Native Americans develop diabetes at a rate of 33%—three times greater than that of whites and twice that of African Americans. People of all races living with diabetes are at two to four times greater risk of developing stroke, hypertension, kidney disease, dental and periodontal disease, and blindness. Recently, the members of the Unkechaug Nation have become increasingly concerned about the exponentially rising rate of diabetes on their reservation, but a window of opportunity exists when lifestyle modifications can stop or significantly delay the progression of disease from prediabetes to diabetes type 2. These changes in diet and exercise are best initiated at the community level, tailored so that they meet the needs of those who are using them.
To understand how to modify an existing set of evidence-based recommendations from the Centers for Disease Control and Prevention, a three-way collaboration has been developed between the Unkechaug Nation, Adelphi University Center for Health Innovation, and Winthrop University Hospital Obesity and Diabetes Institute. In this partnership grant, the Unkechaug Nation’s Initiative to End Diabetes collaborative proposes to 1) outline a set of partnership steps for a community-based effort focused on education and lifestyle modification, 2) explore and design infrastructure for community-engaged research on the reservation, 3) develop a governance structure that would support applications for future funding opportunities, 4) formulate metrics for a measurable outreach plan, and 5) develop a guide for other reservations that wish to adapt prediabetes and diabetes prevention programs.