As the director of the Navajo Area Indian Health Service (NAIHS), your role is to enhance obesity
care in Chinle, Arizona. This entails conducting a community needs assessment, devising a process
innovation, forging partnerships, and formulating both communication and implementation
strategies.
The proposed community-based obesity prevention and treatment plan will engage local leaders and
integrate a culturally responsive approach. The proposal will outline the following:
• the health needs of Chinle's community, identified through a thorough assessment
• suitable process innovations tailored to these needs
• key partnerships essential for the plan's success
• effective communication strategies for rolling out the plan
The proposal will be culturally attuned to the Navajo population and presented in a professional
manner, reflecting the commitment of both you and the NAIHS.
A. Propose a process innovation by doing the following:
1. Summarize the needs of the Chinle population.
The Chinle population needs access to adequate resources to enhance their overall health,
specifically related to diabetes, nutrition, obesity, physical activity and exercise, and tobacco
cessation (Indian Health Service). There is a lack of education available and insufficient
outlets for addressing the most significant health disparities identified by the IHS HPDP.
2. Explain how cultural differences and socioeconomic factors relate to current healthcare trends.
This population primarily lives in poverty without access to many basic essentials like telephone
access or in-home plumbing. (Chinle Service Unit Profile) These social determinants of health
create an environment that are not conducive to a healthy lifestyle. Without access to
adequate food sources or facilities that promote exercise and physical activity, this population
is slated for an endless cycle of declining health and earlier mortality. In addition to
socioeconomic limitations, this population also faces the hurdles of cultural differences with
the promotions of western medicine. Many techniques for assessing overall health and
treating newly diagnosed comorbidities may combat with the traditional beliefs of this culture.
(SAMHSA)
3. Describe the process innovation solution that addresses the summarized needs in part A1.
This new innovation process solution will need to be multifaceted to address the biggest health
concerns for this population, which seem to center around nutrition and physical exercise.
(Indian Health Service) Diabetes, malnutrition, and obesity are all related to poor diet, but can
also be attributed to lack of physical exercise. Due to the poverty level of this area, there is a
lack of availability to nutritious food options and organized physical activity. (Chinle Service
Unit Profile) Building multiple above ground gardens will give the opportunity to grow
nutritious food that will be available to the entire population, as well give an opportunity for
physical activity by walking the gardens to care for the produce. This can take place in many
different ways by building the gardens, preparing the gardens by carrying heavy bags of soil,
digging the gardens, and carrying water cans around to water the produce. The community
, will be motivated to keep up with the gardens to ensure that sufficient food is produced for
everyone, which will give opportunity for physical activity. Looking at the total population of the
community of 4,395, total size of the community of 16.3 square miles with a population of
269.8 people per square mile, and how much food will be needed per person, it will give an
idea of the size of the gardens, as well as how many will be needed. (Chinle Service Unit
Profile) The availability of more nutritious foods and the opportunity for physical activity will
help improve overall health by reducing type 2 diabetes and obesity.
a. Discuss how the patient population or community will interact with the process innovation
solution.
The culture of this population identifies with the importance of cultivating crops. (SAMHSA)
As evidenced by the traditional ways of ceremonial treatments of illness, this culture
utilizes herbs gathered from the land to treat ailments. These gardens can also house
herbal remedies for treatments as well.
b. Explain how the process innovation solution improves an existing process or meets an
unmet need in the community.
This area of Arizona was once a vast plain of rich soil for cultivating crops due to the water
that once rushed into the valley, but “Native farmers can’t count on that water anymore.
Since the 1990s, record drought has put both the farming and culture of the Navajo, or
Dine, nation at great risk” (Hayrinen-Beschloss). Creating a source for plentiful water and
raised gardens with soil specifically targeted to certain crops will more easily ensure
successful growth and harvesting.
4. Explain how your solution is relevant and feasible by providing evidence from
a needs analysis.
According to the needs analysis, there is a clear gap identified between the current state
of health in the community versus the desired result. This solution will positively impact all
the biggest areas of opportunity pertaining to obesity, type 2 diabetes, lack of physical
activity, and lack of access to nutritious food options. (Indian Health Service) With this
community being predominantly in the age range from 10 – 50 years-old, and the median
household income being less than $50,000, this solution will be a cost effective way for
the majority of the population to practice healthy habits. (Chinle Service Unit Profile)
5. Explain how your solution is relevant and feasible by providing evidence from
a cultural analysis.
There is a strong sense of collective community where everyone pitches in for the
betterment of all. This project would give everyone an opportunity to help grow food for
each other. Sharing food is also customary as a sign of welcoming in this culture.
(SAMHSA) As a culture, this community is very connected to self-preservation from the
land, so being able to grow food to be shared with each other in the community aligns with
cultural traditions. (SAMHSA)
6. Discuss how cultural aspects shaped your proposed solution.
This proposed solution takes into account the traditional culture of farming and harvesting
that this community cherishes as it pays tribute to the their ancestors, which is an
important spiritual and cultural mindset. (SAMHSA) This also gives the opportunity for
care in Chinle, Arizona. This entails conducting a community needs assessment, devising a process
innovation, forging partnerships, and formulating both communication and implementation
strategies.
