The purpose of this project is to develop and implement culturally responsive health promotion strategies to reduce rates of death and disability from obesity, diabetes, heart disease, and stroke and to reduce the prevalence of obesity and other chronic disease risk factors and conditions among members of the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) in rural northeast Oregon. To accomplish this, the project combines policy, systems, and environmental changes to increase access to nutritious foods, with an emphasis on indigenous First Foods, opportunities for safe physical activity, and coordination of health system services. The project will work with existing programs within CTUIR and neighboring communities to reduce the burden of chronic diseases among the American Indian and Native Alaskan population.
As a Component 1 applicant, Yellowhawk Tribal Health Center will advance the following outcomes: 1) increased number of places offering healthy foods and beverages; 2) increased percent improvement in number of places offering healthy foods and beverages; 3) increased number of people using safe and accessible places for physical activity; 4) increased percent improvement in number of people using safe and accessible places for physical activity; 5) increased number of community members at high risk for diabetes enrolled in CDC-recognized type 2 diabetes prevention programs offered in AI/AN communities; 6) increased number of patients with high blood pressure or high blood cholesterol engaged in self-management treatment programs; and 7) increased percent improvement in number of patients with high blood pressure or high blood cholesterol engaged in self-management and treatment programs.
This project addresses program strategies 1, 3, and 4. To address strategy 1, obesity prevention, we will 1) expand our community and family garden programs to increase access to and consumption of nutritious and traditional foods; 2) lead CTUIR food sovereignty efforts to restore the indigenous food system; 3) conduct physical activity and nutrition assessments to identify and implement evidence-based policy, systems, and environmental strategies suited to our community; and 4) ensure safe walking and biking environments through built environment assessments and initiating a community-wide Safe Routes to School approach. To address strategy 3, to prevent or delay type 2 diabetes, we will 1) increase awareness among CTUIR community members and health care providers of prediabetes; 2) establish the National Diabetes Prevention Program and CDC-recognized lifestyle change program; and 3) integrate and maintain prediabetes awareness, screening, and education in clinical and community service. To address strategy 4, to prevent heart disease and stroke, we will 1) expand the scope and activities of health promotion specialists, community health nurses, and community health representatives to engage community members living with or at risk of chronic disease and 2) adapt and expand the Million Hearts comprehensive self-measured blood pressure program.
Yellowhawk Tribal Health Center will collaborate with CDC, Northwest Portland Area Indian Health Board (NPAIHB), and project partners to design and implement evaluation activities. The project will build upon existing data collection processes to provide both formative and summative evaluation for project improvement and reporting.