Navajo Area Model Diabetes Program

Shiprock Diabetes Program
Shiprock, New Mexico

Kim Mohs, M D, Director
Mamie Deneteclaw, Coordinator
Northern Navajo Medical Center
P. O. Box 160
Shiprock, N M 87420
Phone: (505) 368-6843
FAX: (505) 368-6260

Program Description

The I H S program provides comprehensive home-based, family-oriented diabetes education for the newly diagnosed (less than 2 years) person with diabetes, his/her family and their community. The program objective is to enable the person with diabetes to live well (physically, emotionally, spiritually, and socially), which empowers them to perform diabetes self-care and make choices that lead to blood sugar control and the prevention of complications. The program is easily accessible to people with diabetes for information, skilled support staff, and referral to other resources. the program also provides diabetes education in the community, and to other health care providers, and promotes awareness and prevention of diabetes within the Navajo Nation. The program consists of four staff: The program director is a registered nurse and certified diabetes educator, diabetes nurse educator, registered dietitian and program secretary

Data/Epidemiolgy

The Model Program provides patient care services in the Shiprock Service Unit area

• Population base-42,000
• Active Registry number

Clinical Accomplishments 1994-1999

• Home visits: 2,150
• Diabetes screening--2,409 (middle & high schools, churches, senior centers, & social events)
• Nutrition Education--2,290 (clients and their families)
• Education (individual)--2,298 clients
• Education (group) (115): 5,562 individuals (C H R's, nursing assistants, community health workers, driver/interpreters, secretaries, nutrition assistants and clients)
• Diabetes conferences-professional (52):2,388 individuals (R Ns, physicians, physician assistants, nurse practitioners, physical therapists, pharmacists and optometrists)
• Community diabetes education (group) (69):4,487 individuals (tribal leaders, councilmen, church members, community members at the chapter houses, health fairs, and other groups/organizations).

Resource Development

• Videos (Narration in Navajo and English)
• Seeing Eyes (retinopathy and laser treatment
• Children of Long Life (exercise and nutrition)
• Insulin Administration (demonstration on injection)
• Eat Less Fat Today (demonstration on less fat selections and cooking with less fat)
• Let's Take A Hike (physical activity for the family)
• Pamphlets and Flip Charts
• Beat Diabetes (illustrations and basic diabetes information)
• Live Long in a Healthy Way (drawings and basic diabetes information)
• What is diabetes (basic information on diabetes)
• Diabetes Navajo terminology (basic Navajo words)

Health promotion and disease prevention activities with the Navajo Nation--includes education on wellness, healthy eating, screening, healthy snack sampling, morning walks, etcetera. Role modeling is encouraged (numbers included in clinic accomplishments section)

• Navajo Nation Tribal Council-1997, 1998
• Diné Spiritual and Cultural Society-1997, 1998, 1999
• Native American Church of Navajoland-1998,1999
• Native American Church of North America-1998, 1999
• Christian Reform Church of Shiprock-1998
• Navajo Nation Tribal TV Station and Radio-1997,1998,1999
• Navajo Area Wide Health Board-1999

Challenges

• No telephone service to majority of homes on the reservation causes difficulty in regular contacts
• Failed appointments by clients cause providers many unnecessary trips to client homes
• No permanent office space, causing program to move 3 times in 5 years
• Due to limited program staffing with Navajo Area Diabetes Program and the Model Diabetes Program, the director and secretary run the Navajo Area Wide Diabetes Program

Unique Contribution

• The program has actively bridged the communication gap between Indian Health Service Diabetes Programs and the Navajo Nation. Information on diabetes is shared on a professional level. Model Diabetes Program staff's ability to create linkages with the I H S and Navajo Nation has created a positive working environment towards the management and prevention of diabetes within the Navajo Nation.