USask research project seeks to combat Type 2 Diabetes with an Indigenous view

USask Photo Dr. Sarah Oosman (PhD), acting director of USask’s School of Rehabilitation Science.

A research project at the University of Saskatchewan (USask) is promoting Indigenous worldviews in helping to prevent Type 2 diabetes, which is a disease that is prevalent in First Nations and Métis communities.

Dr. Sarah Oosman (PhD), acting director of USask’s School of Rehabilitation Science, is one of the lead researchers on a project titled “Strong Bodies, Spirits, Minds, and Voices” Privileging Indigenous Knowledge to Guide Pediatric Type 2 Diabetes Prevention with First Nations and Métis Communities in Saskatchewan.”

She said the goal is to connect with Elders, Knowledge Keepers, youth and families in Indigenous communities who can co-create and implement an Indigenous-driven health promotion intervention toolkit that is grounded in an Indigenous worldview.

“We want to build to support health and promote health with the idea of preventing Type 2 diabetes among Indigenous youth … and in order to do that, we need to be working with the experts, the Knowledge Keepers, the older adults, the youth themselves, (to hear) the experiences that they bring, and people with Type 2 diabetes with experience who identify as indigenous as well. We need to better understand those experiences in order to be responsive to building interventions, activities and health promoting programs that can really look at some of the underlying factors.”

Oosman said there is a one-sided view when it comes to solving some of the challenges Indigenous communities face from Type 2 diabetes. She said the research project would help provide a holistic perspective grounded in the unique culture and language of First Nations, Métis and Inuit populations.

She said working with a diverse group helps researchers look at health promotion research in new ways.

According to Diabetes Canada, age-standardized prevalence rates of diabetes in the country are significantly higher in the Indigenous population due to a number of factors including.

“Canada’s historic and continued colonial policies, such as residential schools, Indian hospitals, and the ’60s Scoop; lack of access to healthy, nutritious, and affordable food; and a strong genetic risk for Type 2 diabetes,” reads the USask press release.

“In order to really get to the bottom of what these types of interventions require, they require all of us to look at a way of addressing racism, addressing discrimination and addressing thinking and perspectives that are often, whether intentionally or not, grounded in colonized practices that are in tension with community priorities, values, belief systems and knowledge,” Oosman said.

To decolonize and reframe the work, Oosman said they need diverse individuals informing their way forward. They also need to honour the strengths and knowledge from people and perspectives in order to build a new knowledge.

Oosman described the work as being culturally humble.

“I think we as non-Indigenous researchers need to find, create space and opportunities to step back in culturally humble ways, to open up opportunities for Indigenous worldview and perspective, to be elevated and to ground and drive everything we’re doing,” she explained.

Diabetes is prevalent at a rate of 17.2 per cent among First Nations peoples living on-reserve, 12.7 per cent among First Nations peoples living off-reserve and 9.9 per cent among Métis peoples – compared to a rate of only five per cent among the general population.

Indigenous and non-Indigenous scholars and community leaders – including community members with Type-2 diabetes lived experience – participated in numerous think tank sessions to help create a comprehensive funding proposal that was informed by First Nations and Métis knowledge, expertise, values, culture, and language.

The proposal calls for culture-based health promotion interventions designed to holistically prevent Type 2 diabetes among Indigenous youth using a preliminary mitos miyoyawin (Cree for “tree of wellness”) framework developed by think tank participants and informed by Indigenous knowledge.

Oosman and her team were recently awarded nearly $2 million in funding over the next five years from the Canadian Institutes of Health Research (CIHR) to continue their research with current community partners and eventually expand it across diverse Indigenous communities throughout Saskatchewan.

Île-à-la-Crosse and James Smith Cree Nation are the first two communities to partner on this project. Several other communities, including Clearwater River Dënë Nation, La Loche, Sweetgrass First Nation, Little Pine First Nation, and Poundmaker Cree Nation, have also started engaging as partners with the project.

Oosman said having five years of funding is fantastic.

“To have five years will truly allow our team to build strong relationships,” she explained. “The relational approach to our work is essential, and building everything on strong relationships is going to help to lead to successful outcomes.”

The five year funding period also allows them to build hope that the commitment can continue after it expires.

“We feel so grateful to be able to have the opportunity to work with diverse community partners and actually have the resources to do a good job,” Oosman said. “We would love to plan where do we go from there, collaboratively, collectively and as a sort of a team approach to figure out where to after five years.”

Oosman said they want to flip the traditional ways of health promotion and use Indigenous perspectives and then add the traditional Western designed programs.

“It’s actually a practice of cultural humility and finding what some would call the middle ground,” she explained.

“I know that our terminology and our society can be problematic, but just I think most people kind of recognize terms like reconciliation and decolonization. What we’re trying to do is learn our practice of cultural humility to create these spaces of working in the middle ground and in the practice of reconciliation, where strength and worldview are respected, that are not always Western or Eurocentric,” she said.

Margaret Larocque, a lead Knowledge Keeper originally from Waterhen Lake First Nation who is guiding the project, noted the importance of addressing diabetes for children in Indigenous communities.

“Diabetes is an epidemic with Indigenous people, and we really need a lot of education and prevention for kids,” she said in a press release.

Indigenous youth have also been involved with the project in order to bring an intergenerational focus. While the project revolves around the prevention of Type 2 diabetes among Indigenous youth in partner communities, Oosman is optimistic the framework could affect how healthcare professionals provide care in Indigenous communities.

Oosman explