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Good Health and Wellness in Indian Country  \nTable of Contents  \nBackground 5  \nIntroduction 6  \nDefinitions 7  \nCommunity Assessment 8  \nTribal Community Team 11  \nCommunity Action Plan 12  \nPhysical Activity 14  \nNutrition 16  \nCommercial Tobacco 19  \nChronic Disease Management 21  \nUnderstanding Terms 23  \nAcknowledgements  \nThis guide was made possible through the Centers for Disease Control and Prevention (CDC) Good Health and Wellness in Indian Country (DP14-1421PPHF14) Cooperative Agreement with the California Rural Indian Health Board, Inc. The content is an adaption of the CDC Community Health Assessment aNd Group Evaluation (CHANGE) Action Guide: Building a Foundation of Knowledge to Prioritize Community Needs.  \nSuggested Citation  \nCalifornia Rural Indian Health Board, Inc. Tribal Policy, Systems, and Environmental Strategies for Reducing Chronic Disease. Sacramento, CA. July 2016.  \nTribal PSE Strategies 4  \nBackground  \nIn 2014, the California Rural Indian Health Board, Inc. (CRIHB) was awarded a Centers for Disease Control and Prevention (CDC) grant,“Good Health and Wellness in Indian Country” referred to as the Advancing California Opportunities to Renew Native health Systems (ACORNS) program. The goal of the CRIHB ACORNS program is to prevent heart disease and manage type 2 diabetes and associated risk factors, such as tobacco use, physical inactivity, and unhealthy diet in American Indian tribes through a holistic approach to population health and wellness.  \nThis grant funded mini-grants that are given to California tribes, tribal health programs (THP) and tribal organizations supported by federally recognized tribes. The ACORNS mini-grants include an adaptation of the CDC Community Health Assessment aNd Group Evaluation (CHANGE) Tool that measures the policy, systems and environmental components (PSEs), within a community; adaptations include an indigenous framework and culturally responsive evaluation techniques. Additionally, CRIHB staff provides technical assistance and multiple trainings to California tribes and tribal programs as applicable. By implementing PSE strategies, communities help tackle health issues such as obesity, diabetes, cancer, and other chronic diseases. PSE strategies are a way of modifying the environment to make healthy choices practical and available to all members of the tribal community. By changing policies and shaping physical landscapes, a big impact can be made.  \n[Additional program information can be found at](Additional program information can be found at www.crihb.org/acorns)[ ](Additional program information can be found at www.crihb.org/acorns)[www.crihb.org/acorns](Additional program information can be found at www.crihb.org/acorns).  \nGarden at Ya-Ka-Ama, photo provided by Indian Child and Family Preservation Program  \nTribal PSE Strategies  \n5  \nBackground  \nIntroduction  \nIntroduction  \nThis document is an adaptation of the Centers for Disease Control and Prevention’s (CDC) Community Health Assessment aNd Group Evaluation (CHANGE) Action Guide: Building a Foundation of Knowledge to Prioritize Community Needs. This document shifted the information in the CHANGE Action Guide to provide guidance for tribes, tribal health programs, and tribal organizations in implementing policy, systems, and environment (PSE) strategies to reduce chronic disease. Prior to implementing these strategies it is suggested tribal communities convene a Tribal Community Team (TCT) . The team serves to provide guidance, support and insight. Implementing a culturally-competent and community sensitive strategy is essential to successful PSE change. Definitions of underlined terms can be found in the section titled “Understanding Terms.”  \nPSE interventions are intended to:  \n• Implement policy change including the passing of laws, ordinances, resolutions, mandate","cbCaiuV9H8gIIySi","https://ap.wps.com/l/cbCaiuV9H8gIIySi","pdf",7682384,32,"English","# Background\n# Introduction\n# Definitions\n# Community Assessment\n# Tribal Community Team\n# Community Action Plan\n## Physical Activity\n## Nutrition\n## Commercial Tobacco\n## Chronic Disease Management\n# Understanding Terms\n# Acknowledgements","[{\"question\":\"What is the ACORNS program and what chronic conditions does it target?\",\"answer\":\"The ACORNS program is a CDC-funded initiative aimed at preventing heart disease and managing type 2 diabetes and related risk factors in American Indian tribes. It focuses on factors such as tobacco use, physical inactivity, and unhealthy diet.\"},{\"question\":\"What is a Tribal Community Team (TCT) and why is it recommended?\",\"answer\":\"Before implementing PSE strategies, tribal communities are suggested to convene a Tribal Community Team. The team provides guidance, support, and insight to help ensure culturally competent and community-sensitive strategy implementation.\"},{\"question\":\"How do policy, systems, and environmental changes differ in PSE interventions?\",\"answer\":\"Policy change involves laws, ordinances, mandates, regulations, or rules. Systems change involves changes to organizational infrastructure, rules, or systems, often alongside policy change. Environmental change modifies physical, social, or economic factors to influence day-to-day practices and behaviors.\"}]","ACORNS Tribal Policy, Systems, and Environmental Strategies - Reducing Chronic Disease | PDF",1790067154,81]