SPIRIT LAKE SPECIAL DIABETES PROGRAM FOR INDIANS: A SACRED LIFE CENTER IMPACT OF NUTRITION AND EXERCISE ON HEALTH

Transcription

1 SPIRIT LAKE SPECIAL DIABETES PROGRAM FOR INDIANS: A SACRED LIFE CENTER IMPACT OF NUTRITION AND EXERCISE ON HEALTH A SACRED LIFE CENTER: ROOTS, REASONS, DEVELOPMENT Tracy Charboneau, MSN RN/Manager Challsey Scallon, MSN RN/Coordinator 1

2 INTRODUCTION t1 t2 t26 t28 2

3 HEALTH PROMOTION Health promotion is behavior motivated by the desire to increase well-being and actualize human health potential (Pender, 2011, p.5) Health equity Health disparities t30 t40 Social determinants of health PUBLIC HEALTH POLICY 3

4 HEALTH EQUITY everyone has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances (CDC, 2017) t46 HEALTH DISPARITIES a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage (Healthy People 2020, 2017) 4

5 HEALTH DISPARITIES RELATED TO DIABETES Native Americans have the highest rates of Type 2 diabetes in the United States, compared to their non-native counterparts (ADA, 2017) Native Americans are 2.2 times more likely to develop Type 2 diabetes compared with non- Hispanic whites (ADA, 2017) NATIVE AMERICANS AND DIABETES Native Americans are 2.3 times more likely to have diabetes than non-hispanic whites t41 Native American children ages are nine times more likely to be diagnosed with Type 2 diabetes than non-hispanic whites 5

6 t42 NATIVE AMERICANS IN NORTH DAKOTA As of 2017, it was reported that there are 31,329 Native Americans living in North Dakota (North Dakota Indian Affairs Commission, 2017) The total number of people in North Dakota who have a diagnosis of Type 2 diabetes is 49,000 (North Dakota Report on Diabetes, 2016) 15% of Native Americans living in ND reported they have been told they have diabetes SPIRIT LAKE AND DIABETES In 2016, there were 2,069 enrolled members of the Spirit Lake Nation living on the reservation In 2016, IHS reported they were providing service to 5,000 enrolled members/descendants of all tribes The diabetes audit report shows that there are currently 607 people registered on the diabetes registry (Spirit Lake Health Center, 2017) 6

7 t43 COMPLICATIONS OF DIABETES IN NORTH DAKOTA Native Americans living in North Dakota are dying 1.6 times more than non-native Americans Blindness Kidney Disease Heart Disease Stroke Amputations MAJOR COMPLICATIONS OF DIABETES AT SPIRIT LAKE Foot complications: neuropathy, amputations Kidney disease: nephropathy/dialysis High blood pressure, which can lead to stroke, heart attack, retinopathy, and kidney disease Heart disease Skin problems (ADA, 2017) 7

8 REASONS FOR A SACRED LIFE CENTER t5 t34 t35 DEVELOPMENT OF A SACRED LIFE CENTER The Diabetes Prevention Program (DPP) Lifestyle classes t36 Highly successful lifestyle intervention program 1,079 participants 45% of participants were racial and ethnic minorities Resulted in a 58% reduction in incidence of diabetes t44 8

9 DPP CONTINUED The methods used included: Lifestyle coaches Frequent contact with participants 16-session core curriculum Supervised physical activity sessions (NIH, 2002) t45 LIFESTYLE COACH TRAINING Spirit Lake hosted the first ever Lifestyle Coach Training for all tribes in North Dakota 40 newly certified Lifestyle Coaches Included IHS Diabetes Program, Community Health Representatives, and other SDPI s. 9

10 t13 t24 t25 LEVELS OF PREVENTION (Astro Health, 2013) BEST PRACTICES SDPI Community-directed grants choose one Best Practice Focus on areas of diabetes prevention and treatment outcome (IHS, 2017) 10

11 SDPI DIABETES BEST PRACTICES Aspirin or other antiplatelet therapy in cardiovascular disease Blood pressure control Chronic kidney disease screening and Monitoring Dental exam Depression screening SDPI BEST PRACTICES CONTINUED... Diabetes-related education Eye exam-retinopathy screening Foot exam Glycemic control Immunizations: hepatitis B Immunizations: influenza 11

12 BEST PRACTICES CONTINUED Immunizations: pneumococcal Immunizations: tetanus/diptheria Lipid management in cardiovascular disease Nutrition education Physical activity education Tobacco use screening Best practice selected Diabetes-related education SPIRIT LAKE SPECIAL DIABETES PROGRAM FOR INDIANS 12

