The Hualapai Tribe is located in rural northwest Arizona (AZ). The Hualapai Reservation (> 1 million acres) is home to approximately 1650 residents (1063 adults), who live in or near the only residential and commercial center, Peach Springs, AZ. Tribal enrollment is approximately 3300; an estimated 50% of enrolled members live off reservation but often work in Peach Springs so have access to HSDPI activities. Medically, the community is served by the IHS Peach Springs Health Center (PSHC) in the Colorado River Service Unit (CRSU). PHSC reports a user population of 3000. PHSC is an outpatient clinic providing primary care (3-4 providers), pharmacological services and public health nursing. Many specialty services, e.g., dentistry, podiatry, kidney dialysis and opthalmology are inconsistent or require travel to contract services in Kingman, AZ (55 mi one way to the west) or CRSU (150 mi one way to the southwest). The Hualapai Tribe manages Emergency Medical Services providing urgent care and transport off reservation. Helicopter emergency services are contracted by the Tribe and available on an as needed basis. PSHC has struggled to maintain consistent providers. Many patients do not have a long-term relationship with a provider and subsequently may hesitate to seek health care unless confronted with an emergency. The education, activities and relationships provided by the HSDPI staff and program are critical in this environment of uncertain patient-provider relationships. HSDPI's best practice is diabetes related education; the staff are well trained and experienced in providing locally and culturally relevant instruction and mentoring. HSPI's target population is adults with a Body Mass Index (BMI) greater than 25, an estimated 96% or 1020 adults. HSPI proposes to enroll 15% of the eligible adults or 153 participants. Enrollment and end of the year measures involve an assessment of BMI, %body fat, HbA1c, a questionnaire trac
king diabetes, food and activity behaviors and knowledge, and one-on-one education. In addition, HSDPI will offer physical activity classes, training and mentoring through the Fitness Center, team challenges to leverage social relationship to make behavior changes, and group diabetes prevention and nutrition education sessions using CDC's Prevent T2 materials and Lunch and Learn healthy food preparation and planning demonstrations. HSDPI accredits its community education and outreach to its integration into tribal programs and events, working to make healthy food choices and physical activities a norm for all community members.