The CMT activities occurred from 2018-2022 as part of the CIHR Pathways Research Project. The relationships and initiatives built during from the CMT project have been carried into the Community-2-community (C2C) Exchange Project that began in the spring of 2022.
Project and Background
Kahnawake Schools Diabetes Prevention Program (KSDPP) Community Mobilization Training (CMT) for Diabetes Prevention: Implementation and scale-up of a best practice training model for diverse Indigenous communities is a community-based participatory research project aimed at studying both the implementation and impact of CMT for type 2 diabetes prevention and healthy lifestyles in Indigenous communities. The goal is to learn about the factors, conditions, and types of social systems that are necessary for the successful implementation and scale-up of the experiences of the KSDPP - a nationally recognized best practice for community level diabetes prevention that began in the Kanien’kehá:ka (Mohawk) community of Kahnàwa:ke (Quebec) in 1994.
The content of KSDPP CMT Manual is delivered as different workshops over 5 days and is facilitated by Indigenous experts in community mobilization. CMT Indigenous community trainees work together to develop a mobilization plan for diabetes prevention based on the KSDPP intervention model adapted and customized according to their own local contexts, culture and community resources. The training facilitator guides a diverse group of community members through various strategic activities. These include teaching sessions on healthy lifestyles, the theoretical backgrounds that drive the program and the interventions; and hands-on activities including focused discussions about community core values that are central to creating individual community vision and mission statements. It also includes conducting environmental scans in each community to identify and assess community resources and readiness to mobilize, focussing on creating partnerships with other community organizations; working on team-building strategies; understanding aspects of volunteerism, and planning healthy lifestyles; and developing public relations approaches to diabetes prevention, health promotion, and wholistic wellness.
The content of KSDPP CMT Manual is delivered as different workshops over 5 days and is facilitated by Indigenous experts in community mobilization. CMT Indigenous community trainees work together to develop a mobilization plan for diabetes prevention based on the KSDPP intervention model adapted and customized according to their own local contexts, culture and community resources. The training facilitator guides a diverse group of community members through various strategic activities. These include teaching sessions on healthy lifestyles, the theoretical backgrounds that drive the program and the interventions; and hands-on activities including focused discussions about community core values that are central to creating individual community vision and mission statements. It also includes conducting environmental scans in each community to identify and assess community resources and readiness to mobilize, focussing on creating partnerships with other community organizations; working on team-building strategies; understanding aspects of volunteerism, and planning healthy lifestyles; and developing public relations approaches to diabetes prevention, health promotion, and wholistic wellness.
Project Funding
Funding for the KSDPP CMT Pathways Research Project 2018- 2022 evaluation component was provided through a grant (CIHR#PI3-151327) from the Canadian Institutes of Health Research (CIHR) Pathways to Health Equity - Institute of Indigenous Peoples’ Health (IIPH) - to Dr. Lucie Lévesque at Queen’s University (Nominated Principal Investigator). Additional in-kind support for the project comes from various institutional and organizational partners.
Funding for the CMT intervention training was provided by a private foundation grant to Dr. Ann C. Macaulay based at McGill University. This funding was critical: first, to the success of the CMT Pathways research grant application to the CIHR; second, to the implementation of the intervention in six Indigenous communities located in Quebec, Manitoba, and Ontario; and third to attract regional and national-level Indigenous organizations to the team, including the National Indigenous Diabetes Association. These funds were used to secure the CMT training facilitator who delivered the CMT sessions in each community, a bilingual CMT facilitator who maintained contact with the francophone community, as well as two occasional assistant facilitators.
CIHR funds supported the securing of a part-time community research assistant in each community who facilitated the CMT group meetings and subsequent CMT local coalition (CAB) meetings, assisted with the research facilitation, and supported the comprehensive evaluation of the CMT intervention.
Funding for the CMT intervention training was provided by a private foundation grant to Dr. Ann C. Macaulay based at McGill University. This funding was critical: first, to the success of the CMT Pathways research grant application to the CIHR; second, to the implementation of the intervention in six Indigenous communities located in Quebec, Manitoba, and Ontario; and third to attract regional and national-level Indigenous organizations to the team, including the National Indigenous Diabetes Association. These funds were used to secure the CMT training facilitator who delivered the CMT sessions in each community, a bilingual CMT facilitator who maintained contact with the francophone community, as well as two occasional assistant facilitators.
