experiences (e.g., social isolation, reduced access to outside activities) have influenced their physical health (e.g., weight/BMI, metabolic control). This is important to do because current participants' wisdom can inform future FEDS participants' successful engagement with the program, and in making sense of how outcome data were (or are) influenced by navigating the FEDS during a considerably different psychosocial context(s) than heretofore traversed.We will coordinate and conduct five group interviews (divided across adults and elderly) within talking circles - which are consistent with American Indian culture(s) as a highly-valued forum wherein important topics can be discussed equitably and safely (Brandenburger et al., 2017; Poupart et al., 2009) and with previous experience within the FEDS in processing important program organization and intervention foci (Mendenhall, in-press; Mendenhall et al., 2010). Interviews will follow a semi-structured format; they will be audio-recorded and transcribed verbatim. Qualitative analyses of transcripts will be organized and analyzed through an iterative data reduction method in which information is extracted and orchestrated into patterns, categories and themes that emerge from the gross data base (Crabtree & Miller, 1999; Etz et al., 2019; Pope et al., 2000). Results will be presented back to, discussed, and interpreted with participants - and then integrated into ongoing FEDS programming and dissemination efforts across local-, national-, lay/community-, and professional/ academic research- forums.Knowledge gained through this research will inform our local work in refining and adapting the FEDS to its contemporary (and evolving) challenges, alongside others' efforts to create similar programs in comparable low-income, urban-dwelling American Indian cohorts who are struggling with health-related foci and concomitant disparities.
Project Methods
The principal aim of the proposed project is to integrate a qualitative investigation into our current efforts. Specifically we will inquire about participants' perceptions regarding (a) what efforts (of many attempted) were the most helpful and effective in modifying this conventionally in-person intervention to a virtual one, and (b) how their COVID-19 experiences (e.g., social isolation, reduced access to outside activities) has influenced their physical health (e.g., weight/BMI, metabolic control).Interviews will follow a semi-structured format; guiding questions will include:1. As the FEDS transitioned to an on-line format, a. what were the most difficult processes that you had to figure out? Possible probes: accessing new technologies; learning how to use new technologies b. how did you figure out how to use the technology(ies) necessary to participate? Possible probes: trial-and-error; assistance from a family member2. What advice would you offer to a new FEDS participant as they prepare to take part in the program "virtually"?3. What thoughts and suggestions do you have regarding what we should stop, continue, and/or do to make the virtual-version(s) of the FEDS most effective?4. In what ways has the COVID-19 pandemic influenced (or not) your diabetes management? a. Physical / biological health? (A1c, BP, BMI, etc.) b. Psychological / emotional health? c. Social / relational health?5. What advice would you offer to a person who has recently been diagnosed with diabetes, and is now learning how to manage it within the context(s) of COVID-19?6. What else would you like to share?Interviews will be audio-recorded and transcribed verbatim. Qualitative analyses of transcripts will be organized and facilitated through NVivo-12, following an iterative data reduction method in which information is extracted and orchestrated into patterns, categories and themes that emerge from the gross data base (Crabtree & Miller, 1999; Pope et al., 2000). The sequence of analytic steps - conducted by Dr. Mendenhall (PI) and other team members (graduate students, community elders) will include the following:1. Get a sense of the whole; read through several of the transcript documents carefully and record initial ideas for categories and themes;2. Pick one document and peruse it again, recording thoughts about its principal substance;3. Repeat Step 2 several times with other documents, and then begin a list of all topics and themes identified. Cluster similar topics together. Place these groupings into columns that might be arranged as major topics, unique topics, miscellaneous;4. Re-visit the data. Abbreviate topics as codes and record the codes next to the appropriate segments of the text. Modify and add new topics and themes if they emerge;5. Find the most descriptive wording for each topic and turn them into categories. Reduce the total list of categories by grouping topics that relate to each other;6. Assemble the data belonging to each category and assimilate the categories into a comprehensive picture.Regular meetings will take place to resolve coding differences and establish indicated inter-rater reliability. Results will be presented back to project participants to further discuss findings' accuracy and associated interpretation/meaning(s), and then integrated into ongoing work in program adaptation and dissemination efforts across local-, national-, lay/community-, and professional/research- forums.