Abstract
According to the Public Health Agency of Canada, the prevalence of type 2 diabetes (T2D) among Indigenous people in Canada is 1.9 times higher than the non-Indigenous and is rising. These rates can be attributed to inequities in the determinants of health as a result of colonization. Having community members engaged in developing programs aimed at improving their health increases the acceptability and success of these programs. We aimed to use community based participatory action research to engage Indigenous people living on reserve in the development of diabetes management programming. The study utilized an exploratory mixed methods approach. Quantitative data was gathered via a survey to assess sociodemographic factors, self-reported health status, traditional food consumption and knowledge. The survey was administered door-to-door on Cowessess First Nation in Saskatchewan and garnered 112 responses from community members ranging from 13 to over 75 years old. Qualitative data was gathered at a town hall event, participants reflected on survey results and shared their ideas for best practices to promote healthy eating and reduce the burden of T2D. Fiftyone percent (n = 57) of respondents indicated that they rarely or never eat traditional Indigenous foods. Factors preventing them from eating traditional foods included no time to hunt, fish, forage or prepare (n = 32), and no access/availability (n = 33). Data from the town hall thematic analyses highlighted that having access to hunting materials, meat preparation, and culturally customized education on T2D were the most frequent ideas to promote health and reduce the burden of T2D. The discussion focused on health benefits of Indigenous traditional foods, limited access to traditional foods and the struggle with the cost of feeding families. Data integration showcases that the community is aware of the benefits of eating traditional foods and are actively working towards solutions to increase access within the community. In conclusion, the community has identified initiatives that increase access/accessibility of traditional foods and indicated openness to working together on future projects.