Abstract A045: Adhering to a culturally responsive framework: Integrating kinship into a multilevel community-based intervention for American Indian adults with comorbid type 2 diabetes and cancer
Authors: Hammer Sheila L. , Godfrey Timian M. 
Published: December 2023

The prolific disparities of type 2 diabetes (T2D) and cancer in tribal communities is well documented. American Indian (AI) adults living with T2D are at greater risk of not only developing cancer, but also dying from it, with cooccurrence becoming increasingly prevalent. On rural tribal reservations, common environmental diabetogenic factors (e.g., obesity, lack of physical activity, poor diet, and stress) are considered as sources of elevated risk for both T2D and cancer. Critically important in improving both diabetes and cancer-related health behaviors and outcomes, particularly for AI people, is psychosocial support from family and community ties (e.g., kinship). Despite supporting evidence, few interventions include kinship as a key factor to promote best outcomes for T2D management among AI adults with a dual diagnosis of cancer. To address this growing issue, there is an urgent need for culturally and contextually adapted interventions aiming to address the cooccurrence of T2D and cancer that are, ideally, led by tribal communities.   In this session, healthcare professional Early-Stage Investigators (ESIs), some of whom also identify as AI, will present community-based participatory research (CBPR) principles used to develop a multilevel Tribally tailored intervention, with kinship as a moderating factor, for AI adults living with both T2D and cancer. The ESIs represent a unique pool of providers invested in the community within which they work by co-creating an intervention which utilizes pre-existing strong community and familial norms. The ESIs further look to break away from the common trend in research to overgeneralize interventions and findings to all AI Tribal communities by tailoring the intervention to each specific Tribal Community engaged in the research intervention. To foster innovative research methods by emphasizing important historic and socio-cultural influences relevant to understanding the holistic context of health disparities in tribal communities, the guiding framework is the NIMHD Minority Health and Health Disparities Research Framework adapted for AI and Alaska Native Nations. In this research, individuals are viewed within the context of the broader social system where they function daily, while families and community are key stakeholders and leaders in the successful management of T2D and cancer. The approach focuses on diabetes-related barriers by providing family and social units with skills for successful T2D and cancer management, healthy communication, and shared commitment. In addition to these domains of influence, involving community systems is critical for a sustainable intervention that effectively addresses health disparities for T2D and cancer.  

Citation Format: Sheila L. Hammer, Timian M. Godfrey. Adhering to a culturally responsive framework: Integrating kinship into a multilevel community-based intervention for American Indian adults with comorbid type 2 diabetes and cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A045.