Communication ETDs

Publication Date

Summer 5-18-2021



Managing diabetes requires a detailed self-care regimen of physical activity, eating well, testing glucose, healthy weight maintenance, and positive emotional outlook in order to maintain health outcomes. Education, clear communication, and sufficient support are needed to address challenging aspects of daily self-care at the onset of diagnosis and throughout the management of the illness. However, many people diagnosed with diabetes are unable to successfully manage their condition. Native Americans are twice as likely to have diabetes than Whites. Although diabetes-related kidney failure and other negative health effects remain a concern among Native Americans, rates of kidney failure in this population have decreased by more than half. Therefore, it is important to understand both strengths and barriers in self-care in this population. The goal of this study was to understand the experiences of Diné (Navajo) community members who have type 2 diabetes mellitus and to explore their perspectives of diabetes, self-care, and support. Methods included qualitative analyses of the diabetes meanings, self-care, and support narratives of 12 Diné narrators. Conclusions led to a new way of seeing diabetes self-care and new ways of managing this chronic illness for personal well-being, home practices, and clinical management. The narratives provided significant understandings of diabetes self-care that are grounded in the use of the Diné language, lifeways, and philosophies. This study provides a narrative that shifts power to Diné people and their form of self-determination when managing diabetes through dominant Western medical standards. Results from this study led to the creation of a culturally congruent framework called Nizhonigo ádaa áháshya: diabetes self-care model, and it bridges Diné centered self-care with Western clinical guidelines. This new, culturally centered framework with diabetes self-care also may contribute to other health communication theories and frameworks. Keywords: Indigenous, Native American, American Indian and Alaskan Native, Diné (Navajo), type 2 diabetes mellitus, diabetes self-care, decolonization, indigenization, holistic




Decolonizing diabetes, Indigenous diabetes self-care

Document Type


Degree Name


Level of Degree


Department Name

Department of Communication and Journalism

First Committee Member (Chair)

Dr. Tamar Ginossar

Second Committee Member

Dr. Jaelyn deMaria

Third Committee Member

Dr. David Weiss

Fourth Committee Member

Dr. S. Fawad Ali Shah

Fifth Committee Member

Dr. Laura Burton