Exploring the Adaption of Mindfulness in Native American Communities to Address Diabetes

探索美国原住民社区如何运用正念来应对糖尿病

基本信息

批准号：
10020329
负责人：
Jeffrey A Proulx
金额：
$ 23.94万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-20 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10020329
关键词：
Address Adherence Adult Attention Award Behavioral Belief Benchmarking Biological Markers Blood Glucose Calendar California Cessation of life Collaborations Collection Common Core Communities Contracts Control Groups Data Data Collection Data Reporting Development Diabetes Mellitus Elderly Fasting Focus Groups Frequencies Funding Future Glycosylated hemoglobin A Goals Health Personnel Health behavior Hydrocortisone Insulin Intervention Knowledge Language Lead Measures Medicine Modeling Native Americans Native-Born Oregon Outcome Measure Participant Patient Self-Report Phase Physiological Population Procedures Process Protocols documentation Randomized Research Research Design Research Personnel Resistance Sampling Stress Tribal Council Tribes Trust Waiting Lists Work adherence rate arm base diabetes management diabetic efficacy study experience feasibility trial follow-up health disparity improved instrument mindfulness mindfulness intervention mindfulness meditation mindfulness-based stress reduction primary outcome programs psychologic psychosocial recruit response retention rate secondary outcome stress reduction tribal member

项目摘要

PROJECT SUMMARY (Exploring the Adaption of Mindfulness in Native American Communities to Address Diabetes) Native Americans have higher rates of contracting, experiencing complications from, and death due to diabetes (1)(2)(3). Several factors may influence health disparities in diabetes, including Native cultural beliefs about diabetes and distrust of western medicine resulting in poor health behaviors (3)(4). Further, as stress is known to exacerbate the effects of diabetes physiologically and through poor health behaviors associated with stress (5)(6)(7), the effects of daily stress may be compounded by historical stress in Native communities (8). Mindfulness-meditation may be an effective means to reduce psychological and physiological stress as well as encourage good health behaviors through heightened attention to diabetes management protocols (9)(10). Although previous studies have indicated that mindfulness practices may be welcome in Native communities (11)(12)(13), there is still little known about the process of adapting mindfulness interventions to Native cultural traditions. We propose to (A) work closely with tribal members to develop trust and support for mindfulness research in the first phase of the K99, (B) develop a core Native-specific MBSR class with optional modules that can be tailored to be Tribe-specific in the second phase of the K99, and (C) in the R00 phase, use two- armed feasibility trials to further develop the core Native-specific mindfulness class with tailored modules and to assess the feasibility of our study design among diabetic adults. Primary outcomes are measures of feasibility and acceptability. Secondary outcomes include behavioral and physiological markers of diabetes management. We hope that these data will motivate an R01-level examination into the efficacy of mindfulness as a means to improve diabetes management and reduce complications due to diabetes in Native communities. This K99/R00 is the preliminary step in the ultimate goal of integrating mindfulness programs with Native contemplative practices as a means to holistically address Native health disparities. These efforts may prove particularly important in a population that has shown a notorious distrust for western medicine.

项目摘要（探索美国原住民社区的正念适应以解决糖尿病）美洲原住民的收缩率更高，因糖尿病而导致的并发症以及死亡（1）（2）（3）。几个因素可能影响糖尿病的健康差异，包括对糖尿病的本地文化信念和对西方医学的不信任，导致健康行为不佳（3）（4）。此外，由于已知压力会加剧生理上的糖尿病的影响，并通过与压力相关的健康行为不良（5）（6）（7），日常压力的影响可能会因本地社区的历史压力而加剧（8）。正念纳入可能是减少心理和生理压力的有效手段，并通过对糖尿病管理方案的高度关注来鼓励良好的健康行为（9）（10）。尽管以前的研究表明，在本地社区中可能会欢迎正念实践（11）（12）（13），但人们对适应正念干预措施的过程鲜为人知。我们建议（a）与部落成员紧密合作，以在K99的第一阶段建立对正念研究的信任和支持，（b）开发具有可选模块的核心特定于本地特定的MBSR类，可以量身定制为部落特定于部落。在K99的第二阶段，（C）在R00阶段，使用两种武装的可行性试验，进一步开发具有量身定制模块的核心本地特异性正念类别，并评估糖尿病成人研究设计的可行性。主要结果是可行性和可接受性的度量。次要结果包括糖尿病管理的行为和生理标记。我们希望这些数据能够激发R01级检查正念的功效，以此作为改善糖尿病管理并减少本地社区糖尿病并发症的一种手段。这款K99/R00是将正念计划与本地沉思实践相结合的最终目标的初步步骤，以此作为整体解决本地健康差异的一种手段。这些努力可能在对西方医学的臭名昭著的人群中尤其重要。