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INTRODUCTION
This study investigates the
education of Native American regarding Type 2 Diabetes Mellitus. It
explores how much knowledgeable NativeAmericans are about the disease as
being such is one of the most important factors in the management of the
disease.
The aim of the study is to
build a plan that would educate Native Americans about Diabetes Mellitus.
In order to do so, the study also explores the barriers to healthcare and
uncovers the best education approach to the group.
The reason this topic is
explored is because of the perception that minorities are uneducated and
are often misinformed about the dangers of chronic diseases and how they
can be managed. Furthermore, Native Americans have their own traditional
practices in healthcare, which stands somewhat as a barrier for them to
accept proper healthcare practices. Through this study, those issues will
be explored. It will greatly help the Native Americans in understanding
basic facts about diabetes and how it should be managed. The plan will be
helpful in being able to penetrate deep into their culture and embed basic
modern treatments and management of diabetes.
BACKGROUND OF THE STUDY
Diabetes is one of the most pervasive and
worsening health problems facing the world today. The disease afflicts a
broad swath of people, young and old. In the United States, there is at
least 15.7 million people, have diabetes; of these, 5.4 million are
unaware that they have the disease. Diabetes is among the leading cause of
death. If inadequately treated, diabetes can cause blindness, kidney
disease, nerve disease, amputations, heart disease, and stroke. Even
conscientious and well-treated diabetics frequently suffer from these
complications and have above-average medical costs.
The United States provide basic
healthcare education to its citizens about the dangers of diabetes.
However, special programs are made to educate minority groups such as the
Native Americans. If observed, the Native Americans have many barriers to
health education, which basically involves their culture, lifestyle,
accessibility and socio-economic status. For instance, Native Americans
are currently experiencing a crisis of hunger and poverty. The Native
Americans suffer from a much higher rate of food insecurity and poverty
than the general population (Henchy et al, 2000). Furthermore, because of
poverty and living in rural areas, Native Americans mostly consume less
expensive and often high fat foods, and less fruits and vegetables (Henchy
et al, 2000).
It has been reported that 40%
of Native American diets are derived from fats (Henchy et al, 2000).
Because of lack of financial capabilities, Native Americans usually do not
have access to a decent hospital or doctor to consult their conditions.
Also, because of lack of transportation and being far away in the rural
area, there is a great difficulty in visiting doctors at urban locations (Henchy
et al, 2000).
Approaches to Native Americans in terms
of healthcare education are usually intervened by the government through
the programs they develop. One example of these programs is the National
Diabetes Education Program (NDEP),
a program that delivers
culturally and linguistically appropriate prevention and control messages
through trusted and valued community-based delivery channels and
intervention approaches (Vinicor, 1999). These approaches are usually
common and are planned to be culturally sensitive enough to relate with
the Native Americans so as they can absorb what the program tries to
teach.
Traditional Healthcare
Practices of Native Americans
Culture is an important issue
in educating Native Americans about Type 2 diabetes. Native Americans have
their own traditional healthcare beliefs that are deeply embedded within
them. Their faith in these beliefs is one of the strongest barriers in
educating them to embrace the modern methods of combating and preventing
Type 2 diabetes.
Native Americans beliefs are
as diverse as the numbers of their tribes. However, majority of tribes
have the following beliefs in common: they believe in the supreme creator;
man is made up of body, mind and spirit; plants and animals are part of
the spirit world; the spirit world exists side by side and intermingles
with the physical world; illness affects the mind and the spirit as well
as the body; wellness is harmony of body, mind and spirit; unwellness is
disharmony in body, mind and spirit; natural wellness is a cause of
witchcraft, and; each of us is responsible for our own wellness (Schrader
and Schrader, 1997).
Native Americans believe that
they can acquire disease from the vengeful spirits of animals as well as
disrespect towards nature. They believe they can also acquire diseases
from a powerful spell casts by a witch. Diseases are not handled by modern
nurses or doctors, but by traditional medicine men trained to perform
‘healing ceremonies’ (Schrader and Schrader, 1997). Ceremonies include
ritual chants and some herbal remedies (Schrader and Schrader, 1997),
which is overall based by faith and can be branded as ‘faith healing’.
Methods to Approach the Group
According to Schrader and
Schrader (1997), and based on the discussion above, the most important
concept of health education to Native Americans is the overlapping of
religion and medical treatment since such link is embedded within their
belief system. This should be the basis in determining what type of adult
learning education should be used so as to implant to them the basic ideas
of diabetes implications management. In this lieu, the humanistic approach
of learning should be applied to them. This may include the three basic
types of learning: affective; behavioral; and cognitive learning.
