Anishinaabeg Path to Knowledge

Talking Circles are used by Native American people to provide a way for people to solve problems that remove barriers and to allow people to express themselves with complete freedom. The purpose of this mixed method project was to impact the knowledge and self-care of diabetes among the Native American population by using advanced nurse-led diabetes education and Talking Circles for diabetes type II education. The project used Madeleine Leininger’s culture care theory as a theoretical framework, and the Plan-Do-Study-Act process to support the design. A total of six participants completed the project and attended all six Talking Circle diabetes education sessions. The project was implemented over a time of eight weeks. The Diabetes Knowledge Test (DKT) tool was used as a pre-and post-test, initially to assess patients’ current awareness and knowledge regarding diabetes and then upon completion of education sessions. A questionnaire comprised of two open-ended questions was used to evaluate perception and changes in self-care behaviors. The results were statistically significant (p=0.00689), DKT pre-questionnaires mean average was 67.7% compared to DKT post-questionnaire mean average of 88.8%. Data averages showed a difference of 24.17%. Seven themes were identified during the qualitative analysis: learned, understand/understood, helped/supported enjoyed, created, inspired and nice. The results of the project were clinically significant, and the project was chosen to support accreditation through the Accreditation Association for Ambulatory Health Care and the National Committee for Quality Assurance. Additionally, the organization plans to implement the project as part of a national standard of care. Further evaluation is recommended to expand the sample as the program that can be implemented in other locations across the country. Finding a method that caters to the Native American urban population will help improve quality care for a population that has the highest percentage of diabetes among all communities in the United States.