Planning and policy development changes based on a tribal WISEWOMAN program

Background: The Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program provides low-income, under or uninsured 40 to 64 year old women the knowledge, skills, and opportunities to improve diet, physical activity, and other lifestyle behaviors to prevent, delay and control cardiovascular disease and other chronic diseases. Southcentral Foundation (SCF), a regional tribal health organization serving American Indian and Alaska Native (AI/AN) people of the urban center of Anchorage and 55 surrounding rural villages, has utilized the implementation of the WISEWOMAN program to initiate system-wide changes in chronic disease screening for AI/AN people. Methods: Using the implementation of a grant funded CVD screening program for a sub-population of the AI/AN community, the Anchorage Native Primary Care Center modified clinical and community health program planning and policy to ensure CVD screening and lifestyle behavior knowledge, skills and opportunities were available to all women ages 40 years and older. Results: Based on the clinical and community health program planning and policy changes in the CVD screening, the groundwork was developed to expand colorectal cancer screening and public education to AI/AN people across the Alaska Tribal Health System through the development of an innovative state-certified colorectal cancer screening clinic offering flexible sigmiodoscopy conducted by a nurse gastroenterologist. Conclusions: The development and implementation of system-wide planning and policy changes across the Alaska Native Tribal Health System around chronic disease prevention and health promotion has been informed by the implementation of individual categorical public health programs.