Adoption and maintenance of physical activity and planned exercise has many benefits for individuals with diabetes and pre-diabetes. It improves blood glucose in type 2 diabetes, weight loss, and joint mobility for older adults (Colberg et al., 2016). According to the National Center for Chronic Disease Prevention and Health Promotion, physical activity helps improve overall health, fitness, and quality of life but also helps reduce the risk for conditions like type 2 diabetes, heart disease, depression, anxiety, and dementia in older adults. The evidence shows that physical activity promotes better function and sleep patterns and fosters growth and development. Selection of this best practice will help the program expand and work towards increasing community-wide opportunities for exercise like cultural hikes to tribal historic sites or cultural practices like the annual foot races. An example of one recommendation for improvement as per the results of the SDPI evaluation. Addressing culture as a determinant of health is important. " Investing in Native American-led strategies to improve physical activity from the historical perspective of changes to the environment, culture, and connection to the land may address the root causes of obesity (Warne & Roanhorse, 2015). Community outreach and education can strengthen our program's presence by helping tribal members learn physical activity guidelines for different age groups. In addition, connecting physical activity education to exercise opportunities can help the community gain skills and confidence to become active. Ultimately, being advocates for their own health. The program's involvement in developing the new health clinic will bring additional benefits, such as hiring an exercise professional to work alongside the program to support the planning of a structured program for primary prevention of those with pre-diabetes and secondary prevention for persons with diabe
tes.