CDC FUNDING IN ACTION

Choctaw Nation Expands Diabetes Prevention in Indian Country

‘Umbrella’ approach combines tribal resources to sustain program

Challenge

During 2017–2018, the rate of type 2 diabetes among American Indian and Alaska Native (AI/AN) adults (14.7%) was the highest of all US racial and ethnic groups and nearly twice as high as that of non-Hispanic Whites (7.5%). The National Diabetes Prevention Program (National DPP) lifestyle change program can cut the risk of developing type 2 diabetes by as much as 58% (71% for people over 60). CDC recognizes organizations that deliver the National DPP if they meet certain standards, such as class attendance and weight loss benchmarks. CDC recognition is a requirement of many payers and key to long-term program sustainability. However, achieving this recognition can be challenging for tribes with limited resources.

Approach

To help smaller tribes participate in the National DPP, the Choctaw Nation set up an “umbrella” organization called the Diabetes Prevention Nations Project. Umbrella hubs allow smaller organizations to partner for cumulative enrollment to meet Diabetes Prevention Recognition Program requirements and leverage the administrative and billing infrastructure of the hub to become sustainable. Through this project, the Choctaw Nation trains, mentors, and supports five tribes that would otherwise not be able to offer a CDC-recognized type 2 diabetes prevention program to their communities and extends recognition to those tribes based on their combined participation.  

Results

Since September 2018, 38 tribal members have enrolled in the Diabetes Prevention Nations Project, and 102 lifestyle coaches have been trained by Choctaw Nation, with additional support from the Chickasaw Nation’s DPP. "The support has been phenomenal,” said lifestyle coach Cayla Mitchell. “Participants thrive as a group. If someone doesn't come in, the other participants text and check in." Choctaw Nation's Lee Ann Sherrill added, "The participants share and get really close … they come together like a family." The Choctaw Nation is also leading a demonstration project to develop and test a Coordinated Distance Learning Center, which will enable AI/AN coaches throughout Indian Country to deliver the program virtually when in-person sessions are not possible. 

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At A Glance

The Diabetes Prevention Nations Project is a promising model for expanding the National DPP across Indian Country. The Choctaw Nation developed this umbrella program after thoughtfully listening and responding to the unique challenges tribes face when seeking to offer a CDC-recognized program to their community members with prediabetes. This collaborative model builds capacity, reduces barriers to access, and acknowledges the need for building relationships grounded in trust and inspired by shared goals to help AI/AN people prevent type 2 diabetes.


Contact: chelsea.wesner@usd.edu or visit CDC Division of Diabetes Translation

The findings and conclusions in this success story are those of the author(s) and do not necessarily represent the official position of the funding agencies or the Centers for Disease Control and Prevention (CDC).

Project Funding: 1022 - National Diabetes Prevention Program (National DPP), administered by the Division of Diabetes Translation