Reno-Sparks Indian Colony Special Diabetes Program for Indians, 3-Nations Wellness Center - The Reno-Sparks Indian Colony (RSIC) proposes to continue the Special Diabetes Program for Indians (SDPI) via the 3-Nations Wellness Center Diabetes Prevention Program. The proposed project will continue to be community-based serving over 5,000 eligible Native Americans in the RSIC service delivery area on an annual budget of $843,807 focusing on the Diabetes-Related Education Best Practice using culturally-appropriate, CDC-approved Diabetes Self-Management Education curricula, community wellness activities, nutrition education projects, foot exams, eye/dental exams, contracted specialists, glucose monitors and diabetes surveillance. The Community Health Needs Assessment conducted independently in 2022 by the RSIC Diabetes and Community Health Programs determined that the top 3 health challenges in the community were Overweight/Obesity (71%), Joint/Back Pain (50%), and Diabetes (28%) followed closely by Mental Health Issues (25%) and Food Insecurity (21%). This is in line with data obtained from the 2020 Webaudit (2019) reflects a pre- pandemic rate of Obese individuals (BMI >30.0kg/m2) of 68% versus 66% in the Phoenix IHS Area. Observations of community needs during the pandemic reflected growing food insecurity. This was largely due to community isolation, quarantine requirements, food deserts, & economic hardship brought on by the pandemic. The RSIC Diabetes program’s collaboration with the Food Bank of Northern Nevada (FBNN) via that organization’s monthly Mobile Harvest food insecurity prevention program saw the pre-pandemic number of individuals served triple once the pandemic’s hardships took effect. Obesity and food insecurity are known to be highly associated with worsening rates of diabetes and other associated markers of that disease. Stress via increased mental health issues brought about by the pandemic only served to exacerbate those issues. Alongside collaboration with the Behavioral, Community Health, and other RSIC departments, the Diabetes program strives to reduce the prevalence of diabetes and associated comorbidities among RSIC tribal members. Since its inception, the Diabetes program has targeted these activities: • 2 Registered Dietitians to counsel on prevention & management using Diabetes Self-Management tools & curricula • Collaborated with RSIC Community Health, Behavioral Health, and Senior Center on regular monthly education events to increase outreach, engage individuals in self-care, & educate about comorbidities & lifestyle change • Engaged youth, adults, & elders in active events such as individualized exercise regimen, roller skating, mountain biking, hiking, bowling and softball leagues to develop positive associations with physical activity for improved glucose management • Demonstrated the use of budget friendly, nutritious foods by implementing a monthly (adults) or bimonthly (kids) cooking class program for all eligible Native individuals •Supported good foot, eye, & dental care by incentivizing recommended exams with shoes, eyeglasses, or dental funding • Employed a Continuous Glucose Monitor program to arm uncontrolled diabetics with expanded tools to bring glucose and A1c to target levels • Contracted a Podiatrist to further elevate good foot care and prevent diabetes-related amputation • Contracted an Acupuncturist, utilizing non-pharmaceutical approaches to manage diabetes-related neuropathy • Contracted a pediatric endocrinologist to support pediatric diabetic patients and kids at-risk for diabetes • Developed a food pantry program to fight food insecurity alongside healthful home cooking education and diabetic recipes Per the community-identified health challenges, the relevant data, and ongoing and upcoming activities, the RSIC Diabetes program will seek to continue to impact rates of diabetes by implementing these strategies to prevent Type II Diabetes.