By Micheal Rios, Tulalip News
Amongst Native peoples, few things in life are as scary as diabetes. And then, after being clinically diagnosed with diabetes, a person must take many steps to resume a normal life, and in most cases, a more healthy lifestyle. What can be just as surprising as the diabetes itself are the unexpected, nonphysical effects, which are equally threatening to one’s quality of life. Although these effects might make the road to diabetes management somewhat bumpy, experts from the Healthy Hearts team from the University of Washington’s Indigenous Wellness Research Institute are demonstrating that life with diabetes not only goes on, but can get better.
The Healthy Hearts team has been working to understand and address cardiovascular disease in the Tulalip community since 2008. The first study, Healthy Hearts Across Generations, collected surveys from 284 randomly selected participants from the Tulalip tribal membership to examine cardiovascular disease risks and look at what coping strategies were most productive. From 2010 to 2012, Healthy Hearts Across Generations also provided 135 community parents and guardians with culturally influenced classes to promote health in their families.
In 2012, planning began for the second Healthy Hearts study called Healthy Hearts, Healthy Minds. This was launched in 2013 for Natives in the Tulalip area whose diabetes/prediabetes put them at greater risk for heart disease. Healthy Hearts, Healthy Minds provided those who were eligible and wanted to participate with one-on-one wellness counseling to take control of their diabetes self-care. This study came to a close in late February.
Local community resources and input from tribal members were used to develop study materials and programs, which were culturally-adapted and designed to promote sticking with positive, healthy behaviors even when it can be tough in the face of busy schedules and other challenges.
Just as exercise strengthens the mind as well as the body, awareness and education play an important role in nonphysical healing. Optimal diabetes management is more likely when people understand the nature and persistence of diabetes, and the fact that it is treatable. It’s more than just sharing facts; people also must be taught how to return to healthier lifestyles and avoid the habits that likely contributed to their health issues in the first place. This is yet another way in which wellness counselors are beneficial, providing an evidence-based intervention strategy to help participants succeed with diabetes management.
“Our focus was the wellness mental state. With diabetes, one of the challenges is that you are asked to do so many things to take care of it yourself. You have to change how you eat, you have to exercise, and check your blood sugar, you have to take your medicine, and don’t forget about getting your eyes and feet checked. It becomes very overwhelming for people,” says Rachelle McCarty, Project Manager of Healthy Hearts, Healthy Minds. “If you are really stressed out, then it’s hard to take care of yourself. That’s where our program aimed to help out. We provided participants with one-on-one coaching and very useful tools and information, so they could minimize their stress level to better manage their diabetes.”
Participants were asked to meet with a wellness coach for 10 sessions over a three-month period. Throughout the sessions, participants worked with their wellness coach to identify individual goals they wished to focus on regarding their pre-diabetes or diabetes and stress. They also worked with their coach to complete the Healthy Hearts, Healthy Minds curriculums, which covered a range of topics and skills like problem-solving, adherence, motivation and relaxation training.
Wellness coach Michelle Tiedeman, who has been with Healthy Hearts since 2009, says “What I enjoyed the most was working one-on-one with individuals and seeing them make one small, positive change at a time that added up to better overall wellness. It has been an honor to work with the Tulalip community the past several years. I have had the pleasure to work with some amazing individuals and see them accomplish great things.”
Healthy Hearts sponsored an informational lunch to share results from Healthy Hearts Across Generations in August 2014, and hosted a community celebration on February 2, 2016 to honor Tulalip’s commitment to health and share results from Healthy Hearts, Healthy Minds. You may have also seen them giving out results flyers and booklets at public events, health fairs, and the semi-annual General Council meeting last year.
Here is a sample of some of the findings:
- 42% of tribal members who responded to the health survey said they do participate in traditional activities like culture night, canoe journey, salmon ceremony, talking circles, and others.
- 40% of tribal members who responded to the health survey reported that they had high blood pressure, 50% of the men and 32% of the women.
- 27% of parents reported that they often use their own behavior as an example to encourage their child(ren) to be physically active.
- 77% shared that they have one or more blood (biological) relatives with diabetes.
- Those who enrolled in Healthy Hearts, Healthy Minds significantly lowered their depressive symptoms.
- Healthy Heart, Healthy Minds participants rated themselves significantly better at sticking with their goals at the end of the program compared to the beginning.
- 70% agreed with the statement, “I have a responsibility to walk in a good way for future generations.”
For help with your diabetes, contact the Diabetes Care and Preventions Program at 360-716-5642. For more information on the projects or results available to date, email the Healthy Hearts, Healthy Minds study at iwri@uw.edu. The projects were funded by the National Heart, Lung and Blood Institute, and the National Institute on Minority Health and Health Disparities.
Contact Micheal Rios, mrios@tulaliptribes-nsn.gov