"Together We Can Return to Balance"-Eastern Woodlands Native Perspectives and Type 2 Diabetes: A Qualitative Study

Publication Date


UMMS Affiliation

Graduate School of Nursing

Document Type



Community-Based Research | Community Health and Preventive Medicine | Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Health Services Research | Nursing | Nutritional and Metabolic Diseases


PURPOSE: To explore the perspectives of Eastern Woodlands Native people with type 2 diabetes (T2DM) in the context of health beliefs, T2DM disease self-management, and family and community connections.

METHODS: A qualitative descriptive method using face-to-face or telephonic semistructured interviews was employed with Native people ages 18 years or older who have a diagnosis of T2DM (N = 12) from an unidentified Eastern Woodlands tribe. The PEN-3 Cultural Model guided the study initially.

RESULTS: The overarching theme "together we can return to balance" corresponded to 5 subthemes: coming to know life paths with T2DM, acknowledging the imbalance, negotiating my way forward, making important connections, and sticking closer to Mother Earth. Dimensions within the subthemes suggest why Native people may not be reaching T2DM treatment goals. Reasons include incomplete diabetes knowledge, difficulty accessing resources, and contextual variations in adoption of conventional diabetes treatments.

CONCLUSION: This study identified themes from Native perspectives about T2DM self-management and about prospects that may mitigate incomplete knowledge and support. Integrating indigenous health and wellness knowledge with conventional principles of diabetes care presents several opportunities for nurses to advance diabetes self-management (DSM) education and support. Including Native health concepts when educating patients about DSM should be viewed as desirable for holistic family and community involvement that is central toward preventing disease progression.

DOI of Published Version



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. Link to article on publisher's site

Journal/Book/Conference Title

The Diabetes educator


Penni P. Sadlon participated in this study as a doctoral student (view her dissertation) in the Graduate School of Nursing at UMass Medical School.

Related Resources

Link to Article in PubMed

PubMed ID