Affective learning is necessary to form their attitudes, feelings and
preferences (Leith, 2002). Behavioral learning, on the other hand, is
necessary to develop their actual performance on the methods and
procedures (Leith, 2002). Finally, cognitive learning is necessary to
ensure that they will remember basic knowledge and concepts (Leith, 2002).
One of the
concepts of learning that should be addressed among Native Americans is
the learning environment. The learning environment should be comfortable
in a sense that there is mutual trust, respect, mutual helpfulness,
freedom of expression, and acceptance of difference (Leith, 2002). Such
learning environment approach should promote a humanistic type of
learning, where Native Americans will be respected of their culture, and
at the same time will accept the modern concepts that are being taught to
them (Leith, 2002).
Another humanistic learning
concept that should work with Native Americans is the acceptance of shared
responsibility (Schrader and Schrader, 1997). The learner should develop a
strong sense of responsibility to self and to others with the ability to
develop towards one’s fullest potential (Schrader and Schrader, 1997). In
other words, the Native Americans to be educated about diabetes should
have responsibility for planning and operating the learning experience
(Leith, 2002).
PLAN FOR IMPLEMENTATION OF HEALTH PROGRAMS
One focus that will be
emphasized in the plan is that
management of nutrients in the body is important for a person
with Type 2 Diabetes. In his journal article, Decoster (20002) presents
challenges to diabetic patients posed by type 2 diabetes. A section
reviewing literature on diet and exercise states that medical nutritional
therapy (MNT) is often the first-line therapy of choice, and that its goal
is to maintain near-normal glucose levels by matching dietary consumption
with actual caloric needs, necessitating that the right foods in correct
proportions be eaten at prescribed times. Another goal is weight loss. In
meeting either goal, the person must become aware of his or her individual
food consumption patterns and basic caloric needs for height, weight, age,
and level of activity; be able to prepare and plan well-balanced meals
using fresh foods as often as possible; be able to read and interpret
nutritional information on food labels; and be able to incorporate regular
meal times into work and home schedules. The problem however is that these
management techniques may contradict with the basic beliefs of Native
Americans. Thus, the following objectives below will be implemented.
The aims of the study are: to know if
Native Americans are well-educated about the basic facts of Type 2
Diabetes; how it can be managed to avoid and prevent the different
complications associated with it; and to present a plan on how to educate
them effectively despite of the barriers to learning that were identified
earlier. The plan is to divide the learning experience into three
sections:
1.
Development of attitude of Native Americans about the modern
management of diabetes.
This will be done by doing a simple
analogy of the modern management process effects using basic Native
American beliefs. Since there are many beliefs among different tribes, the
main task then is to retrieve the basic beliefs of each tribe that will be
addressed. Afterwards, analogies will be developed so as to relate
situations with their culture.
2.
Applying a humanistic approach on teaching.
This means ensuring that the teacher will
reach out to the students individually. It will be ensured that a
comfortable physical environment will be provided. Teachers should act as
resource and co-learners. Mutual trust should be gained by respecting the
basic beliefs of the Native Americans and commenting anything negative
about them. Furthermore, responsibilities should also be developed. The
students must be able to share their options in design and experience and
selection of methods and procedures.
3.
Finally, the development of cognitive knowledge.
After attuning to
their behavior and attitude, the cognitive side of learning will be
targeted. This will be done by conducting daily tests that will monitor
the progress of the students on learning. Tests will be graded typically
through percentage analysis.
Overall, the following is the list of
important points in the plan:
1.
The program should last a month and should address families with or
without diabetes. It should focus on one tribal group at a time (other
groups that will be addressed will also be for a month).
2.
The approach should be humanistic, but also incorporates cognitive
development.
3.
The focus of the education is on how Type 2 diabetes can be
prevented and personally managed.
4.
The Native American culture should be respected.
5.
Growth and progress should be monitored.
FOLLOW-UP
To monitor the progress and
effectiveness of the program, a simple quantitative research will be
conducted a few months after it.
For this task, a structured questionnaire
will be constructed. The questionnaires will be sent to those who attended
the programs.
A 5-point Likert
Scale will be used to measure the degree of agreement on each question or
statements on the questionnaires.
Data will be
analyzed with the use of the latest SPSS. The percentage and weighted mean
of each response on statements will be presented on tables. Conclusions
will be given to confirm the change in attitudes among them and how they
embraced the new knowledge that was taught to them. |
