Cooperative Agreement H1D1IHS1186

ROUND VALLEY INDIAN HEALTH CENTER - SPECIAL DIABETES PROGRAM FOR INDIANS WITH FOCUS ON NUTRITION EDUCATION AIMED AT REDUCING THE RISK FOR DEVELOPING DIABETES AND ITS COMPLICATIONS. - THE ROUND VALLEY INDIAN HEALTH CENTER IS A NON-PROFIT CORPORATION ESTABLISHED IN 1968, DESIGNED TO OFFER HEALTH CARE TO THE PEOPLE OF OUR COMMUNITY. ROUND VALLEY INDIAN HEALTH CENTER IS LOCATED IN AN UNDER-SERVED AREA DESIGNATED AS A RURAL FRONTIER LOCATION IN COVELO, A REMOTE VALLEY COMMUNITY IN NORTHERN MENDOCINO COUNTY, OF CALIFORNIA. IT IS 25 MILES EAST OF HIGHWAY 101 AND AN ADDITIONAL 15 MILES FROM THE NEAREST HOSPITAL AND EMERGENCY SERVICES IN WILLITS, CALIFORNIA. THE ROUND VALLEY INDIAN HEALTH CENTER PROVIDES PRIMARY HEALTH, DENTAL AND BEHAVIORAL HEALTH CARE TO APPROXIMATELY 3,000 PEOPLE LIVING IN COVELO AND THE ADJACENT ROUND VALLEY INDIAN RESERVATION. THERE ARE NO OTHER MEDICAL OR DENTAL SERVICES WITHIN A ONE HOUR RADIUS OF THE RESERVATION OR THE TOWN OF COVELO. ALL SPECIALTY HEALTH SERVICES ARE AT LEAST A THREE TO EIGHT HOUR ROUND TRIP DISTANCE AWAY. THE RESERVATION WAS ESTABLISHED IN 1856 AND IS THE ANCESTRAL HOMELAND OF THE YUKI NATION AND HOME TO SIX OTHER INDIAN TRIBES. THE HEALTH CENTER STAFF IS DEDICATED NOT ONLY TO TREATMENT, PREVENTION, AND PATIENT EDUCATION, BUT ALSO RECOGNIZES TRADITIONAL INDIAN MEDICINE AND HOLISTIC HEALING. UNIQUE CHALLENGES IN PREVENTING AND TREATING DIABETES IN OUR COMMUNITY ARE FREQUENTLY DUE TO OUR REMOTE LOCATION AND LACK OF RESOURCES RELATED TO THE LOCATION. IT HAS BEEN IDENTIFIED THAT 45% OF THE COMMUNITY LIVE BELOW THE POVERTY LEVEL. THIS POVERTY LEVEL AFFECTS THE ABILITY TO PURCHASE QUALITY FOOD AND HEALTH CARE PRODUCTS. DUE TO THE HOUSING SHORTAGE IN COVELO AND THE LONG DRIVE TO THE NEAREST TOWN, IT IS DIFFICULT TO RECRUIT AND RETAIN APPROPRIATELY TRAINED PROFESSIONAL STAFF, AND FOR PATIENTS TO RECEIVE NEEDED CARE. THERE IS A DEFICIT IN TRANSPORTATION AND PHONE/INTERNET SERVICE FOR MANY OF OUR POPULATION. INADEQUATE CELL PHONE COVERAGE AND INTERNET CONNECTIVITY LEAD TO FREQUENT INTERRUPTIONS IN COMMUNICATIONS. DIABETES-RELATED HEALTH ISSUES IN OUR COMMUNITY INCLUDE OBESITY, HYPERTENSION, CARDIOVASCULAR DISEASE, CHRONIC KIDNEY DISEASE AND DEPRESSION WITH A MAJORITY OF OUR PATIENTS IDENTIFIED AS LIVING WITH DIABETES, OVER THE AGE OF 60. ROUND VALLEY 2022 DIABETES AUDIT DATA SHOW THAT 69% OF ACTIVE AMERICAN INDIAN/ALASKA NATIVE PATIENTS HAD A BMI GREATER THAN OR EQUAL TO 30 (OBESE) AND 20% HAD A BMI OF 25.0-29.9 (OVERWEIGHT); 48% WITH BLOOD PRESSURE >140/90; 44% DIAGNOSED WITH CARDIOVASCULAR DISEASE; 16% CHRONIC KIDNEY DISEASE STAGES 3-5; 25% DIAGNOSED WITH DEPRESSION. CONCERNS IDENTIFIED BY OUR COMMUNITY AND CLINIC STAFF TO BE ADDRESSED BY THE SDPI PROGRAM ARE THE NEED TO: INCREASE COMMUNITY/FAMILY/INDIVIDUAL AWARENESS OF AND INVOLVEMENT IN DIABETES PREVENTION AND MANAGEMENT ACTIVITIES. INCREASE COMMUNITY KNOWLEDGE OF PREPARING, SHARING AND USING HEALTHY AND TRADITIONAL FOODS; AND TO INCREASE ACCESS TO HEALTHY FOODS. THIS IS IN THE HOPES OF REDUCING THE RATES OF OBESITY, HYPERTENSION, CARDIOVASCULAR DISEASE, CHRONIC KIDNEY DISEASE AND DEPRESSION. OUR CHOSEN BEST PRACTICE IS "NUTRITION EDUCATION". IN COLLABORATION WITH OTHER PARTNERS WE PLAN TO INCREASE THE PERCENTAGE OF PEOPLE LIVING WITH DIABETES WHO RECEIVE NUTRITION EDUCATION. NUTRITION EDUCATION WILL ALSO BE PROVIDED TO OTHERS IN THE COMMUNITY. NUTRITION EDUCATION IS IMPORTANT AS IT HELPS REDUCE THE RISK FOR DEVELOPING DIABETES AND ITS COMPLICATIONS. NUTRITION AND DIABETES EDUCATION WILL BE OFFERED IN GROUP WORKSHOPS AND INDIVIDUALLY. WE HOPE TO EDUCATE AND EMPOWER OUR PATIENTS BY ASSISTING THEM TO BUILD THE SKILLS AND CONFIDENCE TO MAKE LIFESTYLE CHANGES THAT WILL ALLOW THEM THE HEALTHIEST FUTURES POSSIBLE.