As part of my graduate work, I worked with two other Dietetic Interns to create a Community Wellness Program for Children in Western NY living with Type 2 Diabetes.

1. Welcome to… CampAiyana Where Fun, Wisdom, and Health Blossom into Eternity! NTR 524 Summer 2009 Created by UB Dietetic Interns: Mandy Chan, Erica Eisenberg, and Angela Gallagher

2. What is Aiyana? A Native American name meaning "blossoming" or "eternal flower”. Our campers will forever blossom and thrive with wisdom, knowledge and health. At Camp Aiyana, the seed of this blossoming will begin. The benefits and wisdom gained by campers during their time spent with us will become a part of their lives as they flower into mature and independent self caring individuals coping with Type 2 Diabetes. The lotus depicted in the middle of our logo represents our campers’ knowledge and health blossoming and the circle surrounding the lotus represents a circle of trust, friendship and eternity. As a whole, this strong yet simple abstract drawing represents our community and Aiyana.

3. Our Mission: “In the United States, an alarming statistic shows that about 186,300 people under the age of 20 years have Type 2 diabetes. The mission of Camp Aiyana is to provide a support group for children ages 8-12 years with Type 2 diabetes. We strive to educate our campers so that they can be independent and proactive in their own care and disease management. Motivating parent and guardian involvement in the care of their child is also our goal- we believe caregivers are key factors that are needed for the optimal care of their children and will continuously inspire them to flourish. We pride ourselves in planting the seed of knowledge and wisdom that is so important for young Diabetics to forever blossom into wise and self-caring individuals- this isAiyana.”

4. Reaching for the stars at Camp Aiyana: Our Goals For our campers to gain basic knowledge and skills related to Type 2 Diabetic care. To establish proper dietary knowledge for the management of Type 2 Diabetes within our campers. To create a better understanding of the pathophysiology behind Type 2 Diabetes. To create a support-group atmosphere to ensure that campers know that they aren’t alone during this process of coping with Diabetes. For our campers to be able to know where to find information and get extra help on diabetic management and care. To provide a motivating and inspiring environment for campers to learn and have fun while doing so!

5. Our Objectives: We will encourage proper eating habits and other dietary skills and knowledge through interactive games, group discussion, and hands-on activities. We will provide education to campers using different approaches such as visual displays, educational games, handouts and brochures, and interesting lectures and presentations. We will provide education to parents and caregivers at the end of the camp session by providing informative handouts. We will provide a support group environment through games, ice breakers, reflections at the end of the day, team activities, honors at the end of the day. We will teach the basic pathophysiology of type 2 diabetes with the use of plays, videos, visuals, discussion, and interactive games.

6. The Target Population Children in the Western New York area who are diagnosed with pre-diabetes or type 2 diabetes between the ages of 8-12 years of age.

7. Camp Aiyana in a Nutshell: Overview of Our Program Camp Aiyana is a Type 2 Diabetes management summer camp. It is held at Camp Kenan, a Lockport YMCA Family Center. While at the camp, the kids will be taught the many important aspects of Diabetes management. One of the highlights of the summer is a special concert by the Jonas Brothers sponsored by the American Diabetes Association. Camp Aiyana employs 25 individuals and ~20 volunteers help each year. Financial assistance, grants, and donations are available for Camp Aiyana to run successfully.

8. Our Wonderful Staff 2 RNs, CDE 1 RD, CDE 2 Camp Cooks 20 Camp Counselors Plus ~20 volunteers

9. Building A Team of ONE In order to help the campers feel more comfortable we have many team building activities and ice breakers during the first couple of days of camp. These activities help to build a sense of comfort and ease any anxiety campers might have so they can fully enjoy their experience and make lifelong friends at Camp!

10. What We Have to Offer: Camp Aiyana offers a wide array of tools and resources to aid in each campers understanding of Diabetes. Through presentations, food demos, group learning activities, videos, discussions and quizzes the children will gain support, awareness, and insight into Type 2 Diabetes.

