Assessing and implementing diabetes patient education programs for American Indian communities.

In many American Indian communities, the rate of diabetes has increased dramatically over the past 20 years. This health problem has become a major challenge for the Indian Health Service (IHS). The Diabetes Education Program of the IHS wanted to use the National Standards to promote the best quality diabetes education programs in all IHS and tribal facilities. However, the review criteria for the National Standards had to be adapted to fit the unique needs of the Indian communities. This paper describes the process used to evaluate and modify the review criteria to implement the National Standards within IHS health care facilities.