CIHR Partnership Award – 2010

Kahnawake Schools Diabetes Prevention Project
Kahnawake Mohawk Territory
Kahnawake, Quebec

Eva Johnson
Co-Chairperson, Executive Committee on behalf of the Community Advisory Board (KSDPP)
Executive Director, Kahnawake Environment Protection Office

The winners of the 2010 Partnership Award have harnessed the strengths of their community in an effort to reduce type 2 diabetes.

For the residents of Kahnawake, a Mohawk community southwest of Montreal, the type 2 diabetes problem was becoming too large to ignore. A research study in the 1980s documented high rates of the disease in the community. They wanted to do something to prevent diabetes in future generations.

"Two doctors – Louis T. Montour and Ann Macaulay – first identified that type 2 diabetes was a big issue in Kahnawake and began efforts to do participatory research, which led to interventions," says Ms. Eva Johnson, a community member. "So, because we had medical personnel working at our local hospitals that were identifying the increasing prevalence of diabetes, they took a stand and began to look at ways they could handle this illness."

Out of that first observation, and with much effort to secure research funding, an innovative research project and intervention program, known as the Kahnawake Schools Diabetes Prevention Program Project (KSDPP), was born in 1994.

"There's an interaction between partner universities and the community which is transferred onto the schools through interventions," says Ms. Johnson, who also serves as a KSDPP community advisory board member. "The researchers will actually come into the community after they've gone through an application process to do some research work in the community."

The community and the researchers take the utmost care to ensure that the research and the interventions are always in the best interests of the people of Kahnawake.

"It's never very invasive, it's confidential, and it's either with the children in the schools or with the teachers or their parents to try to get a grasp on diet and activity," explains Ms. Johnson. "So the researchers are welcomed into the community to do some work out of the KSDPP offices, and then their research team will meet and devise the best way to continue with the research."

Kahnawake, like many Native communities across Canada, experiences higher rates of type 2 diabetes than other populations. That has motivated the people of Kahnawake into action to provide continued volunteer support for the KSDPP staff. In turn, KSDPP has built partnerships with many local organizations, which continue to develop more and more diabetes prevention activities.

Several factors have enabled this program to maintain a forward direction of activity, education and research. These factors include the community's ability to mobilize around important issues, its close proximity to researchers dedicated to collaborative research with communities at McGill University, Queen's University, and the University of Montreal, the KSDPP Training Program workshops, and the tight-knit nature of the community.

"Here everybody knows everybody. If somebody has an amputated limb from diabetes, everybody knows about it. You're visible in the community, go to the local hospital, and you see the effects of prolonged diabetes, or untreated diabetes," says Ms. Johnson. "So I think Kahnawake is almost a perfect setting for a host community for the programs and projects that we've sponsored."

As part of the program, students in the schools of Kahnawake participate in a variety of interventions, and the researchers have assessed the impact of the interventions on the changes in lifestyle among elementary school students from 1994 through 2002.

"Some of the children may have a more sedentary lifestyle with all the electronics in their homes and they may not be playing out everyday like they should be to be getting the necessary exercise that they require. So there'll be classes set aside in addition to their regular gymnastics program," says Ms. Johnson. "We have a nutrition policy that was developed with the help of the local hospital staff which basically helps advise parents what types of lunches they should send with their children and what types of lunches aren't really acceptable for their children to grow healthy."

As the partners behind the Kahnawake Schools Diabetes Prevention Project look forward, they intend to continue to build on the program. They envision the KSDPP Centre for Research and Training in Diabetes Prevention will be a centre for health promotion and diabetes prevention interventions and research that can continue to provide valuable information about the importance of lifestyle choices.

That drives the KSDPP forward toward a time when "All people are in perfect health, diabetes no longer exists." This community vision statement comes from the Mohawk and Haudenonsaunee philosophy of considering the importance of our actions and words today as they will impact on Ratikonsatatie – "the faces yet to come," the Seventh Generation.

Ms. Johnson emphasizes, "It's not just diet, it's not just exercise – there's some psychological work going on to change the mindset of people to realize that early intervention and early addressing of issues could go a long way in their future health."

The CIHR Partnership Award recognizes partnerships with one or more external partners from the private, voluntary or public sectors which exemplify excellence by bringing health research communities together to create innovative approaches to research questions; to develop research agendas that are responsive to the health needs, concerns and priorities of Canadians; and to accelerate the translation of knowledge for the benefit of Canadians.