NV-002 - The American Indian and Alaska Native (AIAN) population for the U.S. jumped from 5.2 million in 2010 to 9.6 million in 2020, (U.S. Census, 2000). California’s AI/AN population is reported at 3.6% (up from 1.6 in 2010) and Nevada’s AI/AN population was reported at 5.1% (U.S. Census, 2020). The Washoe Tribe of Nevada and California reports approximately 1,550 enrolled members and currently serves approximately 3,000 members and descendants (US Census Bureau) residing in or near four separate communities (Carson, Stewart, Dresslerville, and Woodfords) across 2 states (Nevada and California); and a significant number of members reside off-reservation. Like Washoe, all tribes throughout the U.S. have suffered adverse effects from the high prevalence of obesity (Story et al, 2000). Overall, studies demonstrate that obesity begins early for AI/AN children and continues into adulthood (IHS, 2001). The obesity rates among AI/AN adolescents is 33.8%, approximately 50% higher than that of all adolescents in the U.S. Many chronic diseases such as type 2 diabetes, heart disease, stroke, arthritis, and breathing problems are associated with the increasing prevalence of obesity and ultimately lead to higher rates of mortality for AI/AN peoples as compared to other racial/ethnic groups in the U.S. Heart disease is the leading cause of death for AI/AN. According to the American Heart Association, heart disease rates are about 50% higher among the 5.2 million people in the U.S. who self-identify as AI/AN. This is not surprising given the elevated prevalence of obesity and diabetes nationally, unhealthy diets, and high rates of smoking AI/AN. The Washoe Tribe of Nevada and California (a federally-recognized tribe) purpose for applying under component 1 is to target: Strategy 1 (Provide a foundation for chronic disease prevention by implementing community-chosen, traditional AI/AN practices that build resilience and strengthen connections to family, culture, and community.) to increase participation in family-centered cultural activities among community members and to increase cultural connectedness through teaching and strengthening of cultural practices such as traditional foods gathering, preparation, cooking or storage. Strategy 2 (Establish and enhance systems that connect community members to community, clinical, and social services and programs to prevent, manage, and control chronic diseases and their risk factors.) to increase referrals for community members to service providers and programs by engaging community members of all ages in traditional wellness activities such as traditional sports, traditional foods knowledge, community walking and hiking groups, while implementing systems for screening, testing, self-monitoring and referrals. and Strategy 3 (promote the implementation of multi-disciplinary team-based care to prevent, manage, and control chronic diseases and to connect patients to community and social service providers to address health-related social and economic needs) to increase use of multidisciplinary care teams that provide patients care using evidence-based practices and guidelines to prevent and manage chronic diseases and risk factors by promoting team-based care to include Community Health Workers (CHWs), Healthy Lifestyle Coaches (HCLs), and others. Facilitate collaboration among care providers to coordinate a comprehensive, culturally responsive holistic approach to care. Use of National Diabetes Prevention Program (NDPP). Nevada’s AI/AN population faces many health disparities related to risk behaviors, poor health status and living conditions, and limited healthcare access. The GHWIC program links community engagement to Tribal Health Center resources; working collaboratively to improve the health of the whole family and community. All three strategies will be targeting the same population of all community members, all ages, residing on or near the four tribal communities within the Washoe Tribe.