CIHR funds supported the securing of a part-time community research assistant in each community who facilitated the CMT group meetings and subsequent CMT local coalition (CAB) meetings, assisted with the research facilitation, and supported the comprehensive evaluation of the CMT intervention.
Community CMT Progress and the COVID-19 Pandemic Impact
CMT-related community activities that were previously held in person were immediately cancelled and staff persons had to develop related activities or alternative activities that were then presented to communities via social media platforms depending on the telecommunications and internet access within the community. For example, communities often turned to Facebook and social media to disseminate healthy lifestyle messaging, physical activity tips and recipes for families, along with the COVID-19 pandemic safety messaging. CMT team members liaised with community contacts via Zoom and telephone during the pandemic.
Outcomes To Date
- Communities developed their own Vision and Mission Statements, a preliminary work plan and Community Advisory Boards.
- A Project Advisory Circle (PAC) was formed to guide project activities. PAC meetings were held semi-annually and brought community and organizational representatives together with research team members to share updates, discuss project direction, research activities, reports, manuscripts, and next steps. The team, in collaboration with members of the KSDPP Community Advisory Board, developed a Community Reviewer Checklist to guide community reviews of grant opportunities- including to assess if grants will benefit community.
- Annual Gatherings of Indigenous community members and the research team were held in Kahnawake over 2 days in 2017, 2018, and 2019, and by Zoom in June 2020 (due to the COVID-19 Pandemic), but not 2021 because community members were focused on COVID-19.
- Cultural Grounding Talking Circles were conducted during CMT research activities. Preliminary analysis is finished, and a framework is nearing completion.
- KSDPP website updated, with significant help from volunteer students.
- Despite COVID-19, messages continued promoting healthy lifestyles.
- Two graduate students (including one Indigenous) earned their Master's degrees; manuscripts based on their work of partnering with community members to map the key components of individual community wellness were published in the Turtle Island Journal of Indigenous Peoples' Health (see publications for McBeath B. et al and Périllat-Amédée S. et al )
- Another Master's student collected data to document KSDPP perspectives on data sovereignty in Indigenous Community-Academic Partnered Health Research (paper in development)
- A scoping review of published literature regarding online health promotion in Indigenous communities in Canada, U.S., Australia and New Zealand is nearing completion- to guide future online health promotion activities.
- In 2021, at the request of a community member, and in partnership with 4 communities, the team developed and submitted a successful CIHR COVID-19 Rapid Response Grant (CIHR GA7-177785) - to study how communities mobilized around COVID-19.
- In 2021, the team developed and submitted a successful Letter of Intent (CIHR DPL-179256) to develop a Team Grant to continue the CMT project for another five years. A full proposal titled "Mobilizing Resilience through Community-to-Community (C2C) Exchange: Seven Generations Thinking for Diabetes Prevention" was submitted in 2022 and funded (CIHR-DRW-187410).
