Combating Cardiovascular Disease, Hypertension, Diabetes, and improving access to safe routes - With the higher rates of chronic disease, obesity, and premature death on Fort Berthold, this project will address the need for increased access to nutritious food. The population consists of approximately 5,655 tribal members who reside on-reservation with an average life-span for tribally enrolled males on Fort Berthold at 54.15 years and females at 61.44 years old. Through culturally relevant education and evidenced-based curriculum, the program will implement strategies to reduce the prevalence of diabetes, obesity, stroke and heart disease. This grant will be used to implement evidenced-informed and culturally-adapted policy, system, and environmental changes to prevent obesity, implement evidenced-informed and culturally-adapted community-clinical linkages to support type 2 diabetes, heart disease and stroke prevention. The Fort Berthold Diabetes Program (FBDP) has administered the Special Diabetes Program for Indians grant for the past 20 years. The FBDP has experience with program planning, performance management, and monitoring progress for goals and outcomes related to community health. The FBDP has five staff who are Certified Master Gardeners through North Dakota State University. In addition, there are two pediatricians and one staff member in Behavioral Health who are also Certified Master Gardeners. These staff will provide technical assistance to community members who want to plant and learn about gardening. Seeds and plants will be distributed to individuals to help them establish their own gardens. Once the greenhouse is established in New Town, greenhouses will be expanded to Mandaree, White Shield, Parshall and Twin Buttes. The communities of Mandaree, White Shield and Twin Buttes do not have grocery stores and consequently no access to fresh produce. The growing season in North Dakota is generally four months which limits gardening and access to fresh vegetables. The cost of fresh produce on Fort Berthold are considerably higher than the national average due to the rural location and extreme seasonal climate change. The FBDP will teach adult classes on food preservation including freeze drying, canning, and freezing to increase access to fruits and vegetables. Food processing starter kits and access to necessary equipment (i.e. food dehydrator, canning, vacuum sealer) will be made available to community members to preserve their own produce. The Registered Dietitians and Certified Master Gardeners will provide food preservation classes. The FBDP will implement evidenced-informed and culturally-adapted community-clinical linkages to support type 2 diabetes prevention. It is our intent to increase identification of community needs, increase number of policies addressing access to sugar in tribal schools, and increase the number of places offering healthy foods. Increase awareness of prediabetes among tribal members/health professionals in Tribal Health to educate about prediabetes and associated risk of type 2 diabetes, heart disease and stroke through a community training sessions and clinics. The Evaluation Plan will include both qualitative and quantitative evaluation measures. Upon receipt of Good Health and Wellness in Indian Country funding, the FBDP will complete an evaluation plan with target performance measures for the proposed activities within the first six months of the award. The FBDP will report on performance measures, develop recipient-specific evaluations plans and conduct the evaluation, and participate in national evaluation studies
