Diabetes Forecast

Honoring Native American Health Programs

Innovation and community involvement were highlighted at this year's John Pipe Voices for Change Awards, part of the American Diabetes Association Awakening the Spirit Subcommittee's efforts to honor the best of diabetes care in Native American communities.

The awards ceremony, held September 28 at the National Indian Health Board's 28th Annual Consumer Conference in Anchorage, Alaska, was instituted in 2009 to recognize the successes of grant recipients in the Special Diabetes Program for Indians. The SDPI is a federal grant program established by the Department of Health and Human Services in 1997. Diabetes affects nearly 17 percent of American Indians and Alaska Natives—the highest age-adjusted prevalence of diabetes among all U.S. racial and ethnic groups.

The Voices for Change awardees are selected by the ADA Awakening the Spirit Subcommittee, a group of volunteers dedicated to helping native people gain the knowledge and skills to prevent diabetes. Gale Marshall, the subcommittee's chair, says the Voices for Change Awards help bring attention to programs and organizations that help whole communities. "The SDPI has really given these programs an opportunity to shine and to perform, and to develop effective strategies to stop diabetes," she says.

This year's winners of the John Pipe Voices for Change Awards also included:
Innovation: Fond du Lac Diabetes Prevention Program in Cloquet, Minn., which started a contest that encouraged every member of the community to get screened for diabetes.
Innovation: Norton Sound Health Corp. Chronic Care Active Management and Prevention (CAMP) in Nome, Alaska, which helps empower people to stave off type 2 diabetes and heart disease.
Advocacy: Native Health Diabetes Program in Phoenix, which aims to improve young people's physical fitness, self-esteem, and nutrition.
Advocacy: The Southeast Alaska Regional Health Consortium's Diabetes and Lifestyle Balance Programs in Sitka, Alaska, which tackle both primary and secondary aspects of prevention.

One such program is the Yakama Healthy Heart Program, part of the Yakama Indian Health Service in Toppenish, Wash., which took this year's Outcomes award (a list of other winners is at left). The program was instituted to help community members build relationships with health care providers. It uses pharmacists as clinical providers for people with type 2 diabetes. Participants meet with pharmacist case managers every month or two, not just for prescription refills but for foot examinations, immunizations, laboratory tests, specialist referrals, and diabetes education.

The result is a relationship of trust between pharmacists and patients, which leads to better diabetes control: 18 percent of the participants in the Yakama Healthy Heart Program have achieved target goals for their A1C, blood pressure, and LDL ("bad") cholesterol, compared with only 7 percent of nonparticipants (and 7 to 13 percent nationally among Native American groups). The results are heartening, says Marshall. "It's these relationships that are making the difference in folks either not living well with diabetes or living well with diabetes," she explains. "When you go to see a doctor, it's like five minutes and you're done. But these patients who are seeing pharmacists, if they feel symptoms [of a heart attack or stroke], they're not ignoring it, because they have these relationships. They call, and they're able [to get help]."

Rex Quaempts, MD, the Yakama program's director, says it is exciting for the program's successes to be honored. "The recognition allows staff to have personal satisfaction on achieving our goals and increases the credibility of the health care services that the Indian Health Service provides to the community," he says. "Most important, the community is extremely satisfied with the increase in access to services and the ability to participate in the program."



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