Health Transition Fund Project NA012: Diabetes Community/Home Support Services for First Nations and Inuit

Promotion and Prevention

Definition

"Activities that target the entire population, to increase awareness of diabetes and its complications, promote healthy eating and active living, and encourage the integration of traditional methods and practices with western-based approaches. Diabetes revention and health promotion activities that focus on the need to educate youth will decrease the likelihood of the next generation suffering from diabetes."
(Aboriginal Diabetes Initiative First Nations On-Reserve and Inuit Program Framework)

Needs Assessment

While the awareness of diabetes as a serious community health issue varied considerably among the pilot communities, all community needs assessments mentioned the need for activities directed at the prevention of diabetes. In articular, the communities mentioned issues related to:

• access to healthy and affordable food choices; and
• opportunities to increase physical activity for everyone.

"...we want to meet with them before they are diabetic, those who are glucose intolerant, so we are now ready with this type of client also... We try to look for ways to get their interest rather than wait until they are sick. We want to involve them (people who are glucose intolerant or predisposed to diabetes) now, to work with them and their families."
Project Coordinator - Wendake First Nation

Activities and Services

Health promotion and prevention were not the major focus of this Project. All of the communities recognized the need to involve both leadership and membership in the assessment of needs and the planning of services in this area. Indeed, involvement in the assessment and planning processes often served to heighten awareness of the need for improved care, treatment and prevention. The need for more health promotion and prevention initiatives was more strongly identified in the evaluation than in the needs assessment.

All of the communities implemented specific activities to increase awareness about diabetes in the community. Examples of these activities included:

• displays in public locations that were changed on a regular basis (health centre, schools, store);
• regular newsletters;
• activities on Treaty Days;
• information and activities in the schools - talks on diabetes and prevention;
• involvement of family members in discussions about diabetes prevention for others in the family of the person already diagnosed; and
• screening clinics.

"The whole team has come to recognize and respect the time it takes to know clients, allow them their time (not pushing) and yet be supportive of their diabetes management."
Home Care Nurse - Sliammon First Nation

Impact of Promotion and Prevention

In the community evaluations, there were several examples of health promotion and prevention being impacted by the Project. This had a spin-off effect as health staff began to expand their efforts beyond those already diagnosed with diabetes.

• In one community, there was a demand for healthier food choices at community meetings. For example, at one meeting with donuts and snacks, organizers were asked about provision of healthier choices such as fruit.
• There is more interest in schools and some school programs have either started or expanded education about diabetes and prevention.
• Diabetes is no longer a taboo topic and is being talked about openly in the communities.
• Family members are seeking information, coming in for screening and asking about lifestyle changes for themselves.
• In one community, the health staff have been able to work with the local store and have used Canada's Food Guide as an education tool.
• Health staff are now planning extended prevention activities to focus on persons who have been identified as at risk of developing diabetes.

"Learning about the Stages of Change was very enlightening for me to learn about how to approach people and help them to identify their own goals. The hardest part for me was to hold back and give only the knowledge that they are requesting."
Home Care Nurse - Red Earth First Nation