Abstract
Many inner-city populations experience disproportionately high disease
rates. Among those adversely affected are the Minneapolis, Minnesota 20,000
American Indian residents who experience limited health care access and suffer
threefold diabetes health disparity. This research project evaluated the extent
to which marketplace clinics, such as those located in the pharmacy areas of
CVS, Walmart, Target, or Supervalu stores extended their business model to be
more culturally aware and inclusive of medically underserved and urban Indian
persons with diabetes. The quantitative study was conducted within the Patient
Activation Measure (PAM) analytical framework in assessing one’s knowledge, skills, and confidence for self-managing
diabetes health and health care. The study’s main theoretical
foundation is that complementary marketplace and community-based
self-management education motivates self-determination, which in turn, actuates
diabetes health improvement. A case-control study tested whether marketplace
clinics and activated support group participants got better at managing their
diabetes relative to the control group. The positive effects of marketplace
clinics and community-based complementation were borne out with respect to
significantly improved blood sugar control, weight loss, and healthful
lifestyle adaptation. Implications for social change include sharing this
complementary network with Minneapolis medically underserved and urban Indian
neighbors. Social change progress could also be realized by incorporating patient
activation methods with diabetes health prevention for 30 Urban Indian Health
Organizations that are located in large cities throughout the country.
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