title: Challenges to participating in a lifestyle intervention program: the Native American Diabetes Project.
abstract: This paper describes the factors that American Indian teachers in the Native American Diabetes Project (NADP) reported affected participation in the NADP lifestyle education sessions.
  
  
  
  A postsession exit interview was conducted with each of the 7 mentors (teachers) of the NADP sessions. Interview questions addressed general perceptions of the sessions, factors that kept participants from coming to the sessions, and attitudes toward diabetes and persons with diabetes. Interviews were transcribed and responses reflecting factors related to participation were marked and organized into topic areas.
  
  
  
  Mentors reported a range of factors that affected participation in the sessions, such as conflicts with community activities and beliefs/attitudes about diabetes. The latter factor includes program knowledge, recruitment methods, attitudes toward the program, and beliefs about diabetes.
  
  
  
  Asking community members what factors they believe affect participation is an important component of increasing participation in community-based programs. Community members can provide a valuable personal perspective of actual and potential conflicts in the community.
authors.affiliation: The Department of Internal Medi­cine, University of New Mexico School  of Medicine, Albuquerque (Mss Griffin, Gilliland, and Perez, and Drs Upson and Carter)
authors.forename: J A
authors.initials: JA
authors.lastname: Griffin
authors.affiliation: The Department of Internal Medi­cine, University of New Mexico School  of Medicine, Albuquerque (Mss Griffin, Gilliland, and Perez, and Drs Upson and Carter)
authors.forename: S S
authors.initials: SS
authors.lastname: Gilliland
authors.affiliation: The Department of Internal Medi­cine, University of New Mexico School  of Medicine, Albuquerque (Mss Griffin, Gilliland, and Perez, and Drs Upson and Carter)
authors.forename: G
authors.initials: G
authors.lastname: Perez
authors.affiliation: The Department of Internal Medi­cine, University of New Mexico School  of Medicine, Albuquerque (Mss Griffin, Gilliland, and Perez, and Drs Upson and Carter)|The Veterans Affairs Medical Center, Albuquerque, New Mexico (Drs Upson and Carter)
authors.forename: D
authors.initials: D
authors.lastname: Upson
authors.affiliation: The Department of Internal Medi­cine, University of New Mexico School  of Medicine, Albuquerque (Mss Griffin, Gilliland, and Perez, and Drs Upson and Carter)|The Veterans Affairs Medical Center, Albuquerque, New Mexico (Drs Upson and Carter)
authors.forename: J S
authors.initials: JS
authors.lastname: Carter
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000517:prevention & control*; D005178:Faculty; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American / Q000193:education* / Q000523:psychology*; D008019:Life Style; D008297:Male; D008611:Mentors / Q000523:psychology; D009516:New Mexico; D010349:Patient Compliance / Q000208:ethnology*; D010353:Patient Education as Topic / Q000458:organization & administration*; D011795:Surveys and Questionnaires