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Healthy Nations Initiative

About Cherokee Nation of Oklahoma

About the Program

In 1993, the Cherokee Nation was awarded a Healthy Nations Grant (Phase 1) to develop a comprehensive prevention and treatment plan for the community. During Phase 1, the Cherokee Nation piloted the project in one county (Adair County) in the fourteen county area known as the TJSA (Tribal Jurisdictional Statistical Area). The program enlisted community members and other tribal workers to assist in development of a public awareness campaign and community-wide prevention plan. A resource directory was developed by the Healthy Nation staff containing all available resources within the TJSA. A Healthy Nations 800 number was established to increase accessibility to referral and resource information.

Activities during Phase 1 included events such as Nativefest or cultural heritage days hosted by several school systems, smoking cessation courses, youth activities including a 25 mile relay run, Stilwellness program (wellness program for elementary school students), and training of various community members in prevention areas, just to name a few. Public awareness material such as posters, brochures, newsletters, and a video were produced in prevention areas utilizing community members as actors, writers and artists. The Healthy Nations logo for our program was developed by a Cherokee member of the Stilwell community.
The program was staffed by two full time workers and two part-time workers during Phase 1. A Health Promotion & Disease Prevention Educator and Administrative Assistant worked as full time staff while the Health Promotion & Disease Prevention Coordinator served as Project Coordinator and an additional Health Promotion & Disease Prevention Educator worked part-time on the project.
The plan for Phase 2 focuses on expanding efforts in the Adair county area to five surrounding counties. Emphasis is on four major areas listed below:

  • GOAL 1: To implement a tribal wide public awareness campaign concerning substance abuse issues based on Phase I pilot.
  • GOAL 2: To implement a tribal-wide community prevention program utilizing all available resources identified and assessed in Phase I.
  • GOAL 3: To implement a tribal-wide early identification and assessment system into the current Cherokee Nation rural health center system.
  • GOAL 4: To enhance current treatment options for substance abuse via staff training and use of community elders.

Staffing for Phase 2 includes the addition of two Health Promotion & Disease Prevention Educators as well as a Media/Marketing Specialist.

The Cherokee Nation is committed to primary prevention of any disease condition and is working diligently to implement programs and policies that promote this premise. Integration of the innovative strategies produced by Phase 1 of the Healthy Nations Project into existing structures is active throughout the Phase 2 process. Cherokee Nation intends that progress in the area of prevention made possible through this funding will continue to work years after completion of the grant.

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Host Community/Organization

When the Cherokee people made the journey along the Trail of Tears more than 150 years ago, they settled in what is now northeastern Oklahoma. The land in that part of Oklahoma resembled their traditional homeland with its rolling hills, beautiful trees and abundant sources of clean water.

The Cherokee people brought with them a vibrant culture that included their native language, religion, beliefs and practices. They adapted themselves to the European culture for their immediate survival and that of future generations. This forward-looking and resilient nature has enabled the Cherokee people to survive, and to bring their culture into the twentieth century.

At this time, more than 65,000 Cherokee people reside in northeastern Oklahoma within the boundaries that were established over 150 years ago. These boundaries contain all or parts of fourteen counties of what is now the State of Oklahoma.

The fourteen counties of Cherokee Nation represent the highest density of Native Americans in the entire State of Oklahoma. For instance, in Adair County Native Americans comprise 43.78% of the total population. Native Americans comprise 33.42% of the total population in Cherokee County, and in Delaware County Native Americans comprise 25.28% of the total population, Like many Native Americans across the United States, the Cherokee people in Oklahoma predominantly reside in rural areas.

Due to the rural nature of the area, people have distinct feelings of isolation. Various types of services are not always provided to rural community members on a regular basis or individuals are not aware of the services that are available. In addition to the isolation there has been a diminishing of community strength and cohesiveness that existed in traditional communities of the past.

Native Americans are poorly prepared to address the problems they are experiencing. Of Native Americans who are 25 years of age and older, 24% in Adair County, 17% I Cherokee County and 23% in Delaware County have less than a 12th grade education.

