Year of Publication

2018

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Corrine Williams

Committee Member

Dr. Christina Studts

Committee Member

Dr. Richard Crosby

Abstract

The primary objective of this proposed program is to decrease the burden of diabetes mellitus type II among the Crow Indian tribe members in Montana by preventing the progression of prediabetes to diabetes. Type II diabetes mellitus (DMII), is a debilitating disease that contributes to increased morbidity and mortality, in addition to billions of healthcare costs annually. In the United States, minority populations carry a higher burden of DMII, however American Indians have the highest prevalence of all. In fact, American Indians are 2.4 times more likely to be diagnosed with diabetes than white people.

In Montana, the Crow Indian tribe carries a disproportionately large percentage of diabetes compared to the rest of the state. We plan to implement an adapted version of the evidence-based Diabetes Prevention Program within the Indian Health Services Infrastructure on the Crow Reservation. The DPP is a primary prevention program that has shown effectiveness in decreasing risk for DMII among a wide range of populations with prediabetes. The program’s goals include eating less fat and fewer calories and exercising at least 150 minutes per week in order to achieve a weight loss of at least 7% of each participant’s body weight. This weight loss translates to a decrease in risk for DMII; the original study demonstrated a 58% reduction in risk for DMII. Utilizing the Montana state based DPP network, the Little Big Horn College will work with IHS providers to refer eligible prediabetes patients to the 12 month long lifestyle modification program coached by trained community health workers. The DPP sessions will be offered by 3 lifestyle coaches in 3 different sites within the reservation. Process and outcome evaluation will measure fidelity, adaptations, biometric variables and psychosocial effects of the program. Through partnerships with various community organizations and tribal leaders, this program has the potential to increase community capacity and empowerment, as well decrease the overall burden of DMII and its health and economic costs to the Crow tribe.

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