Diabetes prevention among American Indians: the role of self-efficacy, risk perception, numeracy and cultural identity

Abstract Background According to the Risk Perception Attitude (RPA) framework, classifying people according to their perceptions of disease risk and their self-efficacy beliefs allows us to predict their likelihood for engaging in preventive behaviors. Health interventions can then be targeted according to RPA group. We applied the framework to type 2 diabetes prevention behaviors among American Indians and expanded it to include culture and numeracy. Methods Using a cross-sectional study design, we surveyed a sample of Northern Plains American Indians in a reservation community setting on self-reported perceptions of diabetes risk, objective diabetes risk, self-efficacy, engagement in healthy behaviors, knowledge of diabetes risk factors, and covariates including demographics, numeracy, and cultural identity. We used the RPA framework to classify participants into four groups based on their perceptions of risk and self-efficacy. Analyses of variance and covariance estimated inter-group differences in behaviors associated with type 2 diabetes prevention. Results Among 128 participants, our only finding consistent with the RPA framework was that self-efficacy and risk perception predicted knowledge about diabetes risk factors. We found limited evidence for the influence of cultural identity within the RPA framework. Overall, participants had lower numeracy skills which tended to be associated with inaccurate perceptions of higher levels of risk. Conclusions The theoretical framework may benefit from inclusion of further contextual factors that influence these behaviors. Attention to numeracy skills stands out in our study as an important influence on the RPA framework, highlighting the importance of attending to numeracy when targeting and tailoring risk information to participants segmented by the RPA framework

Children as Agents of Change: Parent Perceptions of Child-Driven Environmental Health Communication in the Apsáalooke (Crow Indian) Community

While previous research suggests children have successfully acted as health change agents, no studies have examined the role of children in promoting environmental health knowledge and awareness. This study describes parent perceptions of the impact of a five-day water-focused environmental health summer camp on elementary school children in an American Indian community. We interviewed parents about their perception of changes in their child\u27s environmental health knowledge, attitudes, and behaviors. Parents in this study confirmed that their child had shared information related to the camp activities. In addition, parents perceived that their children had increased knowledge and positive changes in attitudes and behaviors related to environmental health. We recommend programs promoting children as change agents develop and use materials for parents that facilitate bidirectional communication with youth so to not place the onus wholly on the child. Our study highlights parental perceptions of the ways the voices and actions of children have the potential to be valuable assets in addressing environmental-related health disparities

Physical Training Center for People with Disabilities

Specific data reveal a high incidence of people with disabilities, both motor and cognitive, in the southern area of ​​the department of Magdalena, Colombia. The absence of centers for the disabled in this geographical area obliges them to move to the municipal seat to find it difficult to access these services, the cost of transportation being an obstacle for the target population, which is mostly low-income. Due to this last condition, they tend to resort to informal caregivers (understood as informal caregiver, any individual in charge of a person with a disability with little knowledge of specific care). In view of the absence of centers of this type, the construction of a Physical Conditioning Center for People with Disabilities located in El Banco, Magdalena is promoted; whose target population is the municipalities and townships located to the south of the department and surrounding departments such as Cesar and Bolívar. It will be projected to serve approximately 640 people per day. The Physical Conditioning Center for People with Disabilities will consist of a 4-level building plus a basement; pools for hydrotherapy; game's zone; area for physical therapy; parking lots and multiple green areas with a lake; all of these connected by inclusive footpaths. Given the long distances along with the conditions of poverty and the lack of inclusive public transportation, it was necessary to design routes that would facilitate people's access to the project. The execution of this project provides an effective solution to the most vulnerable population with disabilities, creating spaces for inclusion and opportunities that generate a better quality of life for the community. The Center for Physical Conditioning for People with Disabilities is a social solution that contributes to the prosperity and growth of each of the people in the south of Magdalena and its surroundings.Datos específicos revelan una alta incidencia de personas en condición de discapacidad, tanto motriz como cognitiva en la zona sur del departamento del Magdalena, Colombia. La ausencia de centros para discapacitados en esta zona geográfica obliga a los mismos a trasladarse a la cabecera municipal para difícilmente acceder a estos servicios, siendo el costo del transporte un obstáculo para la población objetivo, que es en su mayoría de bajos recursos. Por esta última condición, tienden a recurrir a cuidadores informales (entiéndase cómo cuidador informal, todo individuo a cargo de una persona con discapacidad con poco conocimiento de cuidados específicos). En vista de la ausencia de centros de esta índole se impulsa la construcción de un Centro de Acondicionamiento Físico para Personas con Discapacidad ubicado en El Banco, Magdalena; que tiene como población objetivo los municipios y corregimientos ubicados al sur del departamento y aledaños de departamentos como Cesar y Bolívar. Estará proyectado para atender 640 personas diarias aproximadamente. El Centro de Acondicionamiento Físico para Personas con Discapacidad se conformará de un edificio de 4 niveles más un sótano; piscinas para hidroterapia; zona de juegos; área para terapia física; parqueaderos y múltiples zonas verdes con un lago; todos estos conectados mediante senderos peatonales incluyentes. Dada las largas distancias junto con las condiciones de pobreza y la falta de transporte público incluyente, fue necesario diseñar rutas que facilitaran el acceso de las personas al proyecto. La ejecución de este proyecto brinda una solución efectiva a la población con discapacidad más vulnerable, creando espacios de inclusión y oportunidades que generen una mejor calidad de vida para la comunidad. El Centro de Acondicionamiento Físico para Personas con Discapacidad es una solución social que aporta a la prosperidad y el crecimiento de cada una de las personas del sur del Magdalena y sus alrededores