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Abstract: The purpose of this article is to present a review of the literature on diabetes type 2 prevention interventions for Native American populations. The interrelation of the cultural role of food in Native American diets, educational policies related to food, outcomes of federal policies, and the historical background of diabetes are addressed. In addition, published studies of diabetes prevention interventions with Native American populations are examined. Lastly, exemplars of programs that represent best practices in the prevention of diabetes are described.
Key Words: Native America, Type 2 Diabetes, Prevention Programs, Cultural
INTRODUCTION
Much has been written about American Indians and Type 2 diabetes. Search engines bring up hundreds of articles and internet sites on this topic. How do these published reports really impact diabetes prevention for Native Americans? Has what is known gone from awareness to intervention to success in preventing diabetes? The purpose of this article is to present a review of the périment published literature about the prevention of Type 2 diabetes (hereafter called diabetes) among Native Americans and to highlight exemplar programs and empirically tested interventions in the literature that could make a difference. The impetus for this process is the authors' work as Co-Directors for the nursing research training core of the American Indian Diabetes Prevention Center. The mission of the American Indian Diabetes Prevention Center is to prevent or delay the onset of diabetes in American Indians and Alaska Natives. The goal of this project is to teach tribal nurses, who work with Native Americans, about research methods, the process of implementing evidence-based practice, and the ethical conduct of research in the practice setting. In learning about any issue, it is important to review its historical background.
HISTORY OF AMERICAN INDIAN HEALTH IN AMERICA
Native Americans have a rich history of healthy food systems and prosperous agricultural economies. By 800 A.D., North American Indian farmers from Florida to Ontario, Canada were cultivating several crops and developing varieties that were appropriate for the growing season where they lived (Keoke & Porterfield, 2002). Explorers landing in the so called "new world" marveled at the abundance of agricultural crops and the advanced agricultural technology. As a result, many explorers and settlers were aided by Indian farmers' "bounty (Keoke & Porterfield, 2002).