Indigenous Health Community Health Workers Supporting Diabetes in Remote First Nations
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By the North West Local Health Integration Network - October 28, 2017
Managing diabetes can be a challenge for patients living with the modern comforts we all too often take for granted. For people living with Type 2 diabetes in four Northern First Nations, the Sioux Lookout First Nations Health Authority (SLFNHA) is testing an innovative approach to provide these individuals with support.
A pilot project being operated by SLFNHA is aimed at creating a smoother and seamless ‘circle of care’ for adults with Type 2 diabetes, by training and mentoring Community Health Workers (CHWs) to bridge some of the gaps that exist in the system. The aim is to improve community-based case management of Type 2 Diabetes. CHWs are frontline workers who have been trained to deliver basic care in their communities. For this project, SLFNHA worked with Community Health Representatives and Aboriginal Diabetes Initiative workers. This innovative model was informed through global best practices.
Kelly Henderson, the pilot project’s coordinator has seen positive changes in the four First Nations (FN) communities that are part of the pilot: Kasabonika Lake FN, Kingfisher Lake FN, New Slate Falls FN and Kitchenuhmaykoosib Inninuwug (Big Trout Lake FN), with 10 CHWs involved in total. In February 2016, CHWs were given customized training in Treatment Plan Support as the first step of improving community-based care.
“This project is about rebuilding community capacity for self-management. The will is there, CHWs just need the support for programs like this,” says Henderson.
The role of the CHWs is to assist people with Type 2 diabetes stick to their treatment plans, to check in with them and make sure they are keeping appointments, or just to help facilitate appointments with doctors and nurses. CHWs are also trained to do clerical work, such as retrieving patients’ test results which enables nurses and doctors to spend more time treating patients.
“CHWs are from the communities. They speak the language, they understand the local customs and culture,” explains Henderson. “Because of cultural differences, people may not feel comfortable giving feedback directly to clinicians. Our CHWs can help facilitate communication.”
Given the CHWs’ roots in the community, turnover is less of a problem, which isn’t always the case with nurses, whose turnover rates can add strain to the system. “This project is about moving away from the patient-blaming model, to the patient-support model,” continues Henderson. “CHWs are there to support patients to manage their diabetes, and to promote mutual understanding, to remove some of the cultural barriers that patients and clinicians encounter.”
The CHW pilot program aligns with the North West LHIN’s Regional Diabetes Plan, and the LHIN is represented on the program’s steering committee.