Monday, May 12, 2025
5/12/2025
Catawba Service Unit Special Diabetes Program for Indians (CSU SDPI) - The Catawba Service Unit (CSU) Special Diabetes Program for Indians (SDPI) is housed within the CSU, which is an outpatient Indian Health Service healthcare facility located in Rock Hill, South Carolina serving members of the Catawba Indian Nation and any member of a federally recognized American Indian or Alaska Native Tribe. Services provided by the CSU include medical, dental, laboratory, nutrition, diabetes care and education, podiatry, optometry, behavioral health, and pharmacy. By being housed within the CSU, the CSU SDPI is able to provide a myriad of clinical activities and services geared toward diabetes prevention and management. The CSU employs about 30 staff, many of whom serve as key personnel on the CSU SDPI Team. The close proximity of Tribal members to the CSU allows for greater access to clinic services and community events. There are over 3,000 citizens of the Catawba Indian Nation, of which about 680 live on the Reservation. Approximately 75 percent of Tribal members live within two hours of the Reservation. The CSU is located on the Reservation and is near all Tribal programs and departments, making partnerships easy to form and sustain. One of the most prevalent diabetes-related health issues identified by CSU staff, Tribal leadership, and the Tribal community is high blood pressure/heart disease. Government Performance and Results Act data from July 2022 show that only 45.9% of patients diagnosed with diabetes at the CSU have blood pressures <140/<90 mmHg. Although blood pressure goals should be individualized, having a blood pressure <140/<90 mmHg can reduce the risk for complications, such as cardiovascular disease and chronic kidney disease and, therefore, the aim is to have a much higher percentage of patients with diabetes who have blood pressures <140/<90 mmHg. Other items pinpointed in a recent community health survey to be key-diabetes related health concerns include mental health, overweight/obesity, tobacco use, diabetes prevalence, and oral health care. The CSU SDPI has selected Blood Pressure Control as its Best Practice for 2023. Although Blood Pressure Control was selected as the Best Practice for the last two years, the CSU SDPI feels that activities and services related to this Best Practice will take several years to truly make a large impact. Amongst those who have diabetes, high blood pressure dramatically increases the risk of heart disease. Heart disease, in turn, is one of the leading causes of death for American Indians/Alaska Natives. Because blood pressure management is such a critical component of diabetes care, the CSU SDPI would like to focus on this Best Practice to improve the rate of Blood Pressure Control even further. The Target Group, which totals 191 individuals, for the selected Best Practice includes active adult patients with type 1 or type 2 diabetes who are seen at the CSU at least once yearly. The goal is to improve the number and percent of individuals in the Target Group who have a mean blood pressure <140/<90 mmHg. The CSU SDPI proposes to implement multiple activities in 2023 geared toward improving this measure. Proposed activities include a quarterly Blood Pressure Management Day, a 4-week blood pressure management program, a heart healthy grocery store tour, heart healthy cooking demonstrations, brief negotiated interventions with tobacco users, exercise classes, Pharmacy assistance with medication adherence, and blood pressure screenings for patients attending Podiatry and Optometry clinics. Other activities/services not related to the selected Best Practice include a focus on improving the number of patients receiving dental exams and oral health education, continuation of Health Promotion/Disease Prevention activities such as Spirit Sprinters, facilitation of Podiatry, Optometry, and Behavioral Health Clinics, implementation of a continuous glucose monitor program, and initiation of a second cohort of the diabetes prevention program.
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