Reducing Health Disparities Related to Diabetes: Lessons Learned Through the Canadian Diabetes Strategy Community-Based Program
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Case Study 6: Diabetes Intervention Strategy for Quebec Minority English Speaking Communities: Increasing Access to Health Information for Rural and Isolated Regions
- Servizi Comunitari Italo-Canadesi del Quebec
- Committee for Anglophone Social Action—New Carlisle
- Council for Anglophone Magdalen Islander
- East Island Montréal
- Lower North Shore Coalition for Health
- Outaouais Health and Social Services Network
- Townshippers' Association-Cowansville and Estrie
- Vision Gaspé-Percé Now
- Public Health Agency of Canada
- English-speaking youth, adults and seniors
The prevention of obesity in children and older adults
is key to the prevention of type 2 diabetes and several
other chronic diseases. Access to health information and
diabetes services is limited for certain English-speaking
communities in Quebec, particularly those in isolated or
This program aimed to increase awareness of the benefits
of healthy eating and physical activity among high-risk
populations and among decision-makers within the
English-speaking minority communities. In addition, it
sought to develop partnerships between community
organizations and the health and social services centres
The regional English-speaking communities partnered
with local health institutions to carry out various activities
related to prevention and self-management, including:
- Presentations in elementary schools;
- Travelling kiosks on diabetes prevention;
Diabetes screening and testing by nurses at all-ages
Distribution of "survival bags" for individuals with type
A cooking class for children on how to prepare cookies
that are appropriate for diabetic diets, with proceeds
donated to a local homeless shelter.
Process evaluation measures included maintaining a
program diary; qualitative surveys of seniors and steering
committee members, and pre- and post-surveys of
knowledge, awareness and behaviour.
Age-appropriate pre- and post-test questionnaires and
satisfaction forms were administered to high school
students and seniors. In addition, focus groups were held
with seniors and youth in two of the target communities.
Seniors and youth were the main focus of the evaluation,
as most of the project activities were aimed at these
Results indicated that knowledge and awareness of diabetes
increased among participants, but it was difficult to assess
whether any changes had been made to dietary or physical
activity practices. The evaluation also confirmed that
important partnerships were established between the
project partners (community organizations) and the public
Comments on the evaluations centred on three points:
The importance of follow-up, particularly for seniors
(who do not have the benefit of being in a continuous
learning environment like a school);
The need to use individualized approaches when
teaching about healthy lifestyles, such as providing personal attention during presentations, and group
Targeting seniors caregivers' in future program activities,
as they play a significant role in the nutrition and
physical activity practices of seniors.
Reaching the Population
Program activities were carried out in regions with a
high proportion of English-speaking residents.
To reach the general public, activities were carried out in
shopping centres, grocery stores and at public events.
To reach students, activities related to diabetes
prevention were conducted at day camps and
To reach seniors, the program team travelled to medical
clinics and seniors' centres.
It was initially more challenging to reach seniors than
youth because they cannot all be reached at a single
institution (i.e. a school); however, it was easier to
collaborate with seniors' committees than school
committees, as their decision-making processes were
simpler than those in the school system.
The presence of government health officials at
English events was a success, as it helped to increase
understanding between English minority communities
and government decision-makers.
In response to shifting priorities at the provincial and
federal government levels, the lead organization and
partnership communities are focusing on chronic
disease care management in patients with type 2
diabetes. They are currently working on a distance
telemonitoring project involving community networks
across Quebec and local health centres, whereby
patients transmit their blood glucose levels to nurses
and project coordinators via handheld devices, such as
the Blackberry. Dietitians are hired to answer questions
and present information sessions via videoconference.
The acquisition of self-monitoring skills among patients
will be measured to determine the feasibility of using
"The public sector is beginning
to realize the value of community
groups. It was skeptical at first,
but now it values them as
partners and sees how far the
little funds they [community
groups] receive can go."
A number of resources were developed for this program:
Training kits for youth on healthy eating and
- Curriculum modules for elementary school children;
- Pamphlets for all age groups;
- Healthy recipe guides; and
A rap DVD on healthy eating and diabetes prevention
(YouTube site: bit.ly/oKdZ)
For additional information: