Comparison of Physical Activity, Healthy Eating Habits, and Knowledge of Diabetes and Pre-diabetes in Rural Reservation and Off-reservation Communities.

INTRODUCTION: Residents in two small rural communities on the Northern Great Plains completed surveys to determine their community's needs for physical activity, healthy eating habits, and knowledge of diabetes/pre-diabetes. METHODS: One rural American Indian reservation (Community A) and one off-reservation (Community B) were selected for the study. Both communities had similar population size, medical clinic, pharmacy, grocery store and fitness center. Surveys were collected in-person during local community events. RESULTS: More respondents in Community A (41 percent) compared to Community B (18 percent) used the Fitness Center and had more vigorous physical activity (44 percent vs. 5 percent respectively). Compared to Community A, Community B respondents bought more fruits and vegetables (85 percent vs. 96 percent respectively). While a higher rate of diabetes (15.1 percent) in the American Indian population has been reported, this study did not find a significant difference when comparing these two rural communities. Fewer respondents with diabetes in Community A (25 percent), compared to Community B (85 percent) had attended diabetes education. More respondents in Community A (31 percent) than B (13 percent) had pre-diabetes. CONCLUSIONS: Community A's fitness center had personal trainers that provided education, motivation and encouraged individuals to exercise. The majority of respondents in Communities A (85 percent) and B (96 percent) purchased fruits and vegetables. Fruits and vegetables were readily available in the local grocery stores for both small rural communities. More individuals with diabetes (83 percent) in Community B had attended diabetes education classes. More Community A respondents had pre-diabetes; however, diabetes prevention education could reduce their risk of developing type 2 diabetes by 58 percent.

Endometriosis and Infertility.

Endometriosis is a disease that affects a significant portion of reproductive age women. It can cause chronic pelvic pain and has been associated with subfertility. Treatment options differ depending on a patient's reproductive goals; women who do not desire pregnancy are treated with hormonal medications including combined oral contraceptives, progestin only pills or intrauterine devices, gonadotropin releasing hormone agonists and antagonists, and danocrine. The treatment options for women desiring pregnancy are more limited and most often include surgery to improve pain symptoms and increase the chances of conception. However, the chance of a successful pregnancy does not increase with each concurrent endometriosis surgery, and in fact may merely delay fertility treatment using assisted reproductive technology.