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Indian Health Service Health Promotion/Disease Prevention Initiative. Aberdeen Area Tribal Chairmen’s Health Board October 27, 2005 Alberta Becenti, MPH Rapid City, South Dakota. Background. Significant health disparities among American Indian/Alaska Native Obesity Diabetes

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Indian Health Service Health Promotion/Disease Prevention Initiative

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Indian Health ServiceHealth Promotion/Disease Prevention Initiative

Aberdeen Area Tribal Chairmen’s Health Board

October 27, 2005

Alberta Becenti, MPH

Rapid City, South Dakota


  • Significant health disparities among American Indian/Alaska Native

    • Obesity

    • Diabetes

    • Cardiovascular Disease

    • Cancer

    • Injury

  • Many of these health conditions and diseases are related to lifestyle behaviors.


  • Create healthier American Indian and Alaska Native communities by building on individual, family and community strengths and assets.

Overview of Initiative

  • Infrastructure

  • Community Capacity

  • Partnership

  • Resources

  • Evaluation


  • Focus on effective clinical and community public health strategies

  • Identify and implement best practices to reduce the health burden in AI/AN communities

  • Increase community capacity and infrastructure


  • Established Policy Advisory Committee (PAC) to provide oversight and policy guidance to the agency.

    • Representatives include Tribal Leaders, NCAI, NIHB, CDC, NCUIH, TSGAC, Direct Tribes and IHS

    • Meet face-to-face 2x a year


  • PAC Annual Plan (focus on 4 Areas)

    • Educational Policies – focus on physical activity and school food service including vending machines, and competitive food sales.

      • Met with Department of Education, Office of Indian Education to collaborate on this effort.

      • Area HP/DP Coordinators to review their respective state, county, and local policies.

        • Assess readiness for change.


  • PAC Plan (continue)

    • Marketing- develop a marketing plan to increase awareness of HP/DP Initiative

      • Conducted focus group (tribal and federal health care providers, tribal health workers).

        • Develop a marketing plan based on focus group feedback.

    • Community Assessment – NIHB and PAIHB to pilot test a survey instrument and report findings back to the committee.


  • PAC Plan (continue)

    • Partnership – identify and expand partnerships with other federal agencies, academia, foundations and corporations to support HP/DP Initiative

      • Submitted concept paper to RWJF focusing on obesity prevention, community capacity, and community/clinical interventions.

      • MOU with MADD (pending approval)

        Future plan: meet with HUD, USDA, AIHEC, Ford Foundation, and Kellogg Foundation


  • Established a Prevention Task Force to develop a strategic plan to enhance and improve disease prevention and health promotion efforts by identifying diseases with the greatest disparities and developing a framework to address these diseases.

    • Composition:

      Area HP/DP Coordinators, representatives from nutrition, dental, diabetes, medical provider, nursing, injury prevention, health education, and behavioral health.

Prevention Task Force (continue)

  • Identify and expand community and clinical best and promising practices.

  • Promote and support environmental, school, and worksite policies that support healthier behaviors.

  • Identify training needs of the community and providers.

  • Identify benchmarks for monitoring progress (process, impact, & outcome measures).

Infrastructure Benchmarks

Hire IHS Area HPDP Coordinators to work with I/T/U

- Oklahoma (hired)Albuquerque (hired)

  • Tucson (hired)Alaska (hired)

  • California (hired)Billings (hired)

  • Portland (hired)Aberdeen (hired)

  • Nashville (hired)Bemidji

  • Navajo (hired)Phoenix

IHS Health Summit

  • Demonstrate the agency’s commitment to HP/DP to eliminate disparities

  • Create and expand partners

  • Share best and promising practices

    • Areas developed HP/DP plans

    • Area Coordinators are following up on plans

Build Community Capacity

Healthy Native Communities Fellowship (HNCF)

Healthy Native Communities Fellowship

  • HNCF is based on an action-learning model in which insights, skills, and new knowledge is shared and applied in real life situations

    • One year journey

    • Interactive week-long sessions

    • Self-study educational curriculum

    • On-line computer conferencing

    • Topics: grant writing, leadership, data collection and much more.

Where are the teams from?

Community Champion Forum

  • Get together to share what is working in the AI/AN communities

    • Share success stories, network, and recognize local champions

    • Training

      • Marketing

      • Planning/evaluation

      • Grant Writing/management

      • Resources

FY 2005 Fellow Graduates

  • 13 Teams graduated on September 22, 2005 in Washington, DC.

Community Champion Forum

  • Navajo – December 2003

  • Phoenix/Tucson – April 2004

  • Alaska – April 2004

  • Portland/California – January 2005

  • Aberdeen/Billings – October 2004

  • Nashville/Oklahoma – August 2005

  • Bemidji – TBA

  • Albuquerque – October 2005

Community Champion Forum


Let’s Get 1 millionNative people moving!

What is JMI?

