Among First Nations in Canada, diabetes prevalence peaks at age 55-64; rates almost four-fold higher than the general population (36.4% versus 9.9%) 1. Representing more than half of Indigenous peoples in Canada, urban (off-reserve) Indigenous people face disproportionately poorer diabetes-related outcomes secondary to access barriers, racism, structural violence, lack of culturally safe care 2-4. Geographic/jurisdictional challenges 5 limit diabetes services such as telediabetes.
Telehealth is welcomed and cost-effective in those > 40 years old 6 but outcomes for Indigenous older adults (Elders) 7-9 are lacking due to their minimal access to collaboratively developed culturally safe telediabetes programs; thus highlighting community-driven needs 10.
Our CIHR grant, “Building Indigenous Pathways for Diabetes and Obesity Prevention and Management with Urban and Rural Communities in British Columbia” (IDOH2), partners with six BC Interior urban Friendship (FC) and Métis Centers (MC) (off-reserve). These communities identified the need for e-health/telediabetes and electronic medical record (EMR) access.
This 3-year project will examine, in partnership with IDOH2 Friendship/Metis partners and Advisory Teams, how multidisciplinary telediabetes “one-stop” care impacts access and health outcomes for urban Indigenous older adults and caregivers. Request: $597,302.47
Outcomes: Indigenous physicians and local providers are trained diabetes “experts”, culturally safe multidisciplinary telediabetes clinics are embedded within FC/MC programming; Indigenous older adults, caregiver/families access and benefit from services; an Indigenous telediabetes “expert” training and implementation toolkit is disseminated across Canada and beyond.
Knowledge generated addresses a community-identified need, reduces diabetes-related inequities and significantly increases access to specialist/expert care in urban older Indigenous populations. University-community-health authority collaboration influences urban Indigenous policy/health service development. Indigenous workforce capacity is enhanced by increasing skills/knowledge of Indigenous physicians, local providers, trainees and community members. FC/MCs increase capacity to participate/conduct/guide research, advocate for resources, and sustained program/service funding.