Q: Iowa’s Native American Network is working on developing a fact sheet on diabetes and tobacco use, and would like to see examples from other states. Please share any fact sheets that address tobacco use and diabetes, particularly any materials that have been developed for Native Americans.

A:

1. Alabama: Alabama Diabetes Branch has not created factsheets or other literature for Native Americans. We use the poster Managing Diabetes, The Eagle Books, Ten Ways American Indians Can Prevent Type 2 Diabetes, Move It and Reduce Your Risk of Diabetes, National Indian Council on Aging, and other literature from the National Diabetes Education Program (NDEP). However, the Alabama Office of Minority Health includes Native American information in their newsletter from time to time. Attached is the type of information found in the 2008 newsletter.
    
   The American Indian Affairs Commission in Alabama does not have factsheets or handouts but does provide general health information on their website; click Programs, then Indian Health, next Health Survey of Alabama Indians. The survey includes information on diabetes and tobacco use. There is an Indian Health factsheet from the Indian Health Service on the website. Further, a PowerPoint presentation created by the Indian Affairs commission is available, and the Alabama Disparity Report is being produced.
    
2. California: The California Diabetes Program has done some tobacco cessation work focused on reaching Native American programs. The California Diabetes Program, the California Smokers’ Helpline and the California Tobacco Control Program teamed up to create the “Be Proactive campaign: A Campaign to Promote Smoking Cessation among People with Diabetes via Health Care Providers.” The goal of the collaboration that began in October 2004 was to help people with diabetes who smoke to quit by accessing California Smokers’ Helpline services, the state’s free telephone based smoking cessation program. Due to the high prevalence of diabetes among Native Americans, project staff added California Indian Health Services Centers as intervention targets during the 2006-2007 intervention period. However, the project staff had difficulties recruiting these clinics. Several Indian Health Centers stated that it was an inconvenient time to accommodate such a program as the clinics were already overwhelmed with patient care and were unwilling to take on additional program activities. In the end, the project was able to recruit at least 5 Indian Health Centers that oversaw services at 18 clinics.
    
   The following links may be helpful:
   • California Diabetes Program website
   • Diabetes, Smoking and Your Health-Patient Fact Sheet
   • "Do you cAARd?" Campaign - Help Your Patients Quit Smoking
      
3. Connecticut: The State of Connecticut developed the attached fact sheet with the assistance of California. (we have a Spanish version also).
    
4. Michigan: Attached please find a document we place on our website and hand out at meetings, etc. However, we do not have anything specifically geared to the Native American population at this time. If you have any questions, please do not hesitate to call me.
    
5. Utah: A diabetes and tobacco information sheet we use in Utah can be found here. Another fact sheet can be found here.
    
6. West Virginia: While WV does not have a fact sheet specific to Native Americans, here is information we have collaboratively developed for Diabetes and Smoking, to date.
    
   • Smoking and Diabetes Brochure, West Virginia Tobacco Quitline
   • Smoking and Diabetes Fact Sheet, West Virginia Tobacco Quitline

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Partner Response:

1. Centers for Disease Control and Prevention: The Idaho, California and Kentucky Diabetes Prevention and Control Programs all have educational programs focusing on tobacco cessation and diabetes. Nothing AI/AN specific is available, but lots of folks are interested in the diabetes/tobacco information.
    
   Several diabetes/tobacco fact sheets were collected in summer 2010 in a separate inquiry from the chronic disease center, but nothing AI/AN specific:
    
   • Position Paper: Smoking and Diabetes, American Diabetes Association
      
   • Patient information sheet: “Are You Ready to Quit Smoking?”, American Diabetes Association
      
   • Smoking website, American Diabetes Association
   • Diabetes, Smoking, and Your Health Fact Sheet, California Diabetes Program
      
   • “Who Do You Want to See Tomorrow” diabetic retinopathy brochure, Idaho Diabetes Prevention and Control Program and the Idaho Tobacco Prevention and Control Program
      
   • Smoking and Diabetes, University of Pittsburgh Medical Center
      
   Click here to download a one-page message for American Indian and Alaska Native people called “Take Care of Your Heart: Manage Your Diabetes” by the National Diabetes Education Program (NDEP). The fifth bullet is “Stop smoking – seek help.”
    
   Click here to view an AJPH Letter to Editor by our I.H.S. Division of Diabetes Treatment and Prevention colleagues, Kelly Acton and Ann Bullock, providing data from the Diabetes Audit.

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TCN Response:

• CDC references:
  • Office on Smoking and Health
  • Division of Diabetes Translation
    • Native Diabetes Wellness Program
       
• Additional fact sheets:
• CDC fact sheet - American Indian and Alaska Native Heart Disease and Stroke Fact Sheet - touches on smoking and diabetes as risk factors:
• Healthy Maine - Diabetes & Tobacco Fact Sheet
• NJ Gasp - Diabetes and Smoking website
• Northwest Portland Area Indian Health Board – Presentation (has 3 slides on tobacco and diabetes)
• Virginia Tobacco Use Control Project - general fact sheet on smoking and diabetes

Follow-up story – February 2011:

In response to Iowa’s request, many fact sheets were submitted on diabetes and tobacco use, but there was limited information covering both topics and geared toward Native Americans. Based on guidance and examples of existing materials obtained through this Help Your Peers request, the Great Plains Tribal Chairmen’s Health Board created a tri-fold brochure on diabetes and tobacco use for their Native American target audience.

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