Tan Chingfen Graduate School of Nursing Dissertations



Publication Date


Document Type

Dissertation, Doctoral


Graduate School of Nursing

Dissertation Committee Chair

Susan Sullivan-Bolyai


Type 2 diabetes, Native health beliefs, diabetes self-management, qualitative

Subject Categories

Community-Based Research | Endocrinology, Diabetes, and Metabolism | Health Services Research | Nursing | Nutritional and Metabolic Diseases | Quantitative, Qualitative, Comparative, and Historical Methodologies


Purpose: This qualitative descriptive study was undertaken to describe Eastern Woodlands Native adult perspectives, health care beliefs and type 2 diabetes management experiences.

Specific Aims: The specific aims were to 1) explore and describe perceptions of type 2 diabetes among Eastern Woodland Native adults and how they relate to their understandings about the cause and treatment approaches to the disease, 2) describe how family, friends, and community intersect with type 2 diabetes management, 3) describe relationships with health care providers and 4) determine resources that would help diabetes-self management within their community.

Framework: The PEN-3 Model by Airhihenbuwa was the initial framework used for the study.

Methods: A qualitative descriptive design with maximum variation and snowball sampling was used and data was analyzed using qualitative content analysis.

Results: The overarching theme of Together We Can Return To Balance comprised five sub-themes: Coming to Know Life Paths with T2DM, Negotiating My Way Forward, Making Important Connections, Acknowledging the Imbalance, and Sticking Closer to Mother Earth illustrating physical, spiritual, and environmental health factors influencing DSM capacities.

Conclusion: Native perspectives should be viewed as a crucial contextual variation for type 2 diabetes care when developing DSMES and for improving DSM capacities in these populations.


Material from this dissertation has been published in: Sadlon P, Charron-Prochownik D, Sullivan-Bolyai S. "Together We Can Return to Balance"-Eastern Woodlands Native Perspectives and Type 2 Diabetes: A Qualitative Study. Diabetes Educ. 2020 Dec;46(6):597-606. doi: 10.1177/0145721720967631. Epub 2020 Oct 30. PMID: 33126843.



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