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CDR Graydon Yatabe, RD, MPH Office of the Director NCCDPHP/Division of Community Health

Promoting Nutrition in Indian Country. CDR Graydon Yatabe, RD, MPH Office of the Director NCCDPHP/Division of Community Health Centers for Disease Control and Prevention. At the end of this session, participants will be able to:.

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CDR Graydon Yatabe, RD, MPH Office of the Director NCCDPHP/Division of Community Health

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  1. Promoting Nutrition in Indian Country CDR Graydon Yatabe, RD, MPH Office of the Director NCCDPHP/Division of Community Health Centers for Disease Control and Prevention .

  2. At the end of this session, participants will be able to: Identify successful strategies for strengthening cultural competency in Indian communities Describe some of the characteristics of traditional foodways and how dietitians can strengthen the role of these foods in health. Identify steps to implementing The Healthy Start Act.

  3. Eagle Butte, SD

  4. Lodge Grass, MT

  5. Qualla Boundary, NC

  6. Rough Rock in Central Navajo

  7. Road to Fort Defiance from Tsaile

  8. Road to Black Mesa from Pinon

  9. Planting the Seed

  10. What is Public Health Nutrition? Improves or maintains optimum nutritional health of the nation, state or community Emphasizes health promotion and disease prevention

  11. What is Public Health Nutrition? (cont.) Uses multiple, coordinated strategies to reach and influence the community, organizations and individuals that make up the community Requires organized and integrated community nutrition efforts with leadership provided by the state and local health agency

  12. Public Health NutritionCore Responsibilities Needs Assessment and Reassessment Surveillance Resource Identification and Allocation Evaluation and Assurance Strategic Planning Policy Development

  13. LOGIC FRAMEWORK ILLUSTRATING CONCEPTUAL APPROACH TO NUTRITION & COMMUNITY HEALTH Interventions Modifiable Determinants Intermediate Outcomes Community Health Outcomes POPULATION FOOD INTAKE Food Consumption Patterns (e.g. fruits, vegetables) Intake of Nutrients and Food Components Vitamins Minerals Fiber Fats Other food constituents Dietary supplements Alcohol Energy balance Food Supply Factors -Agriculture policy -Nutrition policy -Science and technology -Food production, processing, storage and distribution -Food fortification -Food safety Physiologic Indicators Growth Adipose tissue Musculoskeletal Gastrointestinal Metabolic Cardiovascular Reproductive Immunological Neurological Morbidity Mortality Measures of Health & Fitness Quality of Life Environmental Factors Availability & Price -Neighborhoods -Schools -Worksites -Homes -State and National -Food and nutrition assistance programs Life Stage Requirements Pregnancy Lactation Childhood Adolescence Adulthood Older Adulthood Genetics, Co-morbidities Consumer Demand -Household resources -Nutrition knowledge -Cultural practices -Psychosocial characteristics -Taste and preferences -Advertising and marketing Physical Activity Patterns

  14. Three Levels of Prevention • Primary • Secondary • Tertiary

  15. Three Levels of Intervention • Individual • Community • System or Environmental

  16. So We Want to Improve Lifestyle Behaviors … Where do we put our resources and efforts? 1. Enhancing Individual Knowledge and Skills 4. Fostering Coalitions and Networks 2. Promoting Community Education 5. Changing Organizational Practices 3. Educating Providers 6. Policy and Legislation Education

  17. Plan Develop goals and objectives Create a logic model Construct a formally facilitated strategic plan Perform a community assessment Develop lasting relationships

  18. Plan Regularly review progress Strategic marketing and product placement Deliberate and continual evaluation Data, data, data Communicate success early and often

  19. Mission Statement Advancing a holistic approach to supporting healthy food ways in the Chinle Service area, from the seed to the table.

  20. Commitment Statement We commit to t’aa hwi’ ajit’e’ego (it’s up to you) through Ke’ (partnerships) by fostering evidence-based, community guided, policies and practices that support individuals and communities in making healthy food choices.

  21. Watering the Plant

  22. Logic Model Objective: Create efficient and creative department that enhances services provided by division and ultimately facilitates positive and healthy community food habits.

  23. Three Pronged Service Approach Direct Services Technical and Liaison Services Facilitating Policy and Environmental Change

  24. Three Pronged Service Approach Direct Services Technical and Liaison Services Facilitating Policy and Environmental Change

  25. Three Pronged Service Approach Direct Services Technical and Liaison Services Facilitating Policy and Environmental Change

  26. Three Pronged Service Approach Direct Services Technical and Liaison Services Facilitating Policy and Environmental Change

  27. Partners Our partners include: • Local, Regional and National IHS • Local Community • Retail Food • Media • Navajo Nation • Other tribal, state, regional, federal agencies and programs. 

  28. Local IHS Partners Dietary Health Promotion Native Medicine Wellness Center Diabetes Program Public Health Nursing Clinics Clinical Departments Health Care Providers Chinle Hospital Employee Association

  29. Our Community Partners Parents Elders Iiná Coalition, Inc Adabi Talbot House Chapter Houses Farmers Gardeners Canyon de Chelly Comprehensive Health Services Schools: Student Association Teachers Parent Association Nurses Coaches Wild Cat Den Dorm Assistants Wellness Advisory Committees Food Service

  30. Partners – Retail Foods Shamrock Foods Aramark Sysco Bashas Subway Junction Restaurant Coca Cola Distributors

  31. Partners - Media KTNN Gallup Independent Navajo Times

  32. Partners – Navajo Nation Dine’ College Water Board Navajo Housing Authority Aging Services - Senior Centers Community Health Representatives WIC Special Diabetes Project Office of Dine’ Youth TANF Dept of Agriculture Fire and Rescue New Dawn NTUA NN Police Department Dept of Behavioral Health Daycare/Head start FDPIR Chinle Youth Center Social Services ARISE Institute for Integrated Rural Development

  33. Partners - State Dept of Economic Security Dept of Aging University of AZ Cooperative Extension Arizona Nutrition Network

  34. Partners - Region IHS- Several SRSU partners University of NM Extension Services NM State University NM Farm to Table Southwestern Regional Marketing Network PLANT – Promoting Local Agriculture and Native Traditions (inactive) USDA – Risk Management Agency USDA – Soil Conservation Services National Park Service Yavapai County Public Health

  35. Partners – National Level IHS Division of Diabetes Treatment and Prevention IHS National Nutrition Program USDA – Risk Management Agency Academic Institutions

  36. Service Challenges • Funding • Staffing, staff development and training • Coordinating our vision/approach with partners • Coordinating our progress with partners • No national or area public health nutrition vision or plan

  37. Service Challenges

  38. Service Challenges

  39. Service Challenges

  40. Harvest

  41. CSU Director of Public Health

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