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Health Promotion International Advance Access published online on January 11, 2006
Health Promotion International, doi:10.1093/heapro/dak003
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© The Author (2006). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Article

Development of an integrated diabetes prevention program with First Nations in Canada

L. S. HO 1 *, J. GITTELSOHN 1, S. B. HARRIS 2, and E. FORD 2

1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
2 Centre for Studies in Family Medicine, University of Western Ontario, London, Ontario, Canada

* To whom correspondence should be addressed.
L. S. HO, E-mail: lho{at}jhsph.edu


  Abstract

SUMMARY Type 2 diabetes mellitus is a major cause of morbidity and mortality among First Nations in Canada. We used multiple research methods to develop an integrated multi-institutional diabetes prevention program based on the successful Sandy Lake Health and Diabetes Project and Apache Healthy Stores programs. In-depth interviews, a structured survey, demonstration and feedback sessions, group activities, and meetings with key stakeholders were used to generate knowledge about the needs and resources for each community, and to obtain feedback on SLHDP interventions. First Nations communities were eager to address the increasing epidemic of diabetes. Educating children through a school prevention program was the most popular proposed intervention. Remote communities had poorer access to healthy foods and more on-reserve media and services than the smaller semi-remote reserves. While the reserves shared similar risk factors for diabetes, variations in health beliefs and attitudes and environmental conditions required tailoring of programs to each reserve. In addition, it was necessary to balance community input with proven health promotion strategies. This study demonstrates the importance of formative research in developing integrated health promotion programs for multiple communities based on previously evaluated studies.

Keywords: diabetes; formative research; Native American.
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