Paper short abstract:

Diabetes Care in American Samoa: contributions from anthropology and behavioral medicine. RK Rosen, J DePue, ST McGarvey. Describes the translation, implementation and study outcomes for a RCT of a culturally translated, community health worker delivered, diabetes self-management intervention in a Pacific culture with high diabetes prevalence.

Paper long abstract:

Diabetes Care in American Samoa is a randomized trial of a community health worker and primary care coordinated diabetes intervention. It provided self-management support to diabetes patients in a Pacific culture with high diabetes prevalence. Investigators include biological and medical anthropologists, psychologists, and MDs. This paper considers the cultural translation and delivery of this intervention, including how anthropology within the context of behavioral medicine and public health is different from, but dependent upon, ethnographic work. Practical realities of practicing medical anthropology in the context of global public health are considered, generally and specifically for this project.

We describe our research methodology for adapting this behavioral intervention to this specific cultural context, report the trial outcomes, and reflect on the success of this cultural translation. Reflections include: the effective use of qualitative data protocols in this context; adapting the concept of chronic disease self-management for a sociocentric society; helping patients balance personal health priorities with sometimes competing cultural obligations; conducting the study while managing the different priorities of research, medical care, and local culture.