Development of a Primary Prevention Program: Insight Gained in the Zuni Diabetes Prevention Program

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Abstract
Diabetes prevention programs are essential in Native American communities that are experiencing high rates of non-insulin dependent diabetes mellitus (NIDDM). These programs must be community based and supported in order to succeed. The Zuni Diabetes Prevention Program (Program) is a community-based primary prevention project designed to reduce the prevalence of diabetes risk factors among high-school-age youths. The Program strives to enhance knowledge of diabetes and to support increased physical activity, increased fruit and vegetable intake, and reduced soft drink consumption. The primary mechanisms of intervention are diabetes education, a school-based wellness center, supportive social networks, and modification of the food supply available to teens. Program evaluation uses a multiple cross-sectional model; assessment occurs at three points within the 4-year project. Midproject results indicate a significant reduction in soft drink consumption and an increase in glucose/insulin ratios, suggesting a decline in the inci dence of hyperinsulinemia. Clin Pediatr. 1998;37:131-142