diabetes in this population is on average 2-3 times greater than the U.S. population. AI/ANs also experience higher rates of complications due to diabetes;it is no surprise, then, that cardiovascular disease is the number one cause of death for this group. As demonstrated by the NIDDK-sponsored Diabetes Prevention Program, the risk of developing diabetes can be reduced dramatically in at-risk individuals through lifestyle changes and medication. Likewise, the risk of cardiovascular disease in individuals with diabetes can be reduced through control of blood pressure, reduction in cholesterol levels, glycemic control, aspirin use, smoking cessation, physical activity, and weight management. Given the epidemic proportion of diabetes in AI/AN communities, in 2004 Congress funded a large, 5-year demonstration project to prevent diabetes and its complications among AI/ANs by extending these intervention technologies to them. The accompanying mandate called for rigorous evaluation of the processes and outcomes. 66 AI/AN communities subsequently were funded to participate in this effort, which has become known as the Special Diabetes Program for Indians'Competitive Grant Program. The AIANP at the UCHDSC serves as the Coordinating Center, responsible for both program development and evaluation. During the 1st year, the Coordinating Center, grantees, and IMS Division of Diabetes Prevention and Treatment jointly designed a comprehensive, longitudinal, multi-level approach to assessing both intervention process and outcomes. The design gathers relevant data at strategic points in time (pre- and multiple post-tests) from the individual participant, a key family member, a provider, the organization housing the grantee program, and community stakeholders. Each Diabetes Prevention grantee program (n=36) is required to enrolling 48 new participants per year for 3 years, totaling 5,184 unique individuals;each Healthy Heart grantee program (n=30) is required to enrolling 50 new participants per year for 3 years, totaling 4,500 unique individuals. Despite the comprehensive nature of the evaluation, the collaborative planning process faced a difficult challenge in selecting from among many factors grantees, IHS staff, and the Coordinating Center felt might account for successful intervention outcomes. The assessment of traditional healing and its contribution to preventing diabetes and complications such as cardiovascular disease fell victim to this process. Grantees' subsequent experience during the first year of implementation has assured them that respondent burdens are not as great as they initially had assumed, allowing for additional measures. Thus, we propose to incorporate a reliable, well established measure of traditional healing into the baseline assessment of the individual participants..
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