NCAW engaged Lawrence Ellis & Associates to create a Navajo-specific advanced-facilitation workshop to train the community facilitators who are at the heart of this program.

Situation Summary

Diabetes is the third leading cause of death for Navajos, and affects nearly one-third of all Navajos. Working with Navajo elders and other community leaders, the Navajo Communities in Action for Wellness program (NCAW) identified comprehensive approaches to diabetes prevention and treatment.

Leading-edge thinking in applied medicine - supported by much empirical research - concludes that community wellness programs do not produce healthier people without broad-based community involvement in the programs from inception to implementation.

With this is mind and with funding from the National Diabetes Prevention Center, NCAW staff designed and implemented a large-scale community wellness program across Navajo Nation. The program is designed to reduce the impact of diabetes among close to 300,000 people on Navajo Nation.

Acknowledging that community ownership and involvement are keys to success, NCAW created a program whose centerpiece is a team of facilitators who work with Navajo communities to help them:

• Examine lifestyle habits associated with an increased risk for diabetes,

• Analyze the forces that hold these habits deeply in place,

• Generate solutions that can help transform these habits,

• Navigate between both traditional Navajo medicine practices and Western medicine practices to deliver services best suited to individuals in their communities.

From the client's perspective

"We needed a consultant who was masterful in facilitation, who could help to manage a significant project aimed at large-scale change, and who could work in a culturally-sensitive way in Navajo communities. Lawrence was a natural choice.

He worked with our team over the course of nearly one year. Initially we expected him to introduce facilitation models, frameworks and practices which we would adapt to Navajo culture. However, he gently yet firmly pushed us to higher levels of collaboration where we were equal partners in arriving at the best approach. This method led to a breakthrough from one of our team members.

Instead of adapting external methodologies to Navajo culture - or even looking for Navajo parallels to key facilitation methods - we decided to distinguish the core competencies of facilitation: for example, mindful communication, collaborative problem-solving, situational decision-making, and conflict management.

We interviewed elders, peacemakers, storytellers and other community leaders to discover how each of these core competencies manifested in both traditional and contemporary Navajo culture. The result was a facilitation course rooted in practices that had served Navajos for millennia, and that was augmented by a few complementary non-Navajo practices.

Lawrence helped us significantly throughout the entire project. He assisted with initial project scoping and design, and with interviews with community leaders. He also worked with us to synthesize our findings into models and practices that could be delivered in a workshop format.

Next, we worked diligently to design the entire workshop curriculum. One of his major contributions at this stage of the project was a rigorously detailed Trainer's Guide highlighting key points for each section of the curriculum, several options for how to deliver those key points, and suggested transitions to next workshop topics.

Then, Lawrence co-led the team in delivering the first workshop to approximately twenty community facilitators, including several elders, hospital administrators, grassroots activists, the chief of police of one of our major towns, and others.

Clearly, the results of a long-term, large-scale community wellness program like this one will not be evident for many, many years. In the short-term, however, we have:

• An advanced facilitation workshop rooted in our historical ways of being;

• Significantly enhanced cultural revitalization and pride in our communities from employing our traditional wisdom practices to help combat a major contemporary crisis;

• Dozens of trained facilitators at work in their communities.

We have already begun conversations with Lawrence about how to enhance this program on Navajo Nation, and about how to apply a similar approach to fight diabetes in other Indian nations. We heartily look forward to our continued partnership in these and other endeavors." — Navajo Communities in Action for Wellness (NCAW) Team: Chris Percy, M.D., NCAW Director; Karen Sandoval Mares, NCAW Training Specialist.

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