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Empowering Native Adolescents: Responsibility for Their Health Behaviors.

Rachel A Chambers¹, Dane Hautala², Anne Kenney³

¹Rachel Chambers, Senior Research Associate, Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States;,

American Journal of Health Behavior

|January 6, 2021

Summary

The Together on Diabetes (TOD) program empowers Native American adolescents to manage diabetes risk. Participants increased responsibility-taking for health tasks, engaging more with caregivers in decision-making.

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Area of Science:

Public Health
Pediatric Endocrinology
Behavioral Science

Background:

Type 2 diabetes poses a significant health risk for Native American youth.
Adolescent engagement in self-management is crucial for diabetes prevention and control.
Existing diabetes prevention programs may not adequately address cultural contexts or shared responsibility models.

Purpose of the Study:

To evaluate the impact of the home-based Together on Diabetes (TOD) program on responsibility-taking for diabetes risk tasks among Native American adolescents.
To identify patterns of task sharing between adolescents and caretakers in diabetes risk management.
To assess the stability and changes in these patterns over a 12-month period.

Main Methods:

A 12-session, 6-month home-based diabetes prevention program (TOD) was implemented.
Participants included Native American youth (ages 10-19) at risk for type 2 diabetes and their adult caretakers.
Latent class and transition analyses were used to examine task-sharing patterns (adolescent, shared, caretaker) at baseline, 6 months, and 12 months using the Diabetes and Obesity Task Sharing (DOTS) Questionnaire.

Main Results:

Latent class analysis identified three distinct groups: adolescent-led, shared responsibility, and caretaker-led task sharing.
The adolescent-led class demonstrated the most stability from baseline to 6-month follow-up.
Transitions from the adolescent class primarily led to the shared responsibility class, indicating increased engagement.

Conclusions:

The Together on Diabetes (TOD) program effectively empowers Native American adolescents to assume greater responsibility for their diabetes risk management.
The program fosters increased engagement and shared decision-making between adolescents and their caregivers.
These findings highlight the potential of culturally tailored, home-based interventions for improving adolescent health outcomes.