OVERVIEW
The Kahnawà:ke Schools Diabetes Prevention Program (KSDPP) began in 1994 at the request of community elders after community baseline research documented a high prevalence of both Type 2 diabetes and diabetic complications; the Elders requested ‘that something be done’ to prevent future generations from suffering these high rates of disease. From the beginning, KSDPP was designed as a community-based participatory research program, where the community of Kahnawà:ke, community researchers and academic researchers would 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 through the KSDPP Community Advisory Board that includes representatives from many community organizations together with interested community members. The partnership guidelines are outlined in the KSDPP Code of Research Ethics, that has twice been revised to reflect the evolving partnership experiences, external ethical guidelines and to further strengthen KSDPP research practice through increased decolonizing research teachings and ceremony. (add link)
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 was preventable. The healthy lifestyle promoting interventions have always included incorporating Kanien’kehá:ka (Mohawk) traditions, culture, and ways of knowing including decision making for Seven Generations into the future, that focuses on the impact of decisions today on the faces yet to come. Over the years, 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 always 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 currently being updated to include increased Indigenous directions). KSDPP has focused on elementary school children who attend community schools with the development of an initial health curriculum (currently under revision), a new sleep curriculum, teacher training, a school wellness policy, and school wellness committees and opportunities for parents and extended families to support the children’s healthy lifestyles with information and skills. Community wide interventions throughout the year support the information being disseminated in the schools, and opportunities to practice healthy living with KSDPP promotion of healthy environments and an overall grassroots commitment to the wellbeing and the continuation of the Kanien’kehá:ka (people of Kahnawake).
Since 1994, KSDPP has mobilised the community, and our actions have transformed societal norms from when diabetes was perceived as a death sentence, to 2022 where we are empowered to prevent type 2 diabetes.
RESEARCH IN KAHNAWAKE
KSDPP began by 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: the interventions and process changes in the schools and community; the role of KSDPP as a social movement; the health curriculum; community ownership of the program; the value of social networking to spread ideas; the role of culture in school classes and community workshops; researcher engagement with community; food security; food sovereignty and changes over time in the community incidence and prevalence of Type 2 diabetes. Research results have been used to further strengthen the interventions and to develop the elementary schools’ physical activity policy, a walking school bus and the sleep curriculum. Current research includes a youth empowerment project for those aged 14-18 years that seeks to better understand 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 older youth want to be engaged in the community and newly obtained funding will support implementation of the findings related to this research. (see Nurturing Healthy Growth). 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 & 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; and d) evaluate how the KSDPP program is disseminated and adapted throughout 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 undertaken wellness concept mapping in each community as a basis for planning interventions. (See Community Mobilisation Training).
The Center’s other recent 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.
The KSDPP Center for Research and Training also serves as the hub for the CIHR-funded Quebec province-wide Indigenous health research 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; and, e) provide an exchange forum for groups interested in Indigenous health. Tahatikonhsontóntie' ('the faces yet to come') Québec Network Environment for Indigenous Health Research (Qc NEIHR) https://cihr-irsc.gc.ca/e/52540.html
The Kahnawà:ke Schools Diabetes Prevention Program (KSDPP) began in 1994 at the request of community elders after community baseline research documented a high prevalence of both Type 2 diabetes and diabetic complications; the Elders requested ‘that something be done’ to prevent future generations from suffering these high rates of disease. From the beginning, KSDPP was designed as a community-based participatory research program, where the community of Kahnawà:ke, community researchers and academic researchers would 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 through the KSDPP Community Advisory Board that includes representatives from many community organizations together with interested community members. The partnership guidelines are outlined in the KSDPP Code of Research Ethics, that has twice been revised to reflect the evolving partnership experiences, external ethical guidelines and to further strengthen KSDPP research practice through increased decolonizing research teachings and ceremony. (add link)
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 was preventable. The healthy lifestyle promoting interventions have always included incorporating Kanien’kehá:ka (Mohawk) traditions, culture, and ways of knowing including decision making for Seven Generations into the future, that focuses on the impact of decisions today on the faces yet to come. Over the years, 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 always 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 currently being updated to include increased Indigenous directions). KSDPP has focused on elementary school children who attend community schools with the development of an initial health curriculum (currently under revision), a new sleep curriculum, teacher training, a school wellness policy, and school wellness committees and opportunities for parents and extended families to support the children’s healthy lifestyles with information and skills. Community wide interventions throughout the year support the information being disseminated in the schools, and opportunities to practice healthy living with KSDPP promotion of healthy environments and an overall grassroots commitment to the wellbeing and the continuation of the Kanien’kehá:ka (people of Kahnawake).
Since 1994, KSDPP has mobilised the community, and our actions have transformed societal norms from when diabetes was perceived as a death sentence, to 2022 where we are empowered to prevent type 2 diabetes.
RESEARCH IN KAHNAWAKE
KSDPP began by 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: the interventions and process changes in the schools and community; the role of KSDPP as a social movement; the health curriculum; community ownership of the program; the value of social networking to spread ideas; the role of culture in school classes and community workshops; researcher engagement with community; food security; food sovereignty and changes over time in the community incidence and prevalence of Type 2 diabetes. Research results have been used to further strengthen the interventions and to develop the elementary schools’ physical activity policy, a walking school bus and the sleep curriculum. Current research includes a youth empowerment project for those aged 14-18 years that seeks to better understand 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 older youth want to be engaged in the community and newly obtained funding will support implementation of the findings related to this research. (see Nurturing Healthy Growth). 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 & 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; and d) evaluate how the KSDPP program is disseminated and adapted throughout 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 undertaken wellness concept mapping in each community as a basis for planning interventions. (See Community Mobilisation Training).
The Center’s other recent 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.
The KSDPP Center for Research and Training also serves as the hub for the CIHR-funded Quebec province-wide Indigenous health research 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; and, e) provide an exchange forum for groups interested in Indigenous health. Tahatikonhsontóntie' ('the faces yet to come') Québec Network Environment for Indigenous Health Research (Qc NEIHR) https://cihr-irsc.gc.ca/e/52540.html