Diabetes affects Aboriginal peoples in greater numbers compared with mainstream and multicultural Canadian populations. The Transforming Diabetes in Urban Aboriginal Toronto Project funded by the Canadian Institutes of Health Research, and led by Heather Howard at the Centre for Aboriginal Initiatives at the University of Toronto conducted interviews with 26 Aboriginal and non-Aboriginal health and service providers, as well as interviews with 19 Aboriginal persons living with diabetes, and focus groups with 16 Aboriginal seniors and 11 youth, not all of whom have diabetes. The study’s main finding was a need for greater communication between service providers and the community about available resources, and the University of Toronto team is working in collaboration with the Aboriginal community to construct a website interface that can be used by the Aboriginal community and all service providers to address this need.
Youth participating in the project were actively involved in the website project to disseminate perspectives that were gathered during initial research, and to make their own videos about their perspectives on diabetes. Aboriginal and non-Aboriginal health and social service providers are currently assessing the website tool and strategies to incorporate results of the research into practices that support the development of more efficient and better quality services aimed at the prevention and management of diabetes within the Aboriginal community.
Aboriginal health and social service providers identified key challenges including communication and awareness, service and resource needs, and approaches and understanding. Service providers identified that there is a need to raise more awareness as broadly as possible within the Aboriginal community about their services, that there is a need to diminish preconceived ideas potential Aboriginal clients may have about the programs offered within the community (sometimes based on a negative experience in the past with other programs or service providers) and that work is being done but more could be done to connect with family care and other mainstream healthcare providers to mitigate against negative experiences in mainstream healthcare.
Aboriginal health and social service providers also noted that more opportunities are needed for mainstream healthcare providers and allied professionals like social workers to learn about the needs of the Aboriginal community, that there is a need to be able to advise Aboriginal clients about how to best choose the services that are the best fit for them because there are many choices in the large urban area.
Non-Aboriginal health and social service providers’ note similar areas of concern but express that more resources and information is needed about culturally conscious lifestyle choices (of Aboriginal and other ethnic groups) because many Non-Aboriginal service providers don’t know who Aboriginal people are and if they even serve Aboriginal clients (most believed they did not serve any). These health and service providers are curious to know where Aboriginal people are served, and also noted a need to address lack of trust, and issues around potential discrimination in access to services that some Aboriginal people may face in accessing healthcare.
Key concerns for non-Aboriginal service providers also include patient/client oriented concerns (generally individual-oriented) which means getting people to self-manage; providing tools for self-management, getting people to follow what they are teaching-but recognizing that economics make it impossible, the need to be able to offer one-on-one appointments with clients (perhaps can direct them to other services where there is available) and follow up with clients.
Other concerns include funding which is needed to sustain programs tailored for specific issues, for ex, marginalized women, men dealing with trauma etc and the challenges due to the escalation in diabetes diagnosis and the ability to address the volume of people who need diabetes services.
The feedback from the research is not all negative. Some organizations are doing great things, including partnerships and could model for others. The Transforming Diabetes in Urban Aboriginal Toronto Project is unique in that it brings various perspectives on what diabetes is by offering views from both Aboriginal and non-Aboriginal service providers, but most importantly from individuals who live with diabetes themselves.
The Project will be launching a website which will facilitate communication between service providers and provide information about programs. To see more please visit http://www.transformingdiabetes.ca.