The Winslow Indian Health Care Center is a non-profit ambulatory healthcare corporation chartered under the laws of the Navajo Nation. WIHCC is authorized, pursuant to Navajo Nation Council Resolution CJY-33-10, to administer and operate the Winslow Indian Health Service program under Title V, Self-Governance, of the Indian Self Determination and Education Assistance Act. The WIHCC is a primary healthcare provider with a target population of approximately 18,000 beneficiaries. The service area situates in the southwestern portion of the Navajo reservation encompassing the rural chapter communities of grazing districts 5 and 7: Leupp, Tolani Lake, Birdsprings, Dilkon, Teesto, Indian Wells, Whitecone, and Jeddito. The service area includes the Bordertown communities of Winslow, Joseph City, and Holbrook. The WIHCC is opening the new Dilkon Medical Center during fiscal year 2023.
The WIHCC Diabetes Program is grantee of the SDPI grant since 1998. The program name has formally changed to a more cultural appropriate name: Hozhogoo Iina Wellness Program (HIWP) including the SDPI funded program and activities. The mission, vision, and value of the HIWP follow the WIHCC’s operational statements: Mission: Accessibility, Quality, and Cost Effective Health Care; Vision: A healing and harmonious environment in partnership with communities; Values: Hozhojii do K’e (Harmonious Relationships) Trustworthiness, justice, respect, dignity, service, humility.
The operational structure of the HIWP is a culturally sensitive and patient centered care paradigm referencing the Dine Wellness Model. The concepts and principles of Hoozhogo Iina target health and wellness at the individual, family, and community levels. The Dine Wellness teachings are holistic in context and are based on the spiritual concept of Ke’, represent wellness across the age spectrum, and are integrated with proactive and preventive approaches to health and wellness. The objectives of the HIWP including the SDPI funded program and activities follow the themes representing the four cardinal directions of the Dine Wellness Mode:
• East-Thinking (Nitsahakees) and beginning of Life: To create a patient centered and culturally sensitive diabetes prevention program across the age spectrum. The screening portion (across the age spectrum) of the SDPI funded programs address this aim: Youth Wellness, Health and Fitness, and Nutrition efforts support this aim. Including other outreach screening programs.
• South-Planning (Nahat’a) and targets school age: To increase patient access to a patient centered and culturally sensitive health and wellness program to counter diabetes across the age spectrum. The efforts under this aim that are grant funded include: Youth Wellness- Victory Clinic, Health and Fitness including DM and PCMH referrals to this program in the wellness center, and Nutrition activities for school age children.
• West-Iina (life) and targets adults: To provide educational resources to improve the self-management skill sets of patients and families to prevent diabetes complications at the primary, secondary, and tertiary levels. The DSME program efforts to improve diabetes related education is part of this aim. The Health and Fitness hands on educational efforts in the wellness center as well as the nutrition outreach program addresses this aim. The shoe clinic, and insulin titration clinics are access point for this aim. The proposed CGM activity is part of this aim.
• North-Siihasin (hope/assurance): To ensure a patient centered and culturally sensitive diabetes prevention and treatment program which integrates with the WIHCC’s practice model: The Patient Centered Medical Home. This is the policy making portion of the SDPI funded programs to establish and seed as part of the WIHCC operation.
Overall, HIWP strives to improve access to quality and cost effective diabetes standards of care that within the context of patient centered and culturally sensitive healthcare.