Cooperative Agreement H1D1IHS1217

FRESNO AMERICAN INDIAN HEALTH PROJECT'S SDPI PROGRAM - THE FRESNO AMERICAN INDIAN HEALTH PROJECT AS A NONPROFIT, COMMUNITY-BASED HEALTHCARE PROVIDER IS DEDICATED TO ASSISTING THE URBAN INDIAN COMMUNITY IN FRESNO CITY AND SURROUNDING AREAS BY OFFERING MEDICAL, BEHAVIORAL HEALTH, CULTURAL, PUBLIC HEALTH, AND SOCIAL SERVICES. THE SPECIAL DIABETES PROGRAM FOR INDIANS (SDPI) PROGRAM IS A FACET THAT HAS PROVIDED THE AGENCY THE OPPORTUNITY TO REACH OUT TO THE TARGET POPULATION FOR SPECIFIC HEALTH-RELATED PREVENTION AND PROMOTION ACTIVITIES. THE OUTREACH EFFORTS HAVE ALSO PROVIDED THE OPPORTUNITY TO COLLABORATE WITH OTHER AGENCIES AND ORGANIZATIONS TO PROMOTE THE WELL-BEING OF THE LOCAL NATIVE AMERICAN COMMUNITY IN THE TARGET AREA. CURRENT ACTIVITIES OPERATING UNDER THE SDPI GRANT INCLUDE INDIVIDUAL DIABETES SELF-MANAGEMENT EDUCATION (DSME), GROUP DIABETES CLASSES, PHYSICAL FITNESS CLASSES AND ACTIVITIES, AND CASE MANAGEMENT. DUE TO THE DRASTICALLY INCREASING RATES OF OBESITY AND CHRONIC DISEASE, IT IS THE VISION OF THE CENTER TO EXPAND AND ENHANCE THE CURRENT SDPI PROGRAM TO MEET THE NEEDS OF THE COMMUNITY ACROSS THREE LEVELS OF INTERVENTION: INDIVIDUAL, GROUP & COMMUNITY. IN THE PAST, THE PROGRAM HAS LACKED THE NECESSARY COMPREHENSIVE APPROACH, SPECIFICALLY IN THE PREVENTION EFFORT FOR THOSE AT RISK FOR DIABETES BUT NOT YET DIAGNOSED. NOW WITH AN ESTABLISHED COMMUNITY HEALTH CENTER PROVIDING INTEGRATED MEDICAL AND BEHAVIORAL HEALTH SERVICES, OUR PROGRAM HAS BEEN RESTRUCTURED TO INCLUDE AN ENHANCED LAYER OF PREVENTION, INTERVENTION, AND OUTREACH THAT WILL SIGNIFICANTLY IMPROVE THE AGENCY'S ABILITY TO INFLUENCE AN OVERALL DECREASE IN OBESITY AND CHRONIC DISEASE OVER THE LIFE CYCLE FOR MEMBERS OF THE TARGET POPULATION. ALL ACTIVITIES WILL INCLUDE DIABETES-RELATED EDUCATION AND OFFER NUTRITION EDUCATION, WITH A FOCUS ON THE PREVENTION OF DIABETES IN THE TARGET POPULATION (N=150). INDIVIDUAL-LEVEL INTERVENTIONS WILL INCLUDE ONE ON ONE COUNSELING WITH THE REGISTERED DIETICIAN FOR CLIENTS WITH DIABETES OR PRE-DIABETES DIAGNOSIS AND INTENSIVE CASE MANAGEMENT WITH THE PUBLIC HEALTH NURSE CLIENTS WITH A CORONARY ARTERY DISEASE DIAGNOSIS. GROUP/COMMUNITY LEVEL INTERVENTIONS WILL INCLUDE CLASSES OFFERED NOT ONLY TO THOSE ALREADY DIAGNOSED WITH DIABETES (TYPE I AND TYPE II) OR PREDIABETES, BUT THOSE AT RISK FOR DEVELOPING IT IN THE FUTURE. ADDITIONALLY, A SMALL GROUP INTERVENTION WILL BE PROVIDED IN THE FORM OF WALKING AND EXERCISE CLASSES (N=25) AND LARGER GROUP INTERVENTION IN THE FORM OF A 5K SPIRIT WALK/RUN (N=100). ADDITIONAL ACTIVITIES WILL FOCUS ON EMPLOYEE WELLNESS AND A COMMUNITY INDIGENOUS FOOD CHALLENGE FOR AI/AN CLIENTS. BY PROVIDING THIS COMPREHENSIVE APPROACH, THE CENTER WILL HELP FIGHT OBESITY AND CHRONIC DISEASE AMONG THE TARGET COMMUNITY, AS WELL AS COMBAT THE SOCIAL AND FINANCIAL BURDEN DIABETES AND OBESITY PLACE ON THE NATIVE FAMILIES, THE HEALTH CARE SYSTEM, THE GOVERNMENT, AND THE COMMUNITY AT LARGE.