11. Sample Lesson Title: Identifying food groups & which contain carbohydrates Subject: Students will learn how to group foods based on their nutrition content (focusing on which contain carbs). Grade Level: 4-6th (8 – 10 years old) Time Duration: 30 Minutes Goal: To learn how to identify food groups based on nutrient content. Objectives: 1. Students will learn which about food groups containing carbohyrates vs. food groups without carbohydrates 2. Students will learn about calories and those foods that increase their risk for obesity 3. Students will learn about how food and physical activity affect their insulin

12. Sample Lesson Continued 1. Begin by going over foods groups with carbohydrates – ask them to name foods they eat containing carbs then talk about foods without carbohydrates and generate a list 2. Explain foods that have a direct effect on blood glucose and those that don’t; The Vegetables group, Meat & Meat Alternate group and the Fats & Oils group. (slide 10). 3. Discuss fats and encourage them to avoid eating too much fat because it is a very concentrated source of calories. Discuss the fact that fats have been shown to increase one’s risk for heart disease, one of the complications of diabetes. Take any questions they might have as this is important. 4. Talk about calories: carbohydrate, protein and fat and how they provide the energy (fuel) our body needs to function (the calorie) (slide11). Tell them that each person’s needs for energy depends on a number of factors, including their size, age, sex and activity level. 5. Explain why most people with type 2 Diabetes will benefit from modest weight loss (for example, 10 pounds), because having less body fat helps insulin work better. (slide 12) 6. Explain why most people with type 2 diabetes also benefit from regular moderate physical activity (as it lowers blood sugar AND helps insulin work better). (slide 13) (Lastly, ask how many participants engage in regular physical activity (sports, walking the your dog, etc) and have them share. If you plan to include additional physical activity programming, now is when you can mention when you will be addressing it.)

13. Sample Lesson Continued Activity:Place typical eaten foods into food groups 1. As a group, stack together the food pictures or cards into one of the seven food groups just mentioned: Grains, Beans, Starchy Vegetables; Fruits;Milk/Yogurt; Meat & Meat Alternates; Vegetables; Fats & Oils and Sweets (Other Carbohydrates). (slide 14) 2. Discuss decisions with leaders as they walk around to each group. 3. The leader will ask each group to talk about foods they have placed in each group and compare. 4. Leader will draw an imaginary line down the middle of the table. (slide 15) Leader will then move the food groups/foods that DO contain carbohydrate over to one side of the line and MOVE the food groups/foods that DO NOT contain carbohydrate over to the other side of the line. 5. Lastly, discuss how each group did and take any questions!

14. Sample Video Here’s a sample video used to teach the campers about the pathophysiology of Type 2 Diabetes: We are going to watch sections 1 and 5 which explain what diabetes is and how insulin works in someone with Type 2 Diabetes: http://tracker.diabetes.org/all-about-diabetes.php

15. Helping the Campers Reflect At Aiyana we condone respect and support for all campers. That is why, at the end of each day we find it essential for campers to reflect on their experiences with one another. An hour before bed, campers and their counselors gather around in a circle anywhere they choose to on camp grounds. Each group has a “talking stick that is passed around by one counselor who asks the “question of the night”. One by one, each camper can share their thoughts and feelings about the day with one another.

16. Introducing Our Very Special Guests this Summer:

18. 20% protein

19. 20% fat

20. The campers will receive:

21. 3 servings of dairy

22. 3 servings of vegetables

23. 3-4 servings of fruit

24. 9-12 starch servings

25. 4-7 servings of protein

26. 2 fat servings* For a detailed NutritionistPro breakdown of our menus, please refer to our program manual.

28. Translational Research for the Prevention and Control of Diabetes and Obesity

29. Agency Name: National Institutes of Health

30. Objectives: To test innovative adaptations of evidence based approaches to prevent and treat diabetes and obesity.

31. Donations:

32. WNY Food Bank

33. Supplies all the food needed for the campers and the employees/volunteers

34. Wegmans

36. Behind the Scenes: Funding and Budgeting, continued… Budget: YMCA camping facility: $65,000 Donations: Wegman’s: $332.21 WNY Food Bank: $9,708.00 Grants: Translational Research for the Prevention and Control of Diabetes and Obesity: $50,000 Volunteers: 20 Volunteers (Free labor) Total incoming: $125,040.21 Net gain: $17,950.21

