Indigenous people have the highest prevalence of diabetes in the United States, and, according to a recent study, more than 89 percent of Indigenous elders have been diagnosed with at least one chronic condition.
In 2015, Qualis Health, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Idaho and Washington, began partnering with the Northwest Regional Council’s Tribal Outreach & Assistance Program to improve the health of tribal communities in Washington State and beyond. Qualis Health brought QIN-QIO resources to the Tribal Outreach Program to further develop and strengthen it, including training and support to expand and sustain the program.
What differentiates the Wisdom Warriors program from the standard CDSMP is that it is culturally tailored to indigenous people, while maintaining program fidelity and tribal sovereignty.
The Northwest Regional Council developed the Wisdom Warriors program, a community-based chronic disease self-management program (CDSMP) using culturally appropriate materials and a relevant approach for Native American elders, who are respected for their knowledge and sharing of information. The program provides indigenous people with tools they can use to manage their chronic disease.
What differentiates the Wisdom Warriors program from the standard CDSMP is that it is culturally tailored to indigenous people, while maintaining program fidelity and tribal sovereignty. Tribal elders eat traditional foods, participate in cultural activities and discuss health traditions through their own cultural lens. The workshops are interactive and focus on action planning, decision making and problem solving.
Upon completing the CDSME workshops over a six-week period, elders graduate and become Wisdom Warriors. They receive a special medicine pouch at the graduation ceremony, which they wear when attending monthly support meetings. At these gatherings, participants celebrate each other’s successes in reaching health milestones by earning beads for their medicine pouches and for such activities as canoe journeys, dancing and pow-wows among others. The beads signify their commitment to their personal health and to the health of their tribal communities.
With support from Qualis Health, the inaugural Wisdom Warriors conference was held in June 2018 in Suquamish, Washington, gathering communities together to honor the Wisdom Warriors, as well as to recruit, increase participation and identify leaders. The two-day conference included discussions on the benefits of traditional foods, immunizations, exercise, chronic pain management and cardiac health. The event concluded with an honoring ceremony at which 34 tribes were present, leading to an uptick in interest in the program.
Qualis Health’s partnership with Wisdom Warriors and the Washington State Department of Health has enabled two tribal members to be trained as T-trainers, the top of the “train the trainer” model. Additionally, Lisa Packard, Director of Community Engagement at Qualis Health, was invited to become a T-trainer, and—upon completion of her training—became the first Native American T-trainer. These individuals can now train others to become Master Trainers, further spreading the program. They also can go back to their communities and serve as examples of how to improve long-term personal and population health.