Indian Health Service Health Promotion/Disease Prevention Initiative

1. Indian Health ServiceHealth Promotion/Disease Prevention Initiative Aberdeen Area Tribal Chairmen’s Health Board October 27, 2005 Alberta Becenti, MPH Rapid City, South Dakota

2. Background • Significant health disparities among American Indian/Alaska Native • Obesity • Diabetes • Cardiovascular Disease • Cancer • Injury • Many of these health conditions and diseases are related to lifestyle behaviors.

3. Goal • Create healthier American Indian and Alaska Native communities by building on individual, family and community strengths and assets.

4. Overview of Initiative • Infrastructure • Community Capacity • Partnership • Resources • Evaluation

5. Strategies • Focus on effective clinical and community public health strategies • Identify and implement best practices to reduce the health burden in AI/AN communities • Increase community capacity and infrastructure

6. Strategies • Established Policy Advisory Committee (PAC) to provide oversight and policy guidance to the agency. • Representatives include Tribal Leaders, NCAI, NIHB, CDC, NCUIH, TSGAC, Direct Tribes and IHS • Meet face-to-face 2x a year

7. Strategies • PAC Annual Plan (focus on 4 Areas) • Educational Policies – focus on physical activity and school food service including vending machines, and competitive food sales. • Met with Department of Education, Office of Indian Education to collaborate on this effort. • Area HP/DP Coordinators to review their respective state, county, and local policies. • Assess readiness for change.

8. Strategies • PAC Plan (continue) • Marketing- develop a marketing plan to increase awareness of HP/DP Initiative • Conducted focus group (tribal and federal health care providers, tribal health workers). • Develop a marketing plan based on focus group feedback. • Community Assessment – NIHB and PAIHB to pilot test a survey instrument and report findings back to the committee.

9. Strategies • PAC Plan (continue) • Partnership – identify and expand partnerships with other federal agencies, academia, foundations and corporations to support HP/DP Initiative • Submitted concept paper to RWJF focusing on obesity prevention, community capacity, and community/clinical interventions. • MOU with MADD (pending approval) Future plan: meet with HUD, USDA, AIHEC, Ford Foundation, and Kellogg Foundation

10. Strategies • Established a Prevention Task Force to develop a strategic plan to enhance and improve disease prevention and health promotion efforts by identifying diseases with the greatest disparities and developing a framework to address these diseases. • Composition: Area HP/DP Coordinators, representatives from nutrition, dental, diabetes, medical provider, nursing, injury prevention, health education, and behavioral health.

11. Prevention Task Force (continue) • Identify and expand community and clinical best and promising practices. • Promote and support environmental, school, and worksite policies that support healthier behaviors. • Identify training needs of the community and providers. • Identify benchmarks for monitoring progress (process, impact, & outcome measures).

12. Infrastructure Benchmarks Hire IHS Area HPDP Coordinators to work with I/T/U - Oklahoma (hired) Albuquerque (hired) • Tucson (hired) Alaska (hired) • California (hired) Billings (hired) • Portland (hired) Aberdeen (hired) • Nashville (hired) Bemidji • Navajo (hired) Phoenix

13. IHS Health Summit • Demonstrate the agency’s commitment to HP/DP to eliminate disparities • Create and expand partners • Share best and promising practices • Areas developed HP/DP plans • Area Coordinators are following up on plans

14. Build Community Capacity

15. Healthy Native Communities Fellowship (HNCF)

16. Healthy Native Communities Fellowship • HNCF is based on an action-learning model in which insights, skills, and new knowledge is shared and applied in real life situations • One year journey • Interactive week-long sessions • Self-study educational curriculum • On-line computer conferencing • Topics: grant writing, leadership, data collection and much more.

18. Where are the teams from?

20. Community Champion Forum • Get together to share what is working in the AI/AN communities • Share success stories, network, and recognize local champions • Training • Marketing • Planning/evaluation • Grant Writing/management • Resources

21. FY 2005 Fellow Graduates • 13 Teams graduated on September 22, 2005 in Washington, DC.

22. Community Champion Forum • Navajo – December 2003 • Phoenix/Tucson – April 2004 • Alaska – April 2004 • Portland/California – January 2005 • Aberdeen/Billings – October 2004 • Nashville/Oklahoma – August 2005 • Bemidji – TBA • Albuquerque – October 2005

23. Community Champion Forum

24. JUST MOVE IT! Let’s Get 1 millionNative people moving!

25. What is JMI? • National campaign to promote physical activity for American Indians and Alaska Natives

26. Sign Up to Become A JMI Partner, visit:www.justmoveit.orgJoin this effort to get1 million Native people moving!

27. Improve Information Access • Best/Promising Practices (clinical & community) • Resources • Assessment Tool • Training • Grant opportunities

