Research Project

Holistic Eco-Cultural Avenues of Research and Treatment through Technological Solutions for Type II Diabetes

Abstract

Our study will explore the ways in which individuals make decisions about management of type II diabetes and associated comorbidities beginning from the premise that type II diabetes is a disease of multifactorial origin. More specifically, we aim to look at how type II diabetes and its associated co-morbidities impact the LatinX population. Our study participants will be drawn from the LatinX population in the San Fernando Valley with ties to the California State University, Northridge. Through an ethnographic, qualitative approach we intend to interview type II diabetes patients and their family members using a methodology known as Ecocultural Family Interview (EFI). This will allow us to use the household as the unit of observation and the person with diabetes (PWD) as the unit of analysis. This research will explore decision making and emerging concepts of self-care through dual lenses. First through the lens of the “compliance model” and its attentiveness to micro-processes such as daily routines associated with food choice, exercise, and regularity of visits to a physician, but also through a patient centered “empowerment philosophy” lens, which seeks to understand patient interpretations of illness and well-being more holistically. Under the backdrop of a critical medical anthropological approach (CMA) we intend to contribute to an existing body of literature which addresses patient lived experiences from within the political economies they inhabit, with an emphasis on the role of larger socio-economic macro-processes. Ultimately, we hope to inform future avenues of research related to the creation of a socio-technological solution for treating type II diabetes and associated co-morbidities as it pertains to the increased well-being of LatinX populations.

Research Team

Lead Researcher:

Kevin Zemlicka M.A. : Academic Advisement, Anthropology & Psychology

Collaborators:

Rebecca Gottlieb: Medtronic,The Vice President of Research and Technology at Medtronic Diabetes

Student Team:

Elizabeth Bedrossian
Jasmine Campos- Grijalva
Caitlyn Espino-Benitez
Angelina Geisen
Samira Khabbazzadeh-Rashti
Trevor Levens
Emerson Martinez-Godoy
Steven Mejorado
Margaret Thorne
Jessica Vasquez

Funding

Funding Organization: Medtronic
Funding Program:

Research Problem/Motivation

Co-occurrence of diseases along with diabetes tend to drive and influence each other. These disease co-occurrences include depression, obesity, heart failure, kidney diseases, hypertension, and arrhythmia. However, treatments for diabetes and these co-occurrences are traditionally considered independently of one another without interaction among them. For patients, the disease co-occurrences complicate their lives because they must seek separate specialists and therapists, and no single specialist is available to look across diseases. Significantly, morbidity is expected to increase as the number of co-occurrences increases.

Alignment, Engagement and Contributions to the priorities of NASA’s Mission Directorates

Medtronic

Research Methods

Traditional ethnographic research methods have become problematized under the reality of Covid-19, and the subsequent need to shelter in place. When considering the research design for this study, we propose the following as suitable for research and analysis under the current conditions:

Comprehensive literature review targeting ethnographic studies of communities of type-2 Diabetes patients with special attention paid to experiences of associated co-morbidities.
We will utilize the ethnographic instrument of Ecocultural Family Interview (EFI), which allows for semi-structured interviews with patients and the adult members of their households.
Outreach to participants will occur digitally with the assistance of a graphic design senior from CSUN. Outreach methods will include flyers, and other digital announcements delivered to students through department websites, department office emails, clubs and organizations, and various social media platforms
Our qualitative research design will consider the “household” as the object of analysis and the adult individual with type-2 diabetes within the household as the unit of analysis. This means that we will be looking to include any and all adult members of the primary participant’s household in our data collection methods. The thinking here is that we will acquire a more robust picture of the participants’ diabetes experience by including household members in the research and considering their input in the final analysis.
We will be following the grounded theory approach of Dr. Thomas Weisner by utilizing his Ecological-Cultural Family Interviews (EFI) methodology in our coding and analysis of the data. This will allow us to generate hypotheses to inform the creation of socio-technological solutions for treatment of type-2 Diabetes and associated co-morbidities.
Additionally, we intend to utilize the graphic design student to help create educational materials which may be delivered to communities upon completion of the research. These materials will offer a culturally compassionate rendering of our findings to the community we have worked with (i.e.; each household we interview will receive this product)

Research Deliverables and Products

Students presentations to Medtronic leadership:
- Presentation of proposed research methodologies to Medtronic (complete)
- Literature review completion and presentation of literature review to Medtronic (complete)
Written report based on coding and analysis of interview data (in progress)

Thesis from Samira Khabbazzadeh-Rashti toward completion of M.A. in Anthropology (in progress)
Publication in anthropology journal (Human Organization, City and Society, Medical Anthropology Quarterly are being considered presently)

Research Timeline

Year 1:

The objectives of the first year is to conduct meta-analyses of studies on co-morbidities in diabetes and their interaction, identify those that are more dominant and use them as the focus to develop ethnographic maps highlighting the problems for individual patients, including their needs for support from doctors, hospital visits, and access to community support. Attention of the ethnographic mapping will be focused on the Latin X population in Los Angeles and nearby communities.

Year 2:

January – April 2021: Preliminary research, compilation of literature for literature review, recruitment of associates
April 2021: IRB Protocol initially submitted
May 2021: Literature review completion
June-August 2021: associate training in methodologies
July 2021: IRB Protocol Approved
August 2021: participant recruitment begins
September-November 2021: data collection and analysis
December 2021: finalizing research paper