title: A diabetes prevention assessment tool for American Indians.
abstract: BACKGROUND
  American Indians have a disproportionately higher risk of developing type 2 diabetes. Few data are available about the perceptions of diabetes among American Indians, and no culturally appropriate tools are available for assessment of perceptions related to health and diabetes.
  
  
  METHODS
  A diabetes prevention assessment tool was developed to measure perceptions of health and diabetes among American Indians. Predominant themes from qualitative interviews were used to develop the items for the tool. Data were collected at two autumn powwows, or intertribal dances, in Oklahoma. Reliability testing was performed using 185 surveys from American Indian adults not living on reservations. Principal axis factor analysis was performed to identify possible relationships among the items.
  
  
  RESULTS
  Five themes, or factors, were found to categorize the perceptions of health: 1) lifestyles, 2) barriers to healthy lifestyles, 3) personal responsibility, 4) self-care behaviors, and 5) culturally defined well-being. Two factors classified the perceptions of diabetes: 1) a cognitive factor, related to personal experience, and 2) an affective factor, related to emotions.
  
  
  CONCLUSIONS
  Our diabetes assessment tool identified factors that should be considered when developing health promotion and diabetes prevention programs for American Indians. A valid assessment tool for the American Indian population could provide valuable, formative data that would increase understanding of the culturally related obstacles to health promotion and diabetes prevention.
authors.affiliation: Medical Dietetics Division, The Ohio State University, 453 West 10th Ave, 306A Atwell Hall, Columbus, OH 43210-1234, USA. ctaylor@amp.osu.edu
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Taylor
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Keim
authors.forename: Dale R
authors.initials: DR
authors.lastname: Fuqua
authors.forename: Christine A
authors.initials: CA
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D003469:Culture; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000517:prevention & control* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005239:Fear; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007198:Indians, North American / Q000523:psychology; D008019:Life Style / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009825:Oklahoma / Q000453:epidemiology; D012648:Self Care; D011795:Surveys and Questionnaires