13 CULTURAL VALUES t11 t12 t37 Humility Truth Courage Honesty Respect Love Wisdom (Spirit Lake Nation, 2014) WHAT SHOULD WE NAME THE FITNESS CENTER? A Sacred t8 Life Center 13

14 Winning entry for the name, submitted by Mrs. Lonna Street Winning logo submitted by Mr. Dallas Dogskin 14

15 OVERALL SUCCESS STORY Renovation Sacred Life Center Long-term goal is to decrease newly diagnosed patients by at least 50% within 5 years through nutrition education and physical activity Gardening Project Mini-grant awarded by the American Association of Indian Physicians (AAIP) Healthy Active Native Communities (HANC) grant Starter gardens Recycled wooden pallets & totes Classes for 50 families A Sacred Life Center Staff 15

16 Challsey Scallon, RN, MSN Tracy Charboneau, RN MSN INDIVIDUAL SUCCESS STORIES 16

17 CODY GREYWATER Cody has been coming to A Sacred Life Center since the doors opened He was our 1 st Fitness Member of the Month, He is determined to prevent diabetes as long as possible DERRICK IRONHAWK -Type 2 Diabetes for 14 years -Double amputee for two years -Recently decided to change his life -Hard work and dedication -Walked for the first time in two years 17

18 VICKI GOURNEAU 65 years old Drives 20 miles one way every day to come work out Dropped clothing sizes Decreased A1c KAYLA ROBERTSON The thought of having diabetes scared me so much that I started walking everyday and tried to cut out certain food and it worked for awhile I lost 37 pounds. But then it got cold out and the wellness centers didn t have a lot of equipment to work with. Not only that, I didn t really know how to use the equipment they had. I didn t know what kind of workout to do with the equipment and how long to do a workout. So, by the next year I gained all the weight back and more. After the Sacred Life Center opened I really didn t go because I was thinking I don t know how to use the equipment. After going there, they had me fill out a questionnaire and asked me questions. I didn t really expect it to be like that. The staff were very helpful and worked with me. Now that I am setting goals for my eating habits and figuring out more ways to be active, it really helps. Little things do make a difference in trying to live a more healthy and active life. The Lifestyle classes also taught me how to track my food. By learning how much calories, fat grams, and carbs are in certain foods, it helped me a lot. I started losing more weight by just doing that. Going to the Sacred Life Center really did change my life because all the help and information I received from the center, I put it to use. Every day I workout and eat right, I am walking away from Diabetes! Thank You to all the staff that helped me and kept me motivated! 18

19 PICTURES Deb Wilson, MS & Barb Anderson, BSW RAIN Program Director & Coordinator Gayle Roux, PhD, NP-C, FAAN Dean & Professor UND College of Nursing & Professional Disciplines 19

20 Dr. Chris Burd, RN, PhD QUESTIONS? 20

21 REFERENCES American Diabetes Association (2017). Complications. Retrieved from: American Diabetes Association (2017). Treatment and care for American Indians/Alaska Natives. Retrieved from: American Nurses Association (2017). Public Health Nursing. Retrieved from: g Astro Health (2013). Leavell and Clarke s Levels of Prevention. Retrieved from: Caps, R. (2015). Type 2 diabetes continues to plague Indian reservations, new hopes are scarce. Diabetes Health. Retrieved from: Centers for Disease Control and Prevention. (2015). Use of culturally focused theoretical frameworks for adapting diabetes prevention programs: A qualitative review. Preventing Chronic Disease: Public Health Research, Practice and Policy. Retrieved from Centers for Disease Control and Prevention (2017). Chronic Disease Prevention and Health promotion. Retrieved from: ExploreHealthCareers.org (2017). Public health nurse. Retrieved from: HealthyPeople.gov (2017). Disparities. Retrieved from: IHS Diabetes Care and Outcome Audit (2017). Indian Health Service (IHS). Indian Health Service (2017). Special diabetes program for Indians. Retrieved from: Frans, M., Boucher, J., & Evert, A. (2014). Evidence-based diabetes nutrition therapy: Recommendations are effective: The key is individualization. Diabetes, Metabolic Syndrome, and Obesity: Targets and Therapy, 7,

22 Gittlesohn, J., and Rowan M. (2011). Preventing diabetes and obesity in American Indian communities: The potential of environmental interventions. American Society for Nutrition. Retrieved from: Knowler, W.C., and Ackerman, R. T., (2013). Preventing diabetes in American Indian communities. American Diabetes Association. Retrieved from Pender, N. (2011). Health Promotion in Nursing Practice. 6 th Ed. Upper Saddle River, New Jersey. Pearson Education. Spirit Lake Nation, Retrieved from: 22