The Utah Navajo Health System (UNHS), located in San Juan County, Utah and the northern strip of the Navajo Nation, provides preventative care as well as treatment services for community members with a diabetes diagnosis. UNHS is a P.L. 93-638 contractor for healthcare services in the UNHS service area. UNHS has been providing SDPI services for over 20 years to the communities served. These services include diabetes education, comprehensive diabetes treatment, as well as community activities and prevention education.
American Indians in the UNHS service area are significantly and disproportionately affected by diabetes. The age-adjusted mortality rate per 100,000 is 87.9 for American Indians compared with 51 for African Americans, 30.4 for Hispanics, 21.0 for Whites , and 19.0 for Asians. American Indians in the UNHS areas cited diabetes as the most critical health concerns confronting our communities. Of most individuals interviewed providers also said that diabetes is a critical health concern for this population. In addition, several providers noted obesity and poor nutrition as upstream solutions that need more attention in our communities.
The UNHS SDPI program's impact on the prevention and treatment of diabetes in AI/AN communities is very clear, and the evaluation of this program since its inception here at UNHS has helped our investigators to track and understand their own outcomes. The vast diversity that is present within our system presents a unique challenge when conducting diabetes prevent and treatment interventions in AI/AN communities. With many distinct cultures and traditions represented in tribal communities, designing interventions requires the ability to adapt interventions to meet the unique needs of each of UNHS patients and to address the unique challenges and potential barriers that they may have.
The UNHS service delivery model is based on the identified needs of the target population in the communities served. Basic diabetes education is provided to all UNHS diabetes patients. Each patient is interviewed and assessed in regards to their current diabetes knowledge. Nutrition and diabetes education are provided Certified Diabetes Educators, Register Dietitians, or a Clinical Pharmacist. Group physical activities are offered to all UNHS patients in an effort to improve overall physical fitness and to encourage patients to find an physical activity they enjoy and can make a part of their everyday lives. Centers for Disease Control approved National Diabetes Prevention Program material classes are offered at all UNHS health centers for patients dealing with a diabetes diagnosis.