The proposed community-based obesity prevention and treatment plan will engage local leaders and
integrate a culturally responsive approach. The proposal will outline the following:
• the health needs of Chinle's community, identified through a thorough assessment
• suitable process innovations tailored to these needs
• key partnerships essential for the plan's success
• effective communication strategies for rolling out the plan
The proposal will be culturally attuned to the Navajo population and presented in a professional
manner, reflecting the commitment of both you and the NAIHS.
A. Propose a process innovation by doing the following:
1. Summarize the needs of the Chinle population.
The Chinle population needs access to adequate resources to enhance their overall health,
specifically related to diabetes, nutrition, obesity, physical activity and exercise, and tobacco
cessation (Indian Health Service). There is a lack of education available and insufficient
outlets for addressing the most significant health disparities identified by the IHS HPDP.
2. Explain how cultural differences and socioeconomic factors relate to current healthcare trends.
This population primarily lives in poverty without access to many basic essentials like telephone
access or in-home plumbing. (Chinle Service Unit Profile) These social determinants of health
create an environment that are not conducive to a healthy lifestyle. Without access to
adequate food sources or facilities that promote exercise and physical activity, this population
is slated for an endless cycle of declining health and earlier mortality. In addition to
socioeconomic limitations, this population also faces the hurdles of cultural differences with
the promotions of western medicine. Many techniques for assessing overall health and
treating newly diagnosed comorbidities may combat with the traditional beliefs of this culture.
(SAMHSA)
3. Describe the process innovation solution that addresses the summarized needs in part A1.
This new innovation process solution will need to be multifaceted to address the biggest health
concerns for this population, which seem to center around nutrition and physical exercise.
(Indian Health Service) Diabetes, malnutrition, and obesity are all related to poor diet, but can
also be attributed to lack of physical exercise. Due to the poverty level of this area, there is a
lack of availability to nutritious food options and organized physical activity. (Chinle Service
Unit Profile) Building multiple above ground gardens will give the opportunity to grow
nutritious food that will be available to the entire population, as well give an opportunity for
physical activity by walking the gardens to care for the produce. This can take place in many
different ways by building the gardens, preparing the gardens by carrying heavy bags of soil,
digging the gardens, and carrying water cans around to water the produce. The community
, will be motivated to keep up with the gardens to ensure that sufficient food is produced for
everyone, which will give opportunity for physical activity. Looking at the total population of the
community of 4,395, total size of the community of 16.3 square miles with a population of
269.8 people per square mile, and how much food will be needed per person, it will give an
idea of the size of the gardens, as well as how many will be needed. (Chinle Service Unit
Profile) The availability of more nutritious foods and the opportunity for physical activity will
help improve overall health by reducing type 2 diabetes and obesity.
a. Discuss how the patient population or community will interact with the process innovation
solution.
The culture of this population identifies with the importance of cultivating crops. (SAMHSA)
As evidenced by the traditional ways of ceremonial treatments of illness, this culture
utilizes herbs gathered from the land to treat ailments. These gardens can also house
herbal remedies for treatments as well.
b. Explain how the process innovation solution improves an existing process or meets an
unmet need in the community.
This area of Arizona was once a vast plain of rich soil for cultivating crops due to the water
that once rushed into the valley, but “Native farmers can’t count on that water anymore.
Since the 1990s, record drought has put both the farming and culture of the Navajo, or
Dine, nation at great risk” (Hayrinen-Beschloss). Creating a source for plentiful water and
raised gardens with soil specifically targeted to certain crops will more easily ensure
successful growth and harvesting.
4. Explain how your solution is relevant and feasible by providing evidence from
a needs analysis.
According to the needs analysis, there is a clear gap identified between the current state
of health in the community versus the desired result. This solution will positively impact all
the biggest areas of opportunity pertaining to obesity, type 2 diabetes, lack of physical
activity, and lack of access to nutritious food options. (Indian Health Service) With this
community being predominantly in the age range from 10 – 50 years-old, and the median
household income being less than $50,000, this solution will be a cost effective way for
the majority of the population to practice healthy habits. (Chinle Service Unit Profile)
5. Explain how your solution is relevant and feasible by providing evidence from
a cultural analysis.
There is a strong sense of collective community where everyone pitches in for the
betterment of all. This project would give everyone an opportunity to help grow food for
each other. Sharing food is also customary as a sign of welcoming in this culture.
(SAMHSA) As a culture, this community is very connected to self-preservation from the
land, so being able to grow food to be shared with each other in the community aligns with
cultural traditions. (SAMHSA)
6. Discuss how cultural aspects shaped your proposed solution.
This proposed solution takes into account the traditional culture of farming and harvesting
that this community cherishes as it pays tribute to the their ancestors, which is an
important spiritual and cultural mindset. (SAMHSA) This also gives the opportunity for
