Table 1 Nourish manual—health and well-being modules

Initial 12 weeks

1

Welcome and elder teachings

This week will welcome participants to the program, get them started with their pedometer, and establish expectations. The Elder will start their group off in a good way, with a spiritual foundation

2

Getting Active!—keeping fun, variety and safety in mind

This week will introduce participants to how to become more active. Getting active is encouraged in many forms such as walking, biking, and sedentary breaks such as setting a timer to get up every hour

3

Understanding your natural healthy self

This week is focused on ‘health intentions’ rather than ‘weight goals’. Health intentions are framed to help participants direct to an action, a direction or a focus that contributes to their health in a positive way such as stretching more often, walking more regularly, or exploring cooking

4

Holistic approach to health—reflection

Makoyoh’sokoi takes a holistic approach to health. This week utilizes the Medicine Wheel to look at the domains of emotional, spiritual, mental and physical health

5

Honoring culture and traditions

This week is about exploring culture and traditions. Facilitators will lead an exploration of local food traditions, discuss why they exist, and if there a spiritual or cultural reason for them

6

Positive eating attitudes

Our ability to regulate food sometimes gets disrupted. Not knowing if there is enough food or when the next meal is, dieting, life stress, and sickness can all mess up food regulation. This week introduces elements of how to build an eating routine that supports healthy eating in the weeks to come

7

Take time to eat

Taking time to eat is very important. And this does not simply refer to the act of eating but it also refers to the planning and preparing. This week focuses on two principles: (1) making time for eating (including planning and prep) and (2) listening to your body and nourishing it when it is needed

8

Putting together a meal

This week focuses on putting together a balanced meal. We do not recommend a specific diet for participants. The principle is to identify some dietary habits that are less healthy and try to move away from these. Also, we aim to identify some key dietary habits that the participant may not be doing now and need to try to incorporate

9

Fiber and grains

This week we will focus on carbohydrates in food. First some general comments and then some more specific information about grains and fiber, breads, and cereals. We also introduce the importance of fiber

10

Vegetables and fruits

This week we introduce vegetables and fruits and touch on traditional fruits. We discuss supplying our bodies with important vitamins, minerals, fiber, energy and an abundance of other phyto (plant) chemicals. We talk about options of obtaining these foods (grow them, buy them fresh, canned or frozen) and how with present day methods of processing they remain full of nutrients in all these forms

11

Protein foods

This week discusses how the body needs protein foods to build and maintain muscle, heal tissue, and for a healthy immune system. Some illnesses and treatments can affect your appetite that may lead to eating less and not meeting your protein needs. Legumes, nuts and seeds, traditional meats and seafood are touched on

12

Beverages and the 1⁄2 way celebration!

During this week participants examine the beverages they consume. Sources of hidden calories and sugar such as juice, specialty coffee, and liquor are discussed. Participants also look back at a previous exercise ‘My Food Journal’ and see if their liquid consumption has it changed

Follow-up 6 weeks

13

Food skills—menu planning

This week discusses the importance of menu planning. We touch on benefits of planning ahead of time such as allowing others in your home to get engaged in the process, helping to organize shopping, and to reducing waste. A meal plan guide that includes at least 3 breakfasts, lunches, and dinners is included

14

Food skills—grocery shopping and the influence of medications on health

This week gives some tips when going shopping (e.g., don’t shop when you are hungry or in a hurry and go around the outside of the shopping store, this is usually where the fresh vegetables and fruits are, where dairy products and meats are, and you are avoiding a lot of the processed foods on the inside aisles. A health care provider also gives a talk on the importance of medications and how some medications may cause side effects (e.g., weight gain)

15

Relationship with our body and weight

This week starts by looking back at several reflective exercises, looks at all the elements that may influence health and ability to eat well or be active, and at previous attempts at improving health. Using reflective exercises to monitor all four quadrants of your health, health is discussed as more than just weight

16

Self-care for our body

This week provides examples on how to take care of your body that is outside of the program including—physical activity, managing pain, taking time for the things we love that bring us joy, taking time for ourselves, dressing to feel good and for comfort, eating well, and sleeping well

17

When life takes us away from eating well and special social, cultural or mental health guest

During this week we talk about how stressors, transitions and changes in life can cause us to fall out of a healthy routine or change it and how we can reset our health intentions when this happens. We also recommend that this week include a special guest to discuss the mental, emotional, or spiritual sides of holistic health

18

Final day celebration!

The final day is crafted and modified for each community. This day utilizes what the facilitators learned about the participants throughout the previous 18 weeks and ends in a Medicine Wheel Reflective Exercise