Kahnawà:ke Schools Diabetes Prevention Program (KSDPP) began in 1994 at the request of community elders, when community baseline research documented a high prevalence of both type 2 diabetes and diabetic complications. Elders requested that something be done to prevent future generations from suffering such high rates of disease.
KSDPP was designed as a community-based participatory research program, whereby the community of Kahnawà:ke, community researchers, and academic researchers can work in an equitable partnership to share experiences and expertise. Our approach is to meet in an ethical space where health promotion and participatory research combine with Kanien’kehá:ka (Mohawk) ways of knowing and doing.
The community of Kahnawà:ke is represented by the Community Advisory Board (CAB) which includes representatives from community organizations and interested community members. Partnership guidelines are outlined in the KSDPP Code of Research Ethics, which has been twice revised to reflect evolving partnership experiences, external ethical guidelines, and to further strengthen KSDPP research practice through increased decolonizing of research teachings, and ceremony. KSDPP began with the long-term goal of preventing type 2 diabetes through the short-term goals of increasing physical activity, healthy eating, and a positive attitude that diabetes is preventable. Healthy lifestyle interventions have incorporated Kanien’kehá:ka traditions, culture, and ways of knowing, including decision-making for the next Seven Generations - decisions made today will impact the faces yet to come. KSDPP has evolved from discussing disease prevention to placing greater emphasis on Indigenous health promotion for wholistic wellness with connections to land, culture and language as foundations for the intervention framework. Additional goals have included promoting empowerment, building community and researcher capacity, and community program ownership. Interventions Interventions have been developed and implemented using Haudenosaunee (People of the Longhouse) responsibilities, Social Learning Theory, the Ottawa Charter for Health Promotion, and the PRECEDE-PROCEED model (all updated to include increased Indigenous directions). KSDPP has focused on elementary school children who attend community schools, through the development of an initial health curriculum, a sleep curriculum, teacher training, a school wellness policy, school wellness committees, and opportunities for parents and extended families to support children’s healthy lifestyles with information and skills. Community-wide interventions have supported the information being disseminated in the schools, and have provided opportunities to practice healthy living, with promotion of healthy environments and overall grassroots commitment to the wellbeing and continuation of the Kanien’kehá:ka (people of Kahnawake). Since 1994, KSDPP has mobilised the community and our actions have transformed societal norms from a time when diabetes was perceived as a death sentence, to now, where we are empowered to prevent type 2 diabetes. 
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Research in Kahnawà:ke
Evaluation began by KSDPP evaluating changes in knowledge, perceived parental support, anthropometric attributes, diet, eating patterns, physical activity, TV watching and fitness in elementary school children from Grades 1-6. Over the years, research has evaluated:
Research results have been used to further strengthen the interventions and to develop the elementary schools’ physical activity policy, a walking school bus and sleep curriculum. Current research includes a youth empowerment project for those aged 14-18 years who seek better youth perceptions of lifestyle and diabetes, and to encourage older youth to become role models for diabetes prevention for younger students. (See Indigenous Youth Mentorship Program-IYMP). Another KSDPP project for those 18-35 years has gathered data on how this age group want to be engaged in the community, and newly obtained funding will support implementation of the findings related to this research. (See Skatne Ionwaweientehtaonhátie). KSDPP also provides training opportunities for postgraduate and undergraduate students and community researchers. KSDPP Center for Research and Training The goals for the KSDPP Centre for Research and Training initiated by CIHR funding in 2001-2006 and active to the present time, are to continue to: (a) understand the ongoing evolution of this Indigenous led health promotion program. (b) increase the understanding of and ways of incorporating culture into health promotion intervention programming. c) support the implementation of community mobilisation training programs in other Indigenous communities. d) evaluate how the KSDPP program is disseminated and adapted through a network of both English and French speaking Indigenous communities in Canada, where community members have developed Vision and Mission Statements for their own communities, and subsequently, have undertaken wellness concept mapping in each community as a basis for planning interventions. (See Community Mobilisation Training). Other research activities include conducting a scoping review of online health promotion for Indigenous peoples in Canada, Australia, New Zealand, and the United States, and starting a realist-informed evaluation to develop a program theory that explains the outcomes of the KSDPP community mobilization training. KSDPP Center for Research and Training also serves as the hub for Tahatikonhsontóntie' ('the faces yet to come') Québec Network Environment for Indigenous Health Research (Qc NEIHR), a CIHR-funded, province-wide network whose goals are to: a) increase Indigenous community research capacity. b) increase all Quebec universities’ understanding and practice of respectful partnering with Indigenous communities. c) offer academic training to masters, PhD and postdoctoral students interested in all aspects of Indigenous health. d) offer training to Indigenous community researchers. e) provide an exchange forum for groups interested in Indigenous health. |