In Adair, Cherokee and Delaware Counties the unemployment rates for Native Americans are in excess of 11.2%, which adds to the problem of isolation. While unemployment rates are relatively high, the percentage of Native Americans below poverty level is even more striking. In Adair, Cherokee, and Delaware Counties, the percentage of Native Americans living below the poverty level are 32.7%, 36.2% and 28.5% respectively. Particularly distressing is the fact that in those three counties, between 27.4% and 39.3% of the Native Americans below poverty level are five to 17 years of age. Single female head of household is the norm for one third of the Native American families in Oklahoma (U.S. Census, 1990).
Oklahoma statistics show that 37% of Native Americans are between the ages of 0-17 in contrast to only 25% of the White population. Since the young comprise over one third of Oklahoma’s Native American population it is especially important to address with them the problem of substance abuse.

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Strategy 1: Public Awareness Campaign

During the grant period three videos were produced utilizing community members as scriptwriters and actors. The two videos titled "Bell Community Pride” and “Native Cry for Native Pride” focus on substance abuse in Native communities and healthy alternatives to substance abuse. The third video entitled “Summer Youth Fitness Camp” was the last video produced which promotes healthy lifestyle through team building, fitness, nutrition and cultural awareness. In the first two videos, the film production unit of University of Oklahoma was used to direct the making of the videos. The community devised a draft script and the production unit helped organize and shoot the footage. This proved to serve as an option for more community members to become involved as some assisted with the production and filming. Several of the students were also exposed to potential career options in the area of film production. We learned the production of the video was a valuable as the end product. These videos were disseminated to communities via schools, churches, and our rural Health Centers. The videos have also served as models for other communities interested in producing their own videos and the videos our project has yet to produce. Community reactions were positive, as many people were interested and excited to see familiar Native people in the videos.

In 1996 a community member developed the Healthy Nation logo currently in use. The logo incorporates the direction of the program and depicts the phrase “Srong Mind, Strong Body, Strong Heart”. During the past four years five brochures and five posters were developed featuring community members and their families.
A calendar was developed featuring fourth and fifth grade students’ artwork. The students are part of a Healthy Nation program in the school that focuses on healthy alternatives to substance abuse and other dangerous behaviors. Thirteen students’ work was selected for the calendar from a field of over 350 entries.

The materials were an integral component of the success of the project. Once our materials were distributed we began to see an increase in requests for programs in additional areas not already served. We believe this is due in part to utilizing community members as models and utilizing testimonials from such. The materials were also very culturally specific utilizing the Cherokee Syllabary and Cherokee symbolism. The materials served as an excellent tool to describe to other institutions, agencies, and possible funding sources, the work our program has done and continues to do.

A poster and brochure describing the School-Site Wellness and Great Body Shop Curriculum was produced. The brochure and poster utilize community members as models and both contain testimonials from community members involved in our programs. Another poster and brochure featuring the Cherokee Nation Healthy Nation Summer Youth Fitness Camp was developed featuring Cherokee Nation Tribal members.

Healthy Nation bulletin boards are displayed at WW Hastings Indian hospital, AMO Salina Community Health Center, and Redbird Smith Health Center.
Healthy Nation created a series of displays for our program and many were featured at various community functions and conferences.

A television station from Tulsa, OK completed a short segment on the Healthy Nation School Site Wellness with aired during the evening news.

The video “"Native Cry for Native Pride” was aired and featured on the Rogers State College television station and could be viewed by a large percentage of the Cherokee Nation Service Area.

Cherokee Nation Health Services initiated a marketing campaign concerning healthy behaviors. Healthy Nation assisted in coordination of the campaign with a local marketing firm. The firm developed a new logo for Cherokee Nation Health Services and tagline "Families United – Healthy Nation”. The campaign includes billboards throughout the Cherokee Nation Service Area featuring Healthy Nation participants and community members as models for billboards. The billboards also featured a message in both English and Cherokee. Topics include diabetes, no smoking, Fetal Alcohol Syndrome, responsibility, exercise, communication, and drug-free lifestyle. Fourteen billboards were displayed beginning June 1999 throughout the Cherokee Nation Service Area. A brochure describing the Cherokee Nation Health Services was developed utilizing Healthy Nation participants as models.