  • National campaign to promote physical activity for American Indians and Alaska Natives

Sign Up to Become A JMI Partner, visit:www.justmoveit.orgJoin this effort to get1 million Native people moving!

Improve Information Access

  • Best/Promising Practices (clinical & community)

  • Resources

  • Assessment Tool

  • Training

  • Grant opportunities



Emergency Room Visits

Outpatient Visits

Cardiovascular Disease







Prenatal Care



Future Plan: Improve Information Access to Health Profiles

Partnership Benchmarks

  • HQ and Areas each develop 2 new partners for prevention in 2005

    • State or Federal

    • Academia

    • Foundations & non-profits

    • Corporation

Resource Benchmark

  • Provide direct support to local initiatives in all Areas.

    • Seed money to support local plans

    • Improve access to information & resources


  • Headquarters support

  • National Diabetes Program for Indians

  • Area Support

  • Congressional Funds - $2.074 M.

    • 20 competitive grant awards @ $64,500 in FY 2005.

FY 2005 Grant Awards

  • Kenaitz Indian Tribe – Alaska Area

    • Health Promotion

  • Ho-Chunk Nation – Bemidji Area

    • Get Fit Project

  • Ramah Navajo – Albuquerque Area

    • Youth Camp Project

  • Peta Wakan Tipi – Bemidji Area

    • Obesity Prevention for Youth

FY 2005 HP/DP Grant Awards

  • Native Images – Tucson Area

    • Diabetes Prevention for Urban Native Americans

  • South East Alaska Regional Health

    • WISEFAMILIES through Traditional Knowledge

  • National Indian CTR- California Area

    • An Alcohol intervention for youth

  • South Central Foundation – Alaska

    • Tobacco Free Promotion Project

FY 2005 HP/DP Grant Awards

  • Rock Boy Health Board – Billings Area

    • Health Promotion

  • Alamo Navajo School Board - Albuquerque

    • Outdoor Fitness Project

  • Eastern Aleutian Tribes, Inc – Alaska Area

    • Native Physical Activity

  • Kalispel Tribe of Indians – Portland Area

    • Health Promotion Project

FY 2005 HP/DP Grant Awards

  • Indian Health Care Resource Center

    • Indian Youth Program for Healthy Living

  • San Diego American Indian Health

    • San Diego for Health Wellness Project

  • Choctaw Nation of Oklahoma

    • Get Movin Project

  • Tulalip Tribes – Portland Area

    • Children Obesity Prevention Project

FY 2005 HP/DP Grant Awards

  • Salish Kootenai College – Billings Area

    • Health Promotion

  • Inter-Tribal Council of Michigan – Bemidji

    • Women’s Health Circle

  • Migizi Communication, Inc – Bemidji Area

    • Partnership to Strengthen Indian Famillies

  • Aberdeen Area Tribal Chairman’s Health Board

    • Northern Plains Smoke Free Home Campaign

FY 2006 HP/DP Grants

  • Announcement in March 2006

    • 10 ($10,000) competitive planning grants

    • 12 ($100,000) competitive grants

  • Will be conducting regional workshops


  • Conduct process, impact, and outcome evaluations that are aligned with GPRA and Healthy People 2010 objectives

    • Annual HP/DP Reports

      • Progress, impact, and outcomes

        • Trend reports (RPMS, GPRA)

        • Community Health Assessment

        • Behavioral Risk Surveys

        • Director’s HP/DP Benchmarks

Native American Youth Empowerment Conference

  • Create a venue for youth to share innovative strategies focusing on prevention of violence, injury, substance use/abuse, underage drinking, teen pregnancy, tobacco, HIV/AIDS, and physical inactivity.

  • Empower youth to take active roles in making a positive difference

  • Create a forum for youth and their adult allies to make positive changes in their school and community.

  • Held in Albuquerque, NM with over 400 youth

FY 2006 Youth Projects

  • Regional Youth Summit

  • Protecting You/Protecting Me Training

  • Youth in Action training

Tobacco Free Policy

  • Tobacco Free policy

    • HHS adopted policy in January 2005.

    • All OPDivs to develop policy.

    • Eliminate all tobacco products from HHS properties including owned, controlled, and leased by HHS (includes interior and exterior), unless to do so would violate applicable law.

Tribal Communities Products

  • Improved Access to Information to support Wellness

    • Resources, Training, Best Practice, Assessment Tools, Community Profile

  • Chance to participate in Just Move It

  • Support for Community Directed Wellness Planning

  • Share at and Learn from Community Wellness Champion Forums

Tribal Communities Products

  • Access to Training, Fellowship

  • Regional Resource Roundtables

  • Networking Opportunities

  • One Place to Call for Wellness

Invest in Prevention

  • If you improve in health and well-being

    - Quality of life improves

    - Health Care utilization decreases

    - Disability is controlled

    • Productivity is enhanced

      - Healthier communities

Health Promotion/Disease Prevention

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