Health beliefs and regimen adherence of the American Indian diabetic.

This study investigated relationships between demographic and medical variables, attitudes, perceived beliefs of others, coping methods and adherence to the regimen (diet, medications, activity, smoking and stress modification) of 30 controlled and 30 uncontrolled American Indian diabetics. At the time of the clinic visit, subjects completed a coping scale, Miller Attitude Scale, regimen adherence scale, and demographic and medical data forms. Mean scores indicated attitudes toward adherence were very favorable and coping methods used helpful for all prescriptions of the diabetic regimen. Subjects were strongly adherent to all regimen prescriptions with the highest adherence at home and the lowest adherence at work for the uncontrolled group and recreation and sports settings for the controlled group. Multiple regression analysis indicated perceived beliefs of others were strong indicators of diabetic regimen adherence. Attitudes added to the prediction of adherence for taking medications, and coping methods also added to the prediction of adherence for stress reduction. Findings indicate diabetic care plans should be individualized, include significant others, focus on specific life situations and include data on health belief variables. Diabetes has been noted as a major problem with the American Indian population (Bennett, Burch, & Miller, 1971; West, 1974). Obesity has surfaced as an important risk factor related to diabetes in American Indians with greater prevalence among Indian women than Indian men (Knowler, Pettit, Savage, & Bennett, 1981; Lee, Anderson, Bryan, Bahr, Coniglione, & Cleves, 1985; Young, McIntyre, Dooley, & Rodriguez, 1985; Bonham & Brock, 1985). The medical regimen routinely prescribed for the diabetic involves following the diet, taking medications, limiting smoking, performing activities, and modifying responses to stressful situations. Long-term control of diabetes may be accurately determined by Hb Alc and fasting blood sugars. This may also serve as a validation of adherence to the regimen (Gabby, Hastings, Breslow, Ellison, Bunn, & Gallop, 1977; Fraser, Gray, Borsey, Duncan, & Clark, 1982). Long-term regimen adherence is most inconsistent for the prescriptions of diet and medications. However, adherence to the other prescriptions is not without problems, but they have not been investigated to the extent of diet and medication adherence. In addition, setting has been found to present obstacles to adherence, with the greatest adherence occurring in the home setting (Cerkoney & Hart, American Indian and Alaska Native Mental Health Research, 1(1), June 1987, pp. 27-39. American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)