Apathy and Type 2 Diabetes among American Indians: Exploring the Protective Effects of Traditional Cultural Involvement

Abstract

In this study we examine relationships between traditional cultural factors, apathy, and health-related outcomes among a sample of American Indian adults with type 2 diabetes. Participants completed cross-sectional interviewer-assisted paper and pencil surveys. We tested a proposed model using latent variable path analysis in order to understand the relationships between cultural participation, apathy, frequency of high blood sugar symptoms, and health-related quality of life. The model revealed significant direct effects from cultural participation to apathy, and apathy to both health-related outcomes. No direct effect of cultural participation on either health-related outcome was found; however, cultural participation had a negative indirect effect through apathy on high blood sugar and positive indirect effects on health-related quality of life. This study highlights a potential pathway of cultural involvement to positive diabetes outcomes.

Caregiving Stress Among American Indians With Type 2 Diabetes: The Importance of Awareness of Connectedness and Family Support

“…Thus, while stressful contexts of child caregiving can be harmful to well-being, the presence of a supportive family and sense of connectedness can be advantageous for caregivers with T2D. Our findings are supported by previous literature discussing family and community connections as common cultural values for many AI people (Garrett et al, 2014; Jones & Lindahl, 2011; LaFromboise & Dizon, 2003; Martin et al, 2016), and ultimately, add to a growing body of literature documenting the potential protective impact of culturally meaningful constructs for AI health (e.g., Carlson et al, 2017; Hill, 2006; Kulis et al, 2012; LaFromboise et al, 2006; Martin et al, 2016; Schiefer & Krahé, 2014).…”

“…The Indigenous Stress-Coping Model (ISCM; Walters et al, 2002) identifies cultural practices and the inclusion of family and community as protective factors that can buffer or mediate negative mental and emotional outcomes in the face of stress and trauma. Numerous AI cultural factors including positive ethnic identity, involvement in cultural activities, and spirituality have been previously linked to positive mental and behavioral health outcomes (Carlson et al, 2017; Kulis, Hodge, Ayers, Brown, & Marsiglia, 2012; LaFromboise, Hoyt, Oliver, & Whitbeck, 2006; Schiefer & Krahé, 2014). Furthermore, both family and community are a direct tie to the continuation and practice of AI culture (Walters et al, 2002).…”

A Conceptual Model for Quality of Life Among People with Type 2 Diabetes in the Philippines

“…findings suggesting a relationship between HbA1c and QOL. [36][37][38] The clinic at which this study was conducted measures fasting blood glucose rather than HbA1c to assess glucose control during routine health checkups. Therefore, one reason why HbA1c was not related to QOL in the present study was that participants did not routinely undergo HbA1c measurement and may not have correctly understood the importance of high HbA1c values.…”

Stress and Cardiometabolic Disease Risk for Indigenous Populations throughout the Lifespan

“…One literature review of the role of traditional cultural participation in health and well-being outcomes around the world found that those tribal members that used their traditional language more often had improved high school graduation rates (Hawaii), decreased suicide rates (Canada), reduced smoking (US Plains and Southwest tribes), reduced health risks (Australia), improved health (Hopi), and lower rates of diabetes (Canada) [ 225 ]. Other studies have noted that connection to and immersion into traditional culture, such as attending cultural ceremonies and use of traditional language, is associated with a decrease in metabolic disease-related risk factors including depression and suicidality [ 226 , 227 ], diabetes, smoking, and obesity [ 228 , 229 , 230 ].…”