San Bernardino/Riverside County Indian Health Inc.,

Located in the south, eastern area of California is the San Bernardino / Riverside County Indian Health Inc. that services Morongo, Pechanga, Agua Caliente, San Manuel and Torres-Martinez. Program directors at San Bernardino / Riverside County Indian Health Inc. have developed a comprehensive diabetes intervention program. The program has multiple components including; screening for diabetes, diabetes education, treatment and outreach. The program services five fixed clinics in the Morongo, Pechanga, Soboba, Torres Martinez and the San Manuel areas.

As part of the health agency's comprehensive diabetes intervention project an R.V. has been set up as a mobile medical unit that can reach communities and individuals living in isolated areas. The staff focuses on screening, monitoring diabetes prevalence, intervening and treating diabetes using a community based strategy aimed at preventing diabetes and its complications. The mobile medical unit has two fully equipped examination rooms. It is also equipped to do eye exams. It is a fully self-contained clinic with generator. The diabetes Registrar Sue Frank notifies individuals in the area when the mobile medical unit will be in their community.

Besides the Mobile Medical Unit once a month clinics are held at each site. Fitness classes, cooking classes, diabetes education and a diabetes clinic are all offered. Marcia Roper acting director of the San Bernardino/Riverside County Indian Health, Inc. described the inter-related program. The nutrition component led by Roper has been very successful at getting people off their medication or reducing the amount of medication needed.

Once a month the diabetes program services the six clinics. During this time individuals have the opportunity to see a physician, dietician, podiatrist, fitness leader have an optical exam and often there is a dentists available. Individuals have the option of seeing all the specialists or just one. Fitness classes are offered and at this time there are twenty-four different classes with the goal to have two fitness classes per site. The classes are geared to participants whether they are young, old or wheel chair bound.

In addition to the Mobile Medical Unit, Diabetes Clinics, Fitness classes and Cooking Classes San Bernardino/Riverside County Indian Health Inc. offers a Diabetes Education Program that focuses on prevention and nutrition. The program is six steps or classes. Elements of the classes include an introduction to what is diabetes and introduces the concept of carbohydrate counting to the participants. The program urges participants to wean themselves off caffeine and to track blood sugar levels during this transition time. This coupled with restricting carbohydrate intake, including protein with meals and trying to control stress has led to many in the community to reduce diabetes medication or to be able to stop medication altogether, while others may never have to start taking diabetes medication.

San Bernardino / Riverside County Indian Health Inc. bring together a variety of strategies to provide care and prevention to its service members. Working with the community to better understand what member's needs are and what they are looking for in diabetes care and prevention has been crucial to their success.

For further information contact Marcia Roper R.D. Nutritionist at mroper@rsbcihi.org.

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