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Strategy 2:  Community-Wide Prevention

Community groups with the actual “coalition” name exist in two of our areas. Several groups of tribal members who worked together to improve their communities are not formally organized into a coalition. These groups work in much the same manner as the organized coalitions. The groups were organized or facilitated by Healthy Nation and included Adair County Healthy Nation Coalition, Cherokee County Coalition, Wings of AMO Salina, Community Clinic, Maryetta Wings, Jay Wings, Marble City Wings, and Kenwood Wings.

Groups who were not organized by Healthy Nation, but have been enhanced by Healthy Nation facilitation included Greasy Community Group, Gore High School, Flute Springs Dreamcatchers, Stilwell High School, Chewey Community Organization, Tahlequah High School, Proctor Community Organization, Peavine School, Rocky Ford Community Group, Watts School, Bell Community Action, Westville School System, Delaware County Cherokee Coalition, Salina Middle and High School, Cherokee Nation Headstart Parent Committee, Lyon’s Switch Community Group, Watts Indian Heritage Club and Community Group, and Locust Grove Middle and High.

Major accomplishments of the coalitions include:

  • Assistance with the development and implementation of a substance abuse policy for a local school district.
  • Recognized the need for an increased awareness of gangs and crime in our communities and initiated training for the community from the Bureau of Indian Affairs. The training, "Community Policing in Indian Country” was offered in three communities for community members, law enforcement, school administrators and teachers, and local civic leaders. From the training the Sheriff of one of our counties and community members have developed a task force to combat community problems.
  • Adair County Healthy Nation Coalition members served as counselors for our Summer Youth Fitness Camp, North Carolina Youth Exchange, Wings Running and Fitness Camp, Healthy Nation 5K Run and the Bell Pow-wow.
  • Community service projects such as community clean up of gang graffiti, food drive for needy families, and delivery of gift bags to 237 community Elders.
  • Coalition members from an area school drafted and enacted a drug testing policy for students in all extracurricular activities. The group garnered support from local businesses for expenses related to the drug testing and referral. Students who test positive are referred to a counselor from an area substance abuse treatment center HN and the school have conducted events related to the policy and encouraged a dialogue with parents regarding substance abuse.
  • In 1999, Adair County Coalition entered the Stilwell Christmas Parade with a walking entry of Healthy Nation program participants from individuals included Wings members, School-Site Wellness students, Indian Heritage Club members, coalition members and parents. The Coalition won 1s place with over 350 people joining the walk.

Healthy Nation worked with the established Indian Heritage Clubs and helped facilitate formation of more clubs over the past four years. Healthy Nation initiated some clubs and many had been established but were inactive prior to Healthy Nation involvement. Clubs in seventeen schools worked with Healthy Nation to promote the image of drug free Native communities.

The Healthy Nation program received requests from various communities to assist in developing clubs similar to those in the school systems during the grant period. In 1997, Healthy Nation began to offer funds to various groups to assist in developing community groups and completing various projects.

Although a large part of the funding came from other sources within Cherokee Nation, it was all distributed via the Healthy Nation name and via our office. Healthy Nation required community groups and Indian Heritage Clubs put funding and assistance requests in writing. The organization demonstrated how the proposed community project would help meet the Healthy Nation goals and objectives. When the request were received, the Healthy Nation staff reviewed and voted on the amount and type of assistance appropriate.

Community Funding Project

Healthy Nation awards funds to schools and community organizations within the Tribe’s jurisdiction. Awards must focus on the following goals:

  • Improve public awareness of Substance Abuse in local communities.
  • Develop and implement community-wide prevention programs in local communities.
  • Improve early identification and assessment of substance abuse in local communities.
  • Improve substance abuse treatment options and aftercare in local communities.

