title: A community diabetes education and gardening project to improve diabetes care in a Northwest American Indian tribe.
abstract: OBJECTIVE
  The purpose of this study was to design a culturally appropriate education program for a Northwest American Indian tribe.
  
  
  METHODS
  Needs assessment revealed that a community approach rather than clinic-based education would address multiple barriers to diabetes care. Both process and outcome information are described for community and individual level evaluations.
  
  
  RESULTS
  This intervention design consisted of community diabetes workshops called "How Healthy Am I?--Treating the Whole Person." The workshops represented a traditional view of health and included 4 specific themes: (1) taking care of the body, with an emphasis on diabetes care and physical activity; (2) mental health needs; (3) foods for healthy living; and (4) spirituality and healing the whole person. Workshops were designed to be social and informational, and involve all community members. A community garden was established to improve access to fresh produce and encourage exercise.
  
  
  CONCLUSIONS
  Prior to implementation of the community workshops and evaluations, the tribal government chose to discontinue receiving the federal funding for this project. Elements of a mutually respectful collaboration are outlined and discussed based on the experiences of this project.
authors.affiliation: Department of Epidemiology, University at Albany SUNY, Rensselaer 12144-3456, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D000368:Aged; D000383:Agriculture; D001294:Attitude to Health / Q000208:ethnology; D003153:Community Health Services / Q000458:organization & administration*; D003256:Community Participation; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000517:prevention & control*; D005260:Female; D005638:Fruit; D006801:Humans; D007198:Indians, North American / Q000193:education* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015205:Northwestern United States; D052756:Nutritional Sciences / Q000193:education; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D015397:Program Evaluation; D014675:Vegetables