Flexibility, Compassion, and Support are Keys to Success of the Indian Health Board of Minneapolis' Diabetes Program

Lifestyle Balance class participants.

The Indian Health Board (IHB) of Minneapolis is one of the largest urban Indian health centers in the Nation. It serves over 3,000 American Indians and Alaska Natives. Two of its classes are funded by the Special Diabetes Program for Indians (SDPI). One class is called Lifestyle Balance and is funded by an SDPI Diabetes Prevention Initiatives grant. The other class is called Diabetes Basics and is funded by an SDPI Community-Directed grant.

IHB Diabetes Program Director Lois Brown, RN, PHN, says a key to being successful when addressing health disparities in urban settings is being flexible to remove barriers. "Transportation can be a barrier, and participants may relocate," explains Lois. "We offer transportation to clinic visits and classes. And for clients who may relocate, we offer courses that can be completed within ten weeks, as well as one-on-one classes."

Participants sample healthy meals.

Another key to success is compassion, especially when discussing diabetes complications. "It's common for participants to experience fear, sadness, and depression from memories of family members' complications," explains Lois. These emotions usually surface after a few classes, when participants have built rapport and trust amongst each other. "During the first few classes, people share their knowledge of a connection between sugar and diabetes," says Sammy Gardeen, RD, LD, who teaches the Diabetes Basics class. At about week three, the discussions become more personal. "Participants start opening up. They share their own stories of how diabetes has affected their lives."

During a week four Diabetes Basics class, the topic was complications: heart attacks, comas, and amputations. There was shock and sadness in the room, as well as silence and a few tears. One participant broke the silence by wondering aloud what he should do. He put his head in his hands, clearly distraught. Sammy set her notes down. "When you are feeling overwhelmed, don't be afraid to get counseling, go for a walk, or call a friend." One woman said, "But I'm all alone," and another participant quickly replied, "You've got us."

Diabetes Basics teacher Sammy Gardeen.

Offering heartfelt support and a sense of unity is another key to success. "We let people voice what is in their hearts. We hear each other out," explains Sammy. "Our staff are not the only teachers. Our participants teach each other and us, as much as we ever teach them."