Publications
Périllat-Amédée, S., Delormier, T. W., Flamand, S., Ottawa, G., McBeath, B., McComber, A. M., Macaulay, A., Lévesque, L., & Flamand, D. (2021). Atikamekw Nehirowisiw Mirowatisiwin: Identifying the Strengths of the Manawan Community to Promote Wellness and Healthy Lifestyles. Turtle Island Journal of Indigenous Health, 1(2). https://doi.org/10.33137/tijih.v1i2.36135
McBeath, B., Franks, O., Delormier, T., Périllat-Amédée, S., McComber, A., Abigosis, T., Leafe, D., Macaulay, A., & Lévesque, L. (2021). Reflecting on the use of Concept Mapping as a Method for Community-Led Analysis of Talking Circles. Turtle Island Journal of Indigenous Health, 1(2). https://doi.org/10.33137/tijih.v1i2.36171
McBeath, B., Franks, O., Delormier, T., Périllat-Amédée, S., McComber, A., Abigosis, T., Leafe, D., Macaulay, A., & Lévesque, L. (2021). Reflecting on the use of Concept Mapping as a Method for Community-Led Analysis of Talking Circles. Turtle Island Journal of Indigenous Health, 1(2). https://doi.org/10.33137/tijih.v1i2.36171
Team Members
- Lucie Lévesque, Nominated Principal Applicant, Queen’s University (QU)
- Alex M. McComber, Co-Principal Applicant, Knowledge User, Lead CMT Facilitator, Kahnawà:ke Schools Diabetes Prevention Program (KSDPP)
- Treena Wasonti:io Delormier, Co-Principal Applicant, McGill University, KSDPP
- Ann C. Macaulay, Co-Applicant, McGill University, KSDPP
- Amelia Tekwatonti McGregor, Project Ombudsperson, Elder, KSDPP
- Dave Bergeron, Collaborator, Université du Québec à Rimouski
- Brittany Jock, Collaborator, McGill University
- Martine Lévesque, Collaborator, Université de Montréal
- Mike Alexander, Knowledge Holder, Thunderbird Designs
- Colin Baillie, Co-Applicant – Trainee, PhD Candidate, QU
- Vanessa Tait, Nanaandawewigamig First Nations Health & Social Secretariat of Manitoba (FNHSSM)
- Elizabeth Proskurnik, Southeast Resource Development Council Corp (SERDC)
- Kathleen Laforme, Indigenous Diabetes Health Centre (IDHC)
- Sipi Flamand, Band Council Member, Atikamekw de Manawan
- Francine Moar, Health Director, Atikamekw de Manawan
- Darlene Courchene, Health Director, Black River First Nation
- Pamela Smith, Community Research Assistant, Black River First Nation
- Tanager Abigosis, Community Research Assistant, Brokenhead Ojibway Nation
- Aliesha Desjarlais, Health Director, Brokenhead Ojibway Nation
- Tammi Shaw, Diabetes Worker, Biigtigong Mno-zhi-yaawgamig First Nation
- Denise Leafe, Community Research Assistant, Tyendinaga Mohawk Territory
- Kate Brant, Indigenous Community Development Worker, Tyendinaga Mohawk Territory
- Susan Barberstock, Director, Community Wellbeing, Tyendinaga Mohawk Territory
- Donna Ivimey, Research Coordinator, QU
- Judi Ohsennenáwi Jacobs, Project Manager, KSDPP (retired March 2021)
- Connie Meloche, General Manager KSDPP started April 2021
- Brittany McBeath, Graduate Student, QU
- Cameron Hare, Undergraduate Student Trainee, QU
- Victoria Taylor, Undergraduate Student Trainee, QU
- Danial Vagharfard, Undergraduate Student Trainee, QU
- Shannon Blake, Undergraduate Student Trainee, UOttawa
- Sonia Périllat-Amédée, Research Coordinator, McGill
- Georgia Fraulin, Summer Student (2020) & 4th Year Undergraduate (2020-21), QU
- Lauren George, Summer Student (2020) & 4th Year Undergraduate (2020-21), QU
- Cameron Jedemann, Summer Student, QU (2021)
- Miriam Muirhead, Summer Student, QU (2021)
- Marie-Claude Tremblay, Co-Applicant, Université Laval, KSDPP
- Jon Salsberg, Co-Applicant, University of Limerick, KSDPP
- Jennifer Dockstader, Executive Director, Fort Erie Native Friendship Centre(FENFC)
- Dawn Moughtin, Acting Executive Director, Niagara Region Native Centre (NRNC)
- Roslynn Baird, Executive Director, Indigenous Diabetes Health Circle (IDHC)
- Guylaine Ottawa, Community Research Assistant, Community Health Worker, Atikamekw de Manawan
- Nancy Gros-Louis McHugh, First Nations of Quebec & Labrador Health & Social Services Commission (FNQLHSSC)
- Francine Vincent, Wellness Coordinator, FNQLHSSC
- Jeff Laplante, Executive Director, National Indigenous Diabetes Association (NIDA)