663-P: Online Diabetes Nutrition Education for American Indian and Alaska Native Adults with Type 2 Diabetes: Stakeholder Perspectives

Abstract

Nutrition education is known to promote healthful dietary behaviors and reduce diet-related complications among people with diabetes. American Indians and Alaska Natives (AIAN) have more than double the risk for type 2 diabetes (T2D) and diabetes-related complications than non-Hispanic whites. Despite the high prevalence of T2D in AIAN communities, AIANs often lack access to diabetes-related nutrition education, particularly resources targeted to AIAN audiences. Literature suggests that online nutrition education may effectively serve low-income audiences, but research specific to AIANs is scarce. We employed qualitative focus group and individual interview methods to understand stakeholder perspectives on the feasibility of an online eLearning diabetes nutrition education program for AIAN adults with T2D. We interviewed four types of stakeholders, including: experts in AIAN diabetes nutrition education (n=9); AIAN educators, Native elders, and tribal leaders (n=11); and AIAN adults with T2D (n=29) and their family members (n=22) at 4 geographically distinct urban and reservation sites. Focus groups and interviews were recorded and transcribed verbatim. The constant comparison method guided data coding and thematic analysis and Atlas.ti (Mac Version 8.0) was used to digitalize the analysis. Participants shared that smartphone-based Internet access is common among AIAN adults, except for the very old. Sixty percent of focus group participants indicated that they use the Internet at least daily. Participants reported interest in online education opportunities that are reputable, culturally adapted for AIAN people, and smartphone friendly. Educators and leaders indicated that access to a registered dietitian and food resource management education via online learning would provide Native people with the additional support needed to eat healthfully in communities with high rates of food insecurity and limited access to healthy food. Disclosure S.A. Stotz: None. A.G. Brega: None. K.R. Moore: None. Funding American Diabetes Association (4-18-SMSC-01 to K.R.M.)