Chinle Service Unit Community Nutrition Department

Program Type: Promising Practice -Programs not formally evaluated (or formal evaluation is not yet complete) but identified by experts as programs with results suggesting efficacy and worthy of further study in broader pilot implementation efforts.

Description:
The CSU Department of Community Nutrition is a program that has been developed over the past six years focusing on public health nutrition and wellness. The department utilizes the socio-ecological model and subscribes to the concept of family centered and community based public health capacity building as a foundation for affecting positive, healthy population based behavior change. We believe that, depending upon the situation, time, readiness, and resource availability, we can lead, facilitate, or assist communities along their path to wellness. Our strategies are multilevel and utilize multiple technical and professional skill sets within our staffing structure.

These strategies include:

• worksite based lifestyle management programs to prevent chronic disease based upon Native Lifestyle Balance (completed or ongoing evaluation of four programs demonstrating relative and consistent success)
• providing technical assistance and guidance helping schools implement and evaluate their mandated wellness policies (working in partnership with CSU HP, have helped most schools in service area put wellness policies in place; now working with schools to effectively implement and properly evaluate policies)
• facilitating the coordination of local and regional efforts to enhance the growing of culturally and regionally specific fresh fruits and vegetables using geographically and culturally specific farming methods plus looking at how to enhance the marketing and selling efforts of the local producers (community capacity has increased)
• providing medical nutrition therapy and other nutrition services at the teen clinic of a local high school (more than $27,000 in reimbursement collected in FY07)
• lactation support program that incorporates both Navajo tradition and evidence based clinical practice (greater than $87,000 I reimbursement collected in FY07; education, initiation and duration rates consistently highest, or higher than most, in IHS and as compared with CDC generated rates)
• working with traditional healers to incorporate nutrition education into their practice (two years of work developing a trusting and cooperative relationship to create a culturally focused food guide in final draft stages)
• utilizing mass-media to strategically place non-traditional or "under the radar" healthy nutrition messages (various articles in local newspapers and corporate newsletters)
• social marketing (currently working with an IHS media program to develop a social marketing program to be initiated in central Navajo)
• para-professional model to supplement and expand our nutrition education efforts (train-the-trainer model enhanced with incentive program that rewards nutrition education efforts with monetary and resource reimbursement, having yielded on average greater than $30,000 per year for program partners and many free resources, incl. food demonstration kits and client incentives)
• advocacy efforts within the formal and informal community leadership to drive policy and environmental change (developing relationships with local and regional leadership)

Our partners include:

• grocery stores and other businesses
• local non-profit organizations
• local school districts and their food service systems
• tribal health service programs
• IHS health service programs
• Other state and federal agencies and programs.

The staffing has grown from one Registered Dietitian/Public Health Nutritionist FTE to four Registered Dietitian/Public Health Nutritionist FTEs, one Office Assitant, two FTE permanent Health Technicians, and two-three FTE term Health Technicians. The IHS RRM recommends ~11 PHN/RD FTEs for a service area the size of the Chinle Service Unit. The CSU Community Nutrition department is the primary facilitator of public health nutrition efforts at the community level, and continues to work hard towards increasing and enhancing community partnerships in order for the communities within which we work and live to create an environment that easily supports making the healthiest food choices.

Age Group(s):

Site Type(s):
Community, Clinic/Health Center, Hospital, School, Work site

Health Indicator(s):
Cardiovascular Disease , Diabetes , Healthcare Access , Nutrition

Service Area:
Navajo

Keyword(s):

Overall Cost: $300,000.00

Name: CDR Graydon Yatabe, RD, MPH
Site or Location Name: Chinle Service Unit
Address:
PO Drawer PH
Chinle, AZ 86503
Email: graydon.yatabe@ihs.gov
Phone: 928.674.7488