Four Directions of Wellness – Native Lifestyle Balance

♪ Yá’át’ééh and welcome to Four
Directions of Wellness.
I’m Roberta Diswood. (Introduction of Navajo clans) The Shiprock Diabetes
Prevention Program and Shiprock
Health Promotion Program recently launched Native
Lifestyle Balance Online. NLB is a 16-session diabetes
prevention program designed to
help people lose weight and
become more active. Here to tell us more about this
unique program are the online
coaches, Carol Percy and
Roz Barber. Hi, Carol. Please tell us
about yourself. Hi, Roberta. I grew-up in Wisconsin. So both
my clans, my maternal and
paternal clans, are from
Wisconsin. That’s why I talk this way. And I’ve worked in Shiprock
since 1986 with different
diabetes programs. Well, thank you, Carol.
And Roz? Yá’át’ééh.
(Introduction in Navajo) I’ve been working with Diabetes
Prevention Program since it
started in 1996 here
in Shiprock. Well, thank you, Roz,
for being here. So the Diabetes Prevention
Program started in 1996.
What were the reasons for DPP? The research study… Scientists around the country
decided that we needed to find
out if diabetes could be
prevented or delayed. And so that’s why the
study started. And what were the results
of the DPP study? Well, we used two treatments in
the DPP study – a lifestyle
treatment and the medicine
Metformin. And lifestyle reduced a
person’s risk of diabetes by
58% and Metformin by 31%. So both treatments worked very
well to reduce the person’s
risk of diabetes, but lifestyle worked about
twice as well in those first
few years of the study. And out of DPP comes Native
Lifestyle Balance. So how did
NLB come about? Well, Carol is the one that did
most of the NLB, creating it
and based on the lifestyle that
our participants did. So our participants taught us
about lifestyle, so… The study was done all around
the United States, and our participants here in
Shiprock taught us how they
could use tools to help
themselves to lose weight by living here in Shiprock. And so that was a very neat
thing that we had examples of people
in our community who actually
were successful at the
lifestyle program. And so we took those success
stories and kind of
incorporated them into
Native Lifestyle Balance as examples that people used
successfully. And so let’s talk a
little bit more about the NLB
curriculum and the tools that
are available. So NLB is 16 weeks.
Why 16 weeks? Well, based on what the DPP did
it takes about 16 weeks
in order to lose weight. And for that reason it was
16 lessons. And we believe that people
should lose weight slowly and
gradually, about one to two
pounds a week. And the weight loss goal in
the DPP was 7%. And so for 7% for most people
if they lost one to two pounds
a week over 16 weeks, they could achieve that goal
in a safe way. So that’s one of the goals
of the NLB. And is there anything else
that’s included in those goals
of NLB? Roz’s favorite activity. Yes, activity. They had to do 150 minutes
of activity a week in order
to be successful. And with that, is there a
certain, like I know sometimes
you hear it has to be vigorous
or it has to be moderate. What’s the…? Well you have to do brisk
walking really fast. Make your
heart go faster in order to burn
some calories that you have. And I think what our
participants taught us is that
if they weren’t doing anything, they could start out slowly,
like just take a 10 minutes
per day walk, brisk walk, and then slowly build-up. And so if you did 10 minutes
a day, that would be 70 minutes
a week. And then you would slowly
build-up to 150. And so what are some of the key
tools participants learn
during NLB? Well they learn their lifestyle
change, how they eat, and
healthy eating, and the exercise of course.