37. Camp T-Shirt Design

38. Advertising Materials used Detailed Brochure Camp Aiyana Program Flier

39. Advertising, continued… Camp Aiyana Large Poster Camp Aiyana Large Glossy Poster

40. Why We Need Camp Aiyana: A total of 23.6 million people have diabetes in the United States. 17.9 million People of these individuals have been diagnosed and 5.7 million people are estimated to be undiagnosed. Among the group of people under 20 years of age, about 186,300 people less than 20 years of age have diabetes and the number of cases within this group continue to rise (www.dlife.com) Camp Aiyana recognizes the severity of this public health issue and aims to bring juvenile diabetes awareness to the greater population. Having diabetes and injecting insulin can have a negative effect on self-image and self-esteem, which are fragile enough during this time (www.lifeclinic.com) The establishment of proper and important skills in diabetic management at a young age is most ideal as well as critical. Campers will be placed into a welcoming environment surrounded by other young individuals who are feeling the same emotions, fears, and curiosities. Thus, an ideal support group will be created to ease anxiety in these children.

41. Evaluation Tool Campers will complete these on the last day

42. References Used in the Creation of Camp Aiyana: www.nutritionexplorations.org/educators/lessons/chef-combo/chef-act-applefundo.asp (recipes/lessons) kidshealth.org/classroom/3to5/personal/nutrition/breakfast_handout1.pdf (lesson) aces.nmsu.edu/pubs/_circulars/CR-631E.pdf (lesson) www.diabetesmellitus-information.com/diabetes_food_pyramid.htm (diabetic food pyramid) www.indeed.com (employee budget) www.diabetesstore.com (DM supplies) http://www.cnpp.usda.gov/Publications/FoodPlans/2008/CostofFoodJun08.pdf (Food Cost For Budget) www.group-games.com/team-building/stranded-on-a-desert-island.html (team building game) www.group-games.com/team-building/commonalities-and-uniquities.html (team building game) www.group-games.com/action-games/mother-may-i.html (games) www.group-games.com/action-games/wall-ball.html (games) wilderdom.com/games/descriptions/Minefield.html (games) www.group-games.com/action-games/capture-the-flag.html (fitness games) www.worknotes.com/IL/Chicago/Fit4FunKidsFitness/printNewsFlash4.stm (risk factors of diabetes, food pyramid, healthy lifestyle games) www.jumpbunch.com/kidsquiettime.html (games)

43. References Used in the Creation of Camp Aiyana: www.jumpbunch.com (games) www.cocokids.org (games) www.group-games.com (games) www.kidshealth.org (strawberry cheese tart recipe) www.bigmamasrecipe.com (orange jubilee recipe) http://www.dlife.com/dLife/do/ShowContent/type2_information/preventing_complications/diabetes_foot_facts.html (facts about diabetes) http://www.lifeclinic.com/focus/diabetes/teens_challenge.asp (challenges of diabetes) http://www.challengeofdiabetes.com/juvenile_diabetes/articles/motivating_children_to_exercise.html ( exercise and diabetes) http://main.diabetes.org/site/PageServer?JServSessionIdr001=cdz9m6c671.app10a&pagename=kdg_homepage (kiss diabetes goodbye and ADA) www.people.com/people/archive/article/0,,20060022,00.html (Nick Jonas info) www.diabetesresearch.org (Diabetes Research Institute) http://www.allbusiness.com/marketing/advertising/3983-1.html (Tips for effective advertising) http://babynamesworld.parentsconnect.com/meaning_of_Aiyana.html?cid=YSSP (Definition of “Aiyana”) http://www.dlife.com/dLife/do/ShowContent/type2_information/preventing_complications/diabetes_foot_facts.html (facts and statistics for diabetic population in the US) http://www.lifeclinic.com/focus/diabetes/teens_challenge.asp (The impact of diabetes on adolescents) http://www.challengeofdiabetes.com/juvenile_diabetes/articles/motivating_children_to_exercise.html (The impact of diabetes on children and adolescents and how to motivate children to be active in their own management of their own health)

44. Thank You Everyone!