Taos Pueblo is located in rural Northern New Mexico, roughly 150 miles north of Albuquerque. The county where the Pueblo is located is economically depressed, with 18.9% of individuals living in poverty[1]. Additionally, New Mexico was recently listed as the worst state in the country for child wellbeing by the 2022 Kids Count data book [2].
The people of the Taos Pueblo, like many Native Americans throughout the US, have been facing an epidemic of diabetes-related illness. In 2021, the prevalence of diabetes was 13.3% among IHS’s Patient Criteria for reporting statistics. Moreover, when looking at risk factors for diabetes in the User Population, 80% had a BMI >25, A1C <8.0 was 30%, and the number of Diabetes related conditions is 31%. The numbers in the User Population show that there is an epidemic of risk factors fueling diabetes on the Pueblo.
The Taos Pueblo Diabetes Prevention Program was founded in 1998 under the 2nd iteration of SDPI funding. The program’s initial focus, under the direction of the Taos Pueblo Tribal Government and with the clinical suggestion of the Indian Health Service/Taos Picuris Service Unit, was primary prevention for youth. Increasing access to physical fitness programming for youth was a priority for the community.
Taos Pueblo compacted services through the Title 1 and Title 5 self-governance model in 2006-2009, which encouraged programs to work more collaboratively to provide services to the community. This increased the collaboration between the SDPI and CHR programs, providing an even wider scope of services. CHRs had more access to Diabetes training, education, and supplies and were able to provide more services in one-on-one and home settings for Elders. In recent years, a newly formed Home Visiting program-providing services for prenatal moms and families with children up to the age of 5 has collaborated with our SDPI staff to provide educational sessions-both in fitness and in nutrition.
The SDPI program has a close partnership with the IHS clinic on Tribal Lands, and the treatment is provided through the clinic. One of the goals for this application is to strengthen our relationship with the medical providers at the Service Unit and, with their input, develop a program where clients can be referred, and a variety of prevention and intervention services will be offered.
Our required key measure (RKM) for the FY23 program is Diabetes-related Education. We chose this best practice because the prevalence of diabetes and risk factors for diabetes are high across a wide range of ages. Diabetes-related Education allows the program the greatest flexibility in meeting the needs of varying age ranges. We can consistently support those at the inflection point between wellness and disease by targeting those at risk for diabetes with multiple intervention styles, from Signage to text messages, to cooking demos, to physical fitness programs.
Our main proposed activities for our RKM will be (in brief)
1. Create a community-wide health promotion campaign using a text message service that targets patients diagnosed with pre-diabetes.
2. Provide monthly food preparation demonstrations to families with children 0-5 and those attending Headstart.
3. Conduct weekly home visits to seniors and those at risk for diabetes to provide food preparation demonstrations, nutrition education, and/or physical activity to those who are homebound or have transportation issues.
4. Senior fitness program focusing on balance and physical activity.
5. Youth and Family Activity days at the community center
As in many Tribal communities, the SDPI program has long been known as a model prevention program, and through this application, we look forward to continuing to build on the successes and knowledge gained as the program turns 25 years old!
1 https://www.census.gov/quickfacts/taoscountynewmexico
2 https://assets.aecf.org/m/databook/2022KCDB-profile-NM.pdf