Alliance for Healthy Hearts & Minds (CVCD) (2014-2015)
The CVCD Alliance aimed to determine the causes of heart disease, stroke, cancer, and other chronic diseases and their risk factors, and also factors influencing overall health and disease among Canadians. Approximately 10,000 participants from across Canada will be invited to participate in this program to: 1) understand the role of socio-environmental and contextual factors on CV risk factors, subclinical disease, and clinical CV events at the individual and population levels. This will include investigating the impact of contextual factors on geographic variation in CVD, and their relative impact compared to individual level factors; 2) characterize the unique patterns of contextual factors (as defined above) as well as acculturation, cultural continuity, and migration experience as related to individual CV risk factors, health service utilization, and clinical outcomes among high risk ethnic groups including South Asians, Chinese, African origin, and reserve-based Aboriginal people from across Canada; and 3) identify early subclinical dysfunction in the brain, vessels and the heart using magnetic resonance imaging, and to investigate the associations with contextual and individual determinants of this dysfunction, as well as to assess the predictive value of novel markers of subclinical dysfunction on the development of clinical CV events.
The First Nations Diabetes Surveillance System (FNDSS) (Pilot began in 2012)
The First Nations Diabetes Sentinel Surveillance System (FNDSS) was developed as a system to address the health gap around limited surveillance and evaluation of diabetes in Indigenous communities in Canada. FNDSS is a web-based system that encompasses community diabetes registries and surveillance of diabetes clinical measures. The system allows users to view their historic clinical indicators and prevalence, enter data, and review and track progress and plan quality improvement initiatives. Patient-level and community-level reports and graphs display health performance as compared to the Canadian Diabetes Association Clinical Practice Guidelines recommendations. Honouring the Ownership, Control, Access and Possession principles and the CIHR Guidelines for Health Research Involving Aboriginal Peoples, communities were involved in all aspects of the process, controlled and owned their data, and had access to their data at all times.
Healthy Moms, Healthy Babies (HMHB) – Gestational Diabetes Mellitus (2012-2014)
First Nations women are at an increased risk of developing both type 2 diabetes and gestational diabetes (diabetes during pregnancy), with rates reported to range from 8-18% and on the rise (higher than the general population). Healthy Moms, Healthy Babies was a program developed to help First Nations women manage the effects of gestational diabetes or type 2 diabetes during pregnancy including a Lifestyle Program with regular physical activity and diabetes education sessions. This study assessed the impact of the Community Lifestyle Program on blood sugar levels and weight gain during pregnancy. Also, a comparison of blood sugar levels, delivery experience and baby’s health was done between women who wore a continuous glucose monitor and women who used a standard finger-prick glucose meter.
The Canadian First Nations Diabetes Clinical Management Epidemiologic Study (CIRCLE) (2007-2010)
CIRCLE was a 3-year national research study that partnered with 19 First Nations communities across Canada to document the current state of clinical management of type 2 diabetes and rates of diabetes-related complications and comorbidities in First Nation communities. The CIRCLE study demonstrated that major care gaps exist in the management and treatment of patients with diabetes in First Nations communities. Study results have been presented to First Nation communities and their leaders, and Health Canada policy makers. Four manuscripts have been published; four additional manuscripts are currently in process.
Sandy Lake Health and Diabetes Project (1991-2013)
A multifaceted diabetes prevention program implemented over the past 20 years in the remote fly-in First Nation community of Sandy Lake in northern Ontario. The intervention involved: a school-based diabetes curriculum for children in grades 3 and 4; community activities aimed at increasing awareness and prevention of diabetes including a radio show, walking clubs, grocery store activities, and home visits; and research activities and programs aimed at increasing the understanding of diabetes in the community. The program was developed and monitored through a collaborative partnership between the community and academic researchers. Goals of the Sandy Lake Health and Diabetes Project were to determine the prevalence of diabetes in Sandy Lake, to describe biological and lifestyle factors associated with diabetes, to develop culturally appropriate intervention strategies based on ethnographic data and to provide a model intervention strategy that can be replicated in other First Nations communities. The Sandy Lake Health and Diabetes Project continues to exist in Sandy Lake with the community taking complete ownership of the program and its activities.