Healthy Nation funded proposals from community organizations and Indian Heritage Clubs to collaborate on projects. The following proposals were funded during 1997-1998: Peavine Panther Clan, Tahlequah P.S. Native Reflection, Rocky Mountain School, Grove Project Graduation, Bell Indian Heritage Club, Keys Middle School, Sequoyah Parent Association, Cherry Tree Community Services, Norwood School, Greasy Indian Heritage, Watts Indian Heritage Club, Greasy School 8th grade class, Nicut Residential Cooperative, Lost City School, Salina Middle School Indian in Action, and Cookson Hills Foster Grandparent Program.

The following are community-based funding projects the HN staff has reviewed and funded for 1999-2000. The majority of the projects were funded via Cherokee Nation Health Education with a few funded by Healthy Nation: Badger Lee Baptist Youth, Bell 4-H Club, Bell School Indian Heritage Club, Big Cabin Indian Heritage Club, Cherokee Heights Resident Organization, Cherokee Nation Tribal Youth Club, Chewey Community Organization, Cherry Tree Community Youth Services, D-Fy Westville School, Feathers of Many Colors, Gore Project Gore School, Greasy Community Fellowship, Greasy Elementary School, Greasy Park Association, Grove High Project Graduation, Gum Springs Elementary, Jay Public School Special Education, Jay Summer Track Project, Kenwood Public School, Keys School, Locust Grove Middle School, Lowery Volunteer Fire Dept., Lost City School, Marble City School, New Baptist Church Youth, Nicut Residental Corporation, NSU Native American Student Assoc., Peavine Public School Panther Clan, Pumpkin Hollow Community Assoc., Salina Elementary School, Salina Middle School Indians in Action, Skelly Public School, Stilwell High School Indian Heritage Club, Tahlequah High Drug Free Graduation, S.W.A.R.M. Westville School, Tom Buffingtion Height Resident Organization, Webbers Falls Public School Indian Education, Wickliffe Elementary, Tenkiller Adventure Program, Peavine Panther Basketball Camp, Locust Grove Public Schools NASA, and Grandview School.

The School Site Wellness Program targets elementary students at schools within the Tribe’s jurisdictional service area. The School Site wellness program consists of two components, The Great Body Shop Curriculum and the School-Site Walking Program. The Great Body Shop Curriculum is a comprehensive health and substance abuse prevention curriculum for grades K-6. It is designed to promote acceptance of personal responsibility for health enhancing behaviors and reduction of health risks through the use of critical thinking skills. Our staff teaches this curriculum to fourth graders in various schools students each week. At the end of the school year a student-generated health fair is presented for the school, parents and community. Students create their own displays, speeches, brochures, and demonstrations to teach the community what they have learned about healthy choices throughout the year. There is a waiting list for additional schools requesting the program. The School-Site Walking Program consists of a staff member from Healthy Nation who walks or runs with the classes in an effort to emphasize physical fitness as a way of developing a healthy lifestyle.

The number and extent of the programs has grown tremendously over the grant period. More participating schools were added each year, as listed below.

  • 1993-1994 - Stilwell Elementary wellness for 4th graders
  • 1995-1996 – Stilwell Elementary 3rd and 4th grade, Vian Elementary
  • 1995-1996 – Locust Grove, Marble City, Jay, Bell, Stilwell
  • 1996-1997 - Maryetta, Keys, Lost City, Webbers Falls, Gans, Woodall, Kenwood, Peavine, Leach
  • 1997-1998 - Cave Springs, Gum Springs, Norwood, Grandview, Spavinaw, Osage, Wickliffe
  • 1998-1999 - Continues in all school excepts Leach
  • 1999-2000 - Warner, Central, Belfonte

The Wings Running Club is an ongoing self-paced fitness program set up for people of all ages and all fitness levels. Weekly practice sessions are offered at many communities within the Cherokee Nation, and open to the entire public. Both running and walking accumulates miles which each member can earn incentive fitness gear when reaching set milestones. Optional monthly road races and fun-walks are made available for all Wings members to participate. Currently, there are 5 Wings clubs located throughout Cherokee Nation over 500 members. Wings Running Club was first established in April 1996 at Maryetta Elementary School and has been in the following communities: Jay Wings, Redbird Smith Health Center, Stilwell Wings, Salina, Cherokee Nation Employee Wings, Rocky Mtn. Wings, Marble City Wings, Woodall Wings, Kenwood Wings, Bell Wings, and Pryor Wings.

