Date of Award


Document Type


Degree Name

Master of Science (MS)




Chronic disease inflicts a huge financial and collective burden on the people of this nation. Disparities in chronic disease and health risk behaviors do exist for Native Americans. The multiple disparities of the Spirit Lake Nation are identified through the use of the survey tool that was developed by the National Resource Center of Native American Aging. The quantitative descriptive study collected self-reported data related to perceived health status, behavioral risk factors, chronic disease, and other demographic information among the Spirit Lake Nation elders.

A health promotion and disease prevention model that influences self care appeared to be the most applicable for this study; thus Pender’s Health Promotion model was chosen as the most appropriate. Pender’s Model is multidimensional and holistic in perspective, and similar to the traditional concept of health in Native American people. Pender’s Model is also based on the nature of persons interacting with their environment as they pursue health. The primary assumption is that individuals have an active role in shaping and maintaining health behaviors and modifying the environmental content for health behaviors.

Upon evaluating the data that was obtained through the survey, diabetes was identified as a chronic condition which significantly impacted on the people of the Spirit Lake Nation. Nearly 45% of the elders identified diabetes as a self-reported chronic illness (compared to 14.6% nationally). The literature indicated that diabetes is greatly influenced by behavioral risk factors, thus diet, exercise, and nutrition have a critical impact on the disease process and/or the complications associated with diabetes. Anecdotal information indicates that diabetes has an enormous impact on entire families at Spirit Lake. Family and community education regarding diabetes is needed in order to promote positive outcomes in the community. The “Talking Circle” model is recommended as the teaching method for education in this community. The “Talking Circle” model promotes small group community/family interactive education, promoting participant control of the learning environment in a comfortable and informal process. This process will promote an individual’s active role in shaping and maintaining their own health behaviors and promoting modification of their environment for positive health outcomes.