The Special Diabetes Program for Indians Healthy Heart Demonstration Project at the Wagner Health Care Center in Wagner, South Dakota is administered for the Yankton Sioux Tribe by the IHS. The Yankton Sioux Tribe consists of approximately 7,854 enrolled members, 3,500 of whom live directly on the Yankton Reservation in south central South Dakota. The Wagner Health Care Center’s program is the only Healthy Heart project in the IHS Great Plains Area, which includes the states of South Dakota, Nebraska, Iowa and North Dakota. Program staff include the program director and coordinator/data coordinator, an administrative assistant, and four case managers including two nurses, one registered dietitian, and one physician assistant.
The program has been very successful at recruiting participants. Nearly 400 names are on the program’s recruitment registry, and approximately 100 people are enrolled in the program. Program staff attribute their recruitment success to recruiting patients in the Wagner Health Center’s diabetes clinic who have recently completed the Balancing Your Life with Diabetes Curriculum. Program staff meet with patients in the diabetes clinics and review a specially developed handout to help them discuss blood sugar meter printouts, lab results, and health goals. Program staff then invite the patients to participate in monthly visits for cardiovascular disease risk reduction, as well as the Healthy Heart Demonstration Project.
The program uses case management visits that feature health behavior coaching and motivational interviewing techniques. During these visits, the case managers use specially created interactive tools to make weight loss and lifestyle changes more fun and personal. The case managers also use an activity called “VolumeTrics” which uses the principle of volumetrics, or energy density, to encourage intake of fruits, vegetables, lean meat or buffalo, whole grains, and other foods that fill you up while providing fewer calories.
The program’s annual two day conference for participants has proven to be a very successful retention activity. This conference focuses on improving health through mental, emotional, spiritual, and physical health. Guest speakers present approaches that draw on American Indian traditions to help participants deal with modern-day stresses and chronic disease.
In addition, the program uses a number of activities to recognize participants’ successes and help them stay connected with one another. For example, the program honors its participants with a wall of pictures and certificates, called “Wagner IHS Health Heroes”, to celebrate their health achievements. The program also distributes special lapel and hat pins to participants when they reach specific milestones. Finally, monthly support groups help participants share their successes, support one another, and learn new strategies for healthy lifestyles.
- Using existing resources.
- Working in close collaboration with local entities.
- Celebrating program and participant accomplishments.