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Holistic Approach to Diabetes Management Empowers American Indians

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Publication Date: June 2008

Publisher(s): Robert Wood Johnson Foundation

Topic: Health (Health services for the chronically ill)


The Full Circle Diabetes Program, a Building Community Supports for Diabetes Care project that is a collaboration between the Minneapolis American Indian Center's Ginew/Golden Eagle Program, the Native American Community Clinic and the Diabetes Community Council, helps spread the word about diabetes awareness, self-management and prevention in the American Indian community.

The project's leadership formed the Diabetes Community Council for community members living with or concerned about diabetes. The council works with Full Circle partners to design community activities for people with diabetes and their families. It also provides ways to help people with diabetes cope with the struggles of self-management and access additional resources.

The symbolic Circle Model of community organizing reflects American Indian culture and values, recognizing that all people play a role in the survival and vitality of a community through their individual contributions. The program focuses on providing resources and support for diabetes self-management to promote physical, mental, emotional and spiritual wellness. Descriptions of each form of support follow:

* Physical supports include options for physical activity, regular medical care, case management and access to medical supplies.
* Mental supports—educational supports for the mind—include diabetes classes, self-management workshops and medical case management services. A key component is goal-setting, which is promoted in the project's five-week small group education sessions. Participants also receive educational boosters at the clinic's monthly Diabetes Breakfast.
* Emotional supports include a Talking Circle as well as council-led intergenerational events.
* Spiritual supports focus on attention to culture throughout all of the activities, with an emphasis on respecting and listening to the teachings of one's ancestors to live well.

The Full Circle Diabetes Program's group activities enhance and reinforce the individualized attention provided in the clinic. Its resources and supports for diabetes care reinforce the American Indian cultural belief that wellness results from balance of the body, mind, emotions and spirit.

Key Lessons:

* Applying a holistic approach to self-management, such as the Circle Model, is effective in improving the quality of care and enhancing community wellness and capacity among urban American Indians.
* Chronic disease self-management classes for people with diabetes have been accepted and are successful in an urban American Indian population.


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