31. Immunization Injuries Emergency Room Visits Outpatient Visits Cardiovascular Disease Diabetes Education BRFSS YRFSS Dental Cancer Prenatal Care Population Obesity Future Plan: Improve Information Access to Health Profiles

32. Partnership Benchmarks • HQ and Areas each develop 2 new partners for prevention in 2005 • State or Federal • Academia • Foundations & non-profits • Corporation

33. Resource Benchmark • Provide direct support to local initiatives in all Areas. • Seed money to support local plans • Improve access to information & resources

34. Resources • Headquarters support • National Diabetes Program for Indians • Area Support • Congressional Funds - $2.074 M. • 20 competitive grant awards @ $64,500 in FY 2005.

35. FY 2005 Grant Awards • Kenaitz Indian Tribe – Alaska Area • Health Promotion • Ho-Chunk Nation – Bemidji Area • Get Fit Project • Ramah Navajo – Albuquerque Area • Youth Camp Project • Peta Wakan Tipi – Bemidji Area • Obesity Prevention for Youth

36. FY 2005 HP/DP Grant Awards • Native Images – Tucson Area • Diabetes Prevention for Urban Native Americans • South East Alaska Regional Health • WISEFAMILIES through Traditional Knowledge • National Indian CTR- California Area • An Alcohol intervention for youth • South Central Foundation – Alaska • Tobacco Free Promotion Project

37. FY 2005 HP/DP Grant Awards • Rock Boy Health Board – Billings Area • Health Promotion • Alamo Navajo School Board - Albuquerque • Outdoor Fitness Project • Eastern Aleutian Tribes, Inc – Alaska Area • Native Physical Activity • Kalispel Tribe of Indians – Portland Area • Health Promotion Project

38. FY 2005 HP/DP Grant Awards • Indian Health Care Resource Center • Indian Youth Program for Healthy Living • San Diego American Indian Health • San Diego for Health Wellness Project • Choctaw Nation of Oklahoma • Get Movin Project • Tulalip Tribes – Portland Area • Children Obesity Prevention Project

39. FY 2005 HP/DP Grant Awards • Salish Kootenai College – Billings Area • Health Promotion • Inter-Tribal Council of Michigan – Bemidji • Women’s Health Circle • Migizi Communication, Inc – Bemidji Area • Partnership to Strengthen Indian Famillies • Aberdeen Area Tribal Chairman’s Health Board • Northern Plains Smoke Free Home Campaign

40. FY 2006 HP/DP Grants • Announcement in March 2006 • 10 ($10,000) competitive planning grants • 12 ($100,000) competitive grants • Will be conducting regional workshops

41. Evaluations • Conduct process, impact, and outcome evaluations that are aligned with GPRA and Healthy People 2010 objectives • Annual HP/DP Reports • Progress, impact, and outcomes • Trend reports (RPMS, GPRA) • Community Health Assessment • Behavioral Risk Surveys • Director’s HP/DP Benchmarks

42. Native American Youth Empowerment Conference • Create a venue for youth to share innovative strategies focusing on prevention of violence, injury, substance use/abuse, underage drinking, teen pregnancy, tobacco, HIV/AIDS, and physical inactivity. • Empower youth to take active roles in making a positive difference • Create a forum for youth and their adult allies to make positive changes in their school and community. • Held in Albuquerque, NM with over 400 youth

44. FY 2006 Youth Projects • Regional Youth Summit • Protecting You/Protecting Me Training • Youth in Action training

45. Tobacco Free Policy • Tobacco Free policy • HHS adopted policy in January 2005. • All OPDivs to develop policy. • Eliminate all tobacco products from HHS properties including owned, controlled, and leased by HHS (includes interior and exterior), unless to do so would violate applicable law.

46. Tribal Communities Products • Improved Access to Information to support Wellness • Resources, Training, Best Practice, Assessment Tools, Community Profile • Chance to participate in Just Move It • Support for Community Directed Wellness Planning • Share at and Learn from Community Wellness Champion Forums

47. Tribal Communities Products • Access to Training, Fellowship • Regional Resource Roundtables • Networking Opportunities • One Place to Call for Wellness

48. Invest in Prevention • If you improve in health and well-being - Quality of life improves - Health Care utilization decreases - Disability is controlled • Productivity is enhanced - Healthier communities

49. Health Promotion/Disease Prevention http://www.ihs.gov/hpdp/

50. Any questions?