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On the T.R.A.I.L. to diabetes prevention
By Johanna Lindemann |
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| An epidemic of diabetes on Native American lands would be bad news enough. However, according to Leo Nolan, senior policy analyst at the Indian Health Service (IHS), "There is a pandemic of diabetes in Indian Country." Prevalent and geographically widespread, this disease ravages Native lands with suffering and death. Native Americans have a 420 percent higher rate of diabetes mortality than the general U.S. population. Type 2 diabetes, which used to be called adult-onset diabetes, has been diagnosed in Indian children as young as 4.
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• Diabetic eye disease is the most common cause of blindness in working age adults.
• Diabetic kidney disease is the fastest growing cause of kidney dialysis and transplantation, with over 100,000 cases per year.
• Nervous system damage affects over 60 percent of people with diabetes; more than half of all lower limb amputations in the U.S. occur among people with the disease.
• The risk of heart disease, stroke, and problems during pregnancy are increased by two to four times more for someone with diabetes.
Source: Joslin Diabetes Center at Harvard Medical School |
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A disease in which the body does not produce proper amounts of insulin, a hormone needed to process food into energy for daily life, diabetes can affect virtually every tissue of the body with long-term and severe damage.
According to the Indian Health Service, a federal agency, diabetes rates among American Indian and Alaska Native youth ages 15 to 19 increased 32 percent from 1991 to 1997. Add to that a warning from the American Academy of Pediatrics, which reports that higher rates of this disease among children are directly linked to physical inactivity and poor nutrition (including excessive intake of sugary foods).
On the T.R.A.I.L.
In fall 2002, Boys & Girls Clubs of America joined IHS, the National Congress of American Indians
and Nike to pilot a prevention program aimed at reducing the onset of diabetes among Native American youth. Called On the T.R.A.I.L. (Together Raising Awareness for Indian Life) to Diabetes Prevention,
it is an innovative combination of physical and educational activities.
T.R.A.I.L. is a three-month, 12-part program that provides Club youth with a comprehensive understanding of healthy lifestyles to prevent diabetes. The primary areas addressed are:
- Physical fitness – Making regular physical activity a routine part of Club members' lives.
- Nutrition – Learning about healthy eating.
- Healthy choices – Making positive choices and avoiding risky behaviors such as smoking or using alcohol and other drugs.
- Prevention – Knowing about the importance of
early health screenings and the early warning signs
of disease.
Woven throughout T.R.A.I.L. are self-esteem and prevention activities from national Club programs such
as SMART Moves. Club members draw from these resources as well as tribal traditions and history to learn about nutrition, food choices and the impact
of diabetes.
Collaborations are Key
In a recent interview, Dr. Charles Grim, director of IHS, applauded the progress that Boys & Girls Clubs have made in working with Native Americans.
"I see, as does Indian Country, that Boys & Girls Clubs of America is committed over the long-term to try and do something about diabetes," says Grim. "We are excited about partnering with BGCA to tackle the problem. Clubs offer young people a comfortable, safe environment to educate them about the importance of physical activity, diet and healthy eating."
The strength of the T.R.A.I.L. pilot program is the number and quality of participating partners. Each, including IHS, the National Congress of American Indians, BGCA and Nike, has brought its own particular strength to the table. Says the IHS's
Leo Nolan, "When it comes to Indian health, partnerships work."
From the Field
Preliminary results from the pilot sites have been positive. At the Boys & Girls Clubs of the Mississippi Band of Choctaw Indians in Philadelphia, Miss., members loved the learning games of T.R.A.I.L. and children not in the program are asking to join. To give members a Club-wide approach to lifestyle change, Choctaw Club staff are committed to improving their own dietary habits.
Coralei Kluver, program coordinator at Boys & Girls Club of the Northern Cheyenne Nation in Lame Deer, Mont., found that her T.R.A.I.L. participants had many misconceptions about diabetes – they thought it was contagious and could be acquired through coughing, among other beliefs.
Of the pilot program students, Kluver says: "They feel almost relieved just to understand what they have seen happen in their families. One little girl told me that she hasn't even been putting sugar in her tea when she drinks it. I tried to let her know that a little was okay, but she responded with, 'No, you just don't want to take any chances with things like this!'"
The overall goal of this national diabetes prevention initiative? It is to expand the initial six pilot sites to
25 sites by this fall – and to 100 Native Club sites
by 2007.
Johanna Lindemann is director of strategic communications at BGCA.
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