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The Diabetes Educator

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Health Promotion Practice
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The "In-Between People": Participation of Community Health Representatives in Diabetes Prevention and Care in American Indian and Alaska Native Communities

Dawn Satterfield, RNC, PhD, CDE

Centers for Disease Control and Prevention, Division of Diabetes Translation

Chris Burd, RN, PhD

University of North Dakota, College of Nursing

Lorraine Valdez, BSN, MPA, CDE

Indian Health Service

Gwen Hosey, MS, ARNP, CDE

Indian Health Service

John Eagle Shield

Community Health Representative (CHR) Program, Standing Rock Sioux Tribe

Respected members of American Indian and Alaska Native communities are a critical resource in helping communities mobilize efforts in diabetes prevention and care. Possessing cultural and historical knowledge and training in health promotion and social support, community health representatives (CHRs) are uniquely equipped to broker the needed relationship between a world shaped by culture and history and the world of conventional scientific knowledge. Grounded in principles of social support and interpersonal communication, as well as an understanding of their community’s strengths and history in health protection, CHRs are bridges distinctively positioned to connect these two worlds. With additional training and mentoring in diabetes care and prevention, CHRs, in their self-described roles as "in-between people," can serve both as caring and knowledgeable community members and valuable members of the health care team.

Health Promotion Practice, Vol. 3, No. 2, 166-175 (2002)
DOI: 10.1177/152483990200300212
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