The cultural relevance of diabetes supportive care for Aboriginal peoples offered through Ontario Diabetes Education Centres
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BACKGROUND: Type 2 diabetes disproportionately affects Aboriginal peoples in Canada. Supportive care, comprised of services, resources or support designed to improve the quality of life for persons with diabetes is an important part of the diabetes management system. Diabetes Education Centres (DECs) provide support and education to patients diagnosed with diabetes. There is currently no comprehensive description of diabetes supportive care programs available to Aboriginal populations through DECs, nor is there information about the cultural relevance of such programs. PURPOSE: To document and describe the nature, scope, variation and cultural content in diabetes supportive care services and resources available to Aboriginal persons through Diabetes Education Centres (DECs) in Ontario. Findings from this project will be used to develop recommendations for government agencies that fund DECs and DEC program managers and employees. METHODS: Diabetes care providers (n=56) identified as serving Aboriginal clients were systematically surveyed by telephone in order to document and describe the nature and variation of diabetes supportive care services available to Aboriginal persons with diabetes. Quantitative and qualitative questionnaire items were used to examine strategies used to enhance cultural relevance of diabetes programs, services, and resources. Quantitative results were analyzed in SPSS and Microsoft Excel, while qualitative responses were recorded, transcribed, and imported into NVivo 8 where inductive and deductive content analysis was performed. RESULTS: Findings from the quantitative analyses revealed that the use of cultural strategies varied according to client place of residence and DEC client volume. Integration of cultural strategies was more common for (a) DECs serving an on-reserve clientele, compared to DECs serving an off-reserve clientele; and (b) DECs serving a higher volume of Aboriginal clients. Qualitative analyses revealed differences in (a) program delivery methods for Aboriginal clients, and (b) perceived barriers to providing Aboriginal clients with effective diabetes care. CONCLUSION: Now that we know many Ontario DECs are trying to integrate cultural strategies to various degrees, research efforts can attempt to connect culturally relevant diabetes programs to client outcomes. A positive relationship would have important policy and practice implications.