That’s what they learn and
that’s what they taught us that can be prevent them
becoming a diabetic. And they had to learn at first,
one of the first tools you
learn is to be accountable
to what you’re eating. And so they either wrote down
what they were eating in a book. Or now that we have smart
phones, there’s apps on the
smart phone where you can keep
track of your eating. And so just the fact of writing
down what you’re eating can
make people realize really what
they are eating in a day. And that then sometimes helps
people with behavior change
about what they’re eating. So when you have that,
you know, it counts the calories
and the fat and all of that. And those are really good tools. And then how about like things
with, you know, when life
happens stress happens. You know, how do you guys
deal with that? Well if stress happens, they
can do the walking then. It relieves all the stress and
help them relieve all the
stress. So, and just the fact, you know
of going through life, were
exposed to food and ways to be
inactive each day. And so we have to learn new
habits if we’re use to driving
by the fast food restaurants in
Shiprock and stopping. Then we need to learn new
habits as far as how can you
change that behavior, maybe do it a little less often
but still do it. And then when you make slow
changes like that, that’s how
people were successful. So we were just talking about
how dealing with stress and… But I really want to go back to
that where you were talking
about the keeping track part. Can you tell me a little bit
more about that, and why it’s
important that we keep track? Well we ask people to write
down what they ate every single
day, including things, you know,
like butter on toast or salad
dressing on salad and to estimate how much
they were eating. And then from that, people
learned how many fat grams they
were eating in a day. And we initially had people
focus on eating less fat. And then after that if they
weren’t successful at reaching
their weight loss goals by
counting fat calories, then we had them add in total
calories. And so it really was tools that
people use to become aware
of what they’re eating. And then when people added
in activity, they also tracked
their activity. Roz, I think you’ve kept track
more recently than me. What kinds of things helped
you when you keep track? Well, every time I feel like I
gained some weight back or
I’m not doing so good, I always go back to my book
here. And everyday I write down
just like what we learn from
the participants that we have. So I put down everything. Everything that goes into my
mouth has to be recorded, because that is the very
important thing. If you don’t – if you leave
something out, and then
you wonder how come you’re
not losing weight. Well it’s because you had more
fat or more calories that you
didn’t count. So in other words, don’t cheat
yourself. (laugh) It’s hard though. Well I guess that’s really
interesting though, because sometimes you don’t
want to face what you’re actualy
eating and what’s actually going
into your mouth and what you’re using. So that
really is a good way to think
about that. You are watching Four Directions
of Wellness, and our guests are
Carol Percy and Roz Barber. For over a year, they were
working with Four Directions
Health Communications, producing the 16 NLB sessions
in a video format for online
access. Let’s take a look at a short
promo for the online program. Roz, what do you think about
this five inch piece of
fry bread? Well, people will say
it’s just too small. Or we don’t know how to make
a fry bread. That’s true. At Native Lifestyle Balance, we
become fat and calorie
detectives and learn that this size fry
bread has 8 grams of fat. That’s right, Carol. To become a fat and calorie
detective, go to ♪ So what was the experience like
turning the group sessions into
video format for online access? Number 1 – stressful.
(laugh) You can do it. Anybody can help
with the classes and stuff. We had fun. We laughed a lot at
our acting mistakes. (laugh) And so thinking about what you
guys were doing, What coaching advice would you
give someone watching the shows
that are thinking about trying
the NLB online? Well, they can keep trying.
You fall off. Come back up and
do it again. Don’t ever, ever quit.
Enjoy it. A lot of times when people have
tried to lose weight and have
been unsuccessful, they start to talk to
themselves like they can’t
do it. And we believe that people
can do this, and that they just don’t know
the tools yet to be successful. And we believe that the videos
will help people learn tools
that will help them to be
successful with changing their lifestyle
behaviors and learn new
healthier habits. And so thinking about that,
are there any like, you know, there’s a lot of ways
to lose weight and a lot of
things out there, kind of what makes it unique? What I think is the book. That writing it down.
That really, really helps. So if it didn’t, they wouldn’t
have come up with the book. What the study showed is that
weight loss is the key to
diabetes prevention. And so weight loss, people
achieving that, is what is
important. And for each of us
individually, different things
work. And so it’s just inside that
individual to find out what’s
going to work to help them to be more active and to
eat healthier. And so we believe that the
person has the answers, and that some of the tools in
the videos will help the person
to achieve their goals. So you guys talk about 16-week
session. Is there any like fun
ones or things that you find
interesting within that? It is fun to do that. Make it
fun. Go out and do your
walking, your hiking, and trying a new recipe that
has low fat and low calories. So you learn a lot
along the way. I’d say that there’s lots of
different things that we do
related to eating and activity. And that because when we go to
for instance a family
celebration, and you eat the food there
because it’s a celebration. And that’s okay. And so you learn to tell
yourself, “Okay, I really
enjoyed that day,” “and tomorrow I’m going
to get back on track with
my eating and activity.” Okay. So we’ve been talking about the
online, way to access NLB
online, but are there other
ways you can do NLB? Well, most of the hospital, the
IHS hospital, have or doing
classes – group classes that you can
ask at the health
education department. And so the idea behind the
videos is that if you don’t
have the time to get to group
classes, you can access the videos on
the website that you are going
to give them at the end of our
talk today, and then the person can do it
on their own time if they have
a computer or access to a
smart phone. They’d be able to view the
videos on their own time. And so you’re saying that an
individual can do it in either
in a group setting or by
themselves. Okay, well, I want to thank you
guys both for being here today. If you watched this show and ar
interested in learning about
Native Lifestyle Balance or want to get started on
losing weight, becoming more
active, and living a healthier
lifestyle, the website is This has been Four Directions
of Wellness. Hágoónee’. ♪

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