Diabetes: A Family Matter Program and Toolkit

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Diabetes A Family Matter Program and Toolkit

• Sharon A. Denham, DSN, RN
• Professor, Ohio University School of Nursing

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Support FUNDING

• Centers for Disease Control and Prevention
  National Diabetes Education Program
• Ohio Department of Health Diabetes Prevention and
  Control Program
• Ohio Universitys Appalachian Rural Health
  Institute (ARHI)
• Ohio University, Diabetes Research Initiative
  (DRI).
• Ohio Universitys Office of Research and
  Sponsored Projects Challenge Grants

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SPECIAL ACKNOWLEDGEMENT

• Dr. Frank Schwartz
• Chris Knisely
• Dr. Ann Rathbun

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ACKNOWLEDGEMENTS

• Dr. Margaret Manoogian, Dr. Kathy Rose-Grippa,
  Larry Hamel-Lambert, Amelia Krales, Steve Fetsch,
  Joshua Ramsey, Norm Bebee, Dana Formby, Nicholas
  Sgouros, William Zorn, Dr. Lynn Harter,
  Dr. Karen Remsberg, Dr. Larry Wood, Tara OBrien,
  Patricia Harris, Kallia Wright, Tammy Collier,
  Cara Butcher, Stacey Hartman, Jeff Negrelli, Eimi
  Lev, Maria Averion, Joe Bass

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MORE ACKNOWLEDGEMENTS

• Dr. Jay Shubrook, Barbara Nakanishi, Suzanna
  Theodoras, Carole Merckle, Diabetes Centers
  Diabetes Coalition, Beth Pingle, Francie Astrom,
  Karen Bailey, Dr. Benjamin Bates, Dr. Darlene
  Berryman, Ruth Dudding, Dr. Jennifer Hinton, Dr.
  Mary de Groot, Susan Isaac, Dr. Jane
  Hamel-Lambert, Dr. Bruce Martin, Dr. David Mould,
  Deborah Murray, Dr. Rafael Obregon, Tracey
  ODell, Dr. Brian Quick, Nancy Schell, Jane
  Snider, Kathy Trace, Deanna Tribe

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VERY Special Thanks

• Dr. Jane Kelly
• Nancy Schaefer
• Cheryl Branham
• Kathy Chapman
• Ellen Peterson

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EXTRA SPECIAL THANKS

• Kimberly Malone
• Michelle Malone
• Leslie Malone
• Antonio Keith (T.J.)
• Teran Keith
• Ann Rathbun

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Dedication to Kimberly Malone
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Health Care in Our nation

• Access
• High costs and affordability
• Lack of health care insurance
• Increased numbers of seniors
• Increases in chronic illness
• Electronic medical records
• Epidemic of diabetes obesity

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Appalachia
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ASSUMPTIONS

• Diabetes is a growing problem in Appalachian
  region.
• Cultural uniqueness of the region.
• Lack targeted diabetes education and teaching
  materials.
• Family is important in lives for Appalachian
  people.
• Lack family-focused diabetes education materials.
• Primary care largely inadequate for holistic
  needs.

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ASSUMPTIONS

• Diabetes experts and other health practitioners
  are not readily accessible to many.
• Need new approaches to address healthy lifestyle
  behaviors, diabetes prevention, and diabetes
  self-management.
• Community programs and volunteers have been
  successful.

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ASSUMPTIONS

• Excellent diabetes education materials for health
  professionals already exist and is available.
• Diabetes educators may not be knowledgeable
  about
• Community or population health
• Working with coalitions
• Volunteer programs
• Development, implementation, and
• evaluation of sustainable community
• programs.

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ASSUMPTIONS

• Broadband access is not yet readily available,
  but availability continues to grow.
• Social networking can be a valuable tool for
  mobilizing people and groups.

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Program Purposes

• Healthy lifestyles, diabetes prevention, and
  diabetes self-management
• Type 2 diabetes (primarily)
• Rural focus
• Program for Appalachian communities

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Family Health Model (Denham, 2003)

• Family-Focused versus Medical Model
• Family Context (family history, genetics, place,
  culture)
• Family Function (communication, caregiving,
  story-telling)
• Family Routines

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The Storied Lives of Diabetes

• Lived experience and biomedical accounts
• Narrative competence and clinical care
• Diabetes as a Family Disease
• Diabetes more than individual problem (extended
  kin networks, place, faith, etc.)
• Health legacies
• Reconstruct new stories (e.g., not being
  beholden to others)

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Community Perspectives

• Ecological context
• Diversity
• Geography
• Multiple interacting sectors
• More than traditional ideas of health care

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Material Development

• Low literacy and Health Literacy
• Cultural identification (avoid stereotypes)
• Empowerment
• Living with diabetes

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Material Development

• Novel approaches/innovative ideas
• Interdisciplinary input
• Web 2.0 availability
• Multiple types of audiences

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Citizen Action

• Give local people a voice.
• Take personal actions to improve the quality of
  life of those that live in your community.
• Work with others to positively mobilize the
  resources available in your community to address
  the health of local residents.
• Empowerment and active involvement of all local
  residents.

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Citizen Action

• Train the trainer model
• Community coalitions
• SUGAR Helpers (Support to Unite Generations in
  the Appalachian Region)

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Materials

• Diabetes Educator Manual
• SUGAR Helper Manual
• Series of brochures
• Posters
• Fotonovellas
• Bookmarkers
• Film
• Plays

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Toolkit Activities

• www.diabetesfamily.net
• Toolkit section of website
• Multiple activities
• Ask Me Campaign

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Website www.diabetesfamily.net