American Indian and Alaska Native (AI/AN) communities are at substantial risk of diabetes. Consequently, In 1997, Congress created the Special Diabetes Program for Indians (SDPI) to fund diabetes prevention and treatment programs throughout Indian Country. This initiative led to substantial improvement in blood glucose, blood pressure, and cholesterol levels among AI/ANs with diabetes, accompanied by significant decline in diabetes-related end-stage renal disease. A subset of these programs translated evidence-based diabetes prevention and treatment practices into the everyday world of Indian health. Modest weight loss through dietary changes and increased physical activity reduced incident diabetes by 57% among participants. An intensive case management approach to reducing risk of cardiovascular disease also yielded substantial weight loss, increased physical activity, improved diet, smoking cessation, and aspirin use: major indicators of this serious complication. Yet the lessons from this exciting work have been slow to be learned. The subsequent institutionalization of such well-documented evidence-based practices has been constrained by a poor understanding of community dynamics, program capacity, resource allocation, organizational commitment, and policy. The Center for American Indian and Alaska Native Diabetes Translation Research (CAIANDTR) at the University of Colorado Anschutz Medical Campus (UC/AMC has begun to address this problem by: 1) Expanding its Research Base to include faculty at our sister universities through an innovative network of Satellite Centers whose research either directly targets diabetes prevention and treatment or is translational in nature with clear potential for application to diabetes translation research; 2) Extending the knowledge, skills, and experience of this Research Base -- emphasizing 6 specialty areas, including community engagement, cultural adaptations of intervention, health literacy, health technologies, dissemination and implementation science, and sustainability -- to facilitate a multidisciplinary, culturally grounded, problem-oriented translational research program of major scientific and programmatic importance, and 3) Rigorously evaluating the impact of the training, technical assistance, and consultations provided to other investigators in the U.S. seeking to work with AI/AN communities, as well as to those struggling to pursue diabetes translational research in rural and other racial/ethnic minority populations. This rich array resources relevant to diabetes translation research, generally, and to AI/ANs specifically, is engendering new capacity to address these diabetes-related health disparities.
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