Primary, Secondary, and Tertiary Prevention of Type 2 Diabetes - Project Abstract Summary The Northern Cheyenne Indian Reservation is located in present-day southeastern Montana, and is approximately 444,000 acres in size with 99% tribal ownership. We have approximately 10,840 enrolled tribal members with about 4,939 residing on the reservation. The reservation has 5 small districts or communities. Lame Deer district being centrally located and the largest community, Muddy district, Ashland district, Birney district and Busby district. All districts are about 20 miles from the centrally located district of Lame Deer. Lame Deer has a grocery store, post office, Tribal Programs and the Indian Health Service. The remoteness of the reservation has led to limited access to fresh vegetables and limited protein choices. The communities have attempted Gardens with some success but the drought ground and limited water resources has limited the amount of vegetables harvested. Deer, Elk and fresh game are in limited supply for on the reservation hunting. Many community members travel 100 miles one way to the larger city of Billings to shop for groceries and necessities for daily living. This is usually done once a month or bi monthly. The Indian Health service is located in Lame Deer and offers out-patient services. Specialty services are limited to the Purchasing Referred Care system of rating for services. These are referred to Billings, MT. Transportation and transportation services are limited as well. The Special Diabetes program for Indians (SDPI) staff have been incorporated into the Improving Patient care (IPC) Teams. We do assist all PC teams and team members with diabetes education and self-management support for specific panels of patients. We work on specific Diabetes GPRA measurements and Diabetes Audit measures to improve quality of care. The SDPI staff also work in the clinic for Specialty clinics such as the Nephrology clinic and the Podiatry clinic. The Podiatry clinic is held bi monthly and the nephrology clinic is held monthly and one quarterly visit. The SDPI staff also assist with transportation to and from these specialty clinics. The Wellness Center is the central office for the SDPI staff and Diabetes Services located in Lame Deer. We have a warm friendly environment that welcomes the patients to our program. We have 8 full time staff members with a Registered Dietitian (RD) on contract. The RD has developed the Healthy Plate Program (HPP) which we have incorporated into our curriculum of Balancing your life and Diabetes. The HPP has components that offer Self Management support. Our facility has a kitchen so we can offer Cooking demonstrations and Food demonstrations. We have structured our facility to offer hand on demonstrations of healthy choices whether its beverages, snacks and/or meal preparation. We have the most success with goal setting and plan development with patients on a one on one daily patient contacts.
