Table 2 Factor Loadings (Rotated*) Principal Components

Increase provider knowledge about diabetes management

Improve clinical practice guidelines

Provide specialized training to deal with diabetes related complications

Address staffing shortages

Help patients seek preventative care so they don't only seek acute care

Reduce frequency of missed appointments

Improve adherence to medication

Address environmental factors (e.g. type of food in store) that make it difficult for patients to adopt healthy lifestyles

Motivate patients to adopt healthy lifestyles

Address communication difficulties between healthcare staff and patients

Develop a system or improve the system for diabetes management and follow up

Extend the time healthcare staff are in the community

Ease access to post-clinical services (lab, referrals, medications)

Advocate making diabetes care a priority for clinic staff

Advocate making diabetes care a priority for tribal leadership