We are impacting entire families from grandparents to toddlers, persons with diabetes, people with cardiovascular diseases and serious runners who compete in road races. Some of our annual events are as Red Cross Relief Run 5K, Jingle Bell 5K Run, Run Long/Run Short 5K/ 20K, Keys Health Fair K – 5th grade, Health Fair at Warner School, Big Cabin Community Youth Benefit, Cherokee Holiday Run, Hospice Run, Cherokee Nation Housing Authority Employee Health Fair, Full Moon Classic Run, Strawberry Festival Run, Azalea Festival 5K Run, Indian Symposium 10K Run, Cultural Day at Central Public H.S., Huckleberry 5K Run, and the Cherokee Nation Employee Health Fair.

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Strategy 3: Early Identification, 
Intervention and Referral

In an effort to implement a tribal-wide early identification and assessment system into the current Cherokee Nation system, Healthy Nation staff received training in early identification and assessment of substance abuse in community settings by attending the Substance Abuse Prevention Conference in Tulsa as well as the National Association of Native American Children of Alcoholics in Tulsa. They also developed a resource directory for use within the Cherokee Nation programs. The directory will be on the Cherokee Nation Web page and hard copy distributed to each Cherokee Nation program. The directory is cross-referenced for easy access of information.

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Strategy 4:  Substance Abuse Treatment 
and Relapse Prevention

Healthy Nation has coordinated a systematic approach to assessment and treatment of tobacco abuse by implementing a Smoking Cessation Tobacco Abuse Prevention Program. The purpose of the program is to reduce death and disability among Native Americans caused by tobacco abuse. The program provides assistance to those who wish to cease cigarette and smokeless tobacco use with a behavior modification program and supplemented by nicotine replacement therapy. This program has been in existence since 1992 and over 700 people have participated with a 30% recovery rate. Anyone over age 18 who is eligible for services at Cherokee Nation rural health centers or Indian Health Service facilities may participate. All participants must actively participate in an eight-week behavior modification course. These sessions were provided through the Muskogee Clinic, the WW Hastings Prenatal Smoking Cessation Education, the WW Hastings Smoking Cessation Program, and the Wilma P. Mankiller Clinic.

During the summer of 1998 twenty students with ten adults from Cherokee Nation/Healthy Nation traveled to North Carolina to visit the Healthy Cherokee in a cultural youth exchange. Everyone enjoyed the beauty of the land and the interesting historical sites. Our group felt a special kinship and a strong sense of returning to their roots. As we traveled throughout North Carolina there was two special moments that stand out. The first was when we traveled to the original spot where the Cherokee's came from. It was a mound and the story goes that 30 chiefs' are buried there. We circled the mound and many in our group took off their shoes and touched the ground with their bare feet, the ground of their ancestors. It was a very moving experience. The second extraordinary moment came when we traveled to the Snowbird Community. The community treated us with an Indian Taco dinner and we felt like they were welcoming us home. We were asked to bring soil from Oklahoma to participate in a mound building ceremony. No one knew what this ceremony was until we arrived. It is a ceremony that has been lost and that they were trying to bring back. A head singer prayed and sang as each of us threw dirt on the mound. We went around the mound seven times and it was interesting - red Oklahoma dirt mixed with North Carolina dirt. We were brought together in that moment, in the dirt within the circle. Two people, Eastern Cherokee and Oklahoma Cherokee ...yet...we are one people. It was a very solemn and moving experience, one that we are grateful for and one that we will never forget.

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Cherokee Nation of Oklahoma
Healthy Nations Program

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Colorado School of Public Health

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