Diabetes Education in Tribal Schools

Diabetes-Based Education in Tribal Schools (DETS)

Health Is Life in Balance K–-12 Curricula

November 2009

1.       Why is a K–12 DETS curriculum needed?

Once considered an adult disease, type 2 diabetes is increasingly being diagnosed in young people in all U.S. populations, and diabetes is almost three times more common in the American Indian and Alaska Native (AI/AN) population than in the general population. Many people are unaware that the onset of diabetes can often be prevented or delayed. The DETS curriculum intends to change perceptions, knowledge, and attitudes about diabetes through classroom learning experiences that will empower students to adopt healthier lifestyles.


2.       Who is the target audience for the DETS curriculum?

The DETS curriculum focuses on K12 students in tribal schools and schools with a high percentage of AI/AN students. Students learn the concept of balance using the Circle of Balance, a culturally based model, while also learning science. They get the tools and knowledge they need to make healthy lifestyle choices. Classroom learning is expected to benefit immediate families and community members as students bring home what they learn. Education professionals will benefit from the curriculum as it brings new knowledge and teaching strategies into the classroom.


3.      How much does the curriculum cost, and how long will it take to get to me once I order it?

The curriculum is FREE. The estimated time between when an order is placed and received is four to six weeks. Please see http://dets.niddk.nih.gov for information on how to order your FREE curriculum.


4.       How did the DETS Health Is Life in Balance curriculum get started?

In 2001, the congressionally authorized Diabetes Mellitus Coordinating Committee, chaired by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH), hosted a meeting with the Indian Health Service Division of Diabetes Treatment and Prevention (IHS/DDTP) and the Tribal Leaders Diabetes Committee (TLDC) to address the seriousness of type 2 diabetes in AI/AN communities. At the meeting, NIDDK accepted the challenge from the TLDC to lead the effort to prevent type 2 diabetes in AI/AN youth by developing a curriculum that would teach the science of diabetes in tribal schools.

What followed was a unique, collaborative effort that included NIDDK, IHS/DDTP, the Centers for Disease Control and Prevention Native Diabetes Wellness Program (CDC/NDWP), eight Tribal Colleges and Universities (TCUs), and the NIH Office of Science Education (NIH/OSE). The result of this collaboration is the DETS Health Is Life in Balance K12 curriculum.


5.      What is the DETS curriculum trying to teach and change?

The curriculum is a creative approach to helping students live life in balance. It should help reduce the incidence of diabetes in youth and improve the care of type 2 diabetes among the population. The DETS curriculum units are aligned with national science, health, and social studies education standards. They also weave together inquiry learning, exposure to science and health-related careers, and AI/AN cultural and community knowledge.


6.      What are the goals of the DETS K12 Curriculum?

  • Increase the understanding of health, diabetes, and maintaining life in balance among American Indian/Alaska Native students. (Teach about diabetes)

The curriculum incorporates inquiry-based learning that will enhance students’ science process skills. Lessons encourage students to become researchers. Investigative inquiry (observing, measuring, predicting, inferring, classifying, experimenting, communicating, etc.) allows students to emulate the work of real-life researchers. The discoveries of diagnosis, treatment, control, and prevention of diabetes increase student understanding and appreciation for direct and indirect effects of scientific research within a cultural framework.

  • Increase American Indian/Alaska Native students’ understanding and application of scientific and community knowledge. (Value and use scientific and traditional knowledge) 

The DETS curriculum supports the integration of AI/AN culture and tribal community knowledge with diabetes-related science. Lesson plans enhance the content being taught to meet educational standards within school districts. 

  • Increase interest in science and health professions among American Indian/Alaska Native youth. (Encourage science and health careers)

The DETS curriculum encourages students to gain an understanding of diabetes-related biomedical sciences. Lessons are built around role models who are health science professionals.  Students increase their awareness of careers in science and health. They also learn about the value of the involvement of these professionals in their communities.


7.       What is the instructional content of the curriculum units?

At the K4 level, students will

  • develop a concept of health through balance in life;
  • identify how making healthy food choices and being physically active every day can prevent diabetes;
  • explore the concepts of balance and imbalance through learning activities and visual aids and apply these concepts to maintaining health; and
  • explore four areas of their lives—body, mind, feelings, and the world—that work together in harmony to promote good health.

Please note that all K-4 units are interdisciplinary curriculum units emphasizing health science with strong language arts components, and that the kindergarten units are suitable for both K and pre-K levels.

At the grades 58 level, students using the social studies unit will be able to

  • describe lifestyle in terms of dietary patterns, physical activity levels, and personal choices; and
  • identify environmental changes that can be made to improve or maintain personal health and the health of families and communities.

At grades 5-8 level, students using the science unit will

  • understand, as the result of scientific investigation and the accumulation of evidence, that disease develops slowly across time; and
  • understand that diabetes is a disease in which a person’s body is not able to use glucose properly.

At the grades 912 level, students using the science unit will

  • learn through analyzing case studies how the physical, mental, emotional, and spiritual aspects of a person’s life are affected when someone has diabetes and how to use those aspects of life plus input from the community to regain balance and health;
  • understand by using models how the hormones insulin and glucagons regulate blood glucose levels and maintain homeostasis; and
  • understand how problems with the body’s use of insulin disrupt the homeostatic regulation of blood glucose and lead to diabetes.

At the grades 9-12 level, students using the health unit will

  • learn by conducting interviews with community members what others know about diabetes and what misconceptions about diabetes are common;
  • participate in role playing to learn about careers in health professions that deal with diabetes;
  • learn about the risk factors for type 2 diabetes including which can be controlled through personal behavior and which cannot; and
  • learn that people can reduce their chances of getting type 2 diabetes by making lifestyle changes.


8.       How does the DETS curriculum work with a teacher’s regular curriculum?

The DETS units take about four weeks to complete. Typically, schools supplement their regular curriculum with DETS units. Because the DETS units are aligned with national science, health, and social studies education standards, it is easy to blend them into an established curriculum.


9.       Does the DETS curriculum work?

A 2007 evaluation of the curriculum, involving 1,519 students and 63 teachers across the country, showed pre-to-post student achievement gains at all three grade-level bands (elementary, middle, and high school). Teachers stated that the curriculum was easy to use, was more engaging than similar curricula, and had strong Native American content. Overall, students reported that the DETS curriculum was “just right”: not too hard but not too easy.


10.     Who developed the DETS curriculum?

Eight Tribal College and Universities (TCUs) were central to the project:

  • Cankdeska Cikana Community College (Fort Totten, ND);
  • Fort Peck Community College (Poplar, MT);
  • Haskell Indian Nations University (Lawrence, KS);
  • Keweenaw Bay Ojibwa Community College (Baraga, MI);
  • Leech Lake Tribal College (Cass Lake, MN);
  • Northwest Indian College (Bellingham, WA);
  • Southwestern Indian Polytechnic Institute (Albuquerque, NM); and
  • Stone Child College (Box Elder, MT). 

These institutions entered into a cooperative agreement with NIH with funds provided by NIH, IHS, and CDC. They identified and worked with experienced teachers and curriculum developers to produce the units.


11.     How do I learn more about the free DETS curriculum and how to obtain copies?

To learn more, please check http://dets.niddk.nih.gov and feel free contact the Tribal College or University representative for your state for additional information.

North Dakota, South Dakota, Iowa, Nebraska, Missouri, Arkansas, Mississippi
Ann Wadsworth
Candeska Cikana Community College

North West Montana, Northern Colorado Joni Ackerman
Fort Peck Community College

Kansas, Central and West Oklahoma, Texas, Louisiana
Shelly Bointy
Haskell Indian National University

Michigan, Eastern Wisconsin, Massachusetts, Rhode Island, Connecticut
Lynn Aho
Keweenaw Bay Ojibwa Community College
laho@kbocc.org or diabeteseducation@hotmail.com

Minnesota, Western Wisconsin, Illinois, Indiana
Juanita Wiley Reopelle
Leech Lake Tribal College

Washington, Oregon, Northern Idaho, Northern California, Northern Utah
Bill Freeman
Northwest Indian College

New Mexico, Arizona, Southern Utah, Southern Colorado
Carol Maller
Southwestern Indian Polytechnic Institute

Montana, Idaho, Wyoming
Corey Sangrey
Stone Child College
406-395-4875 ext. 246

Alaska, Southern California, Florida, Hawaii, Nebraska, Nevada, New York
Carolee Dodge Francis
University of Nevada at Las Vegas

Diabetes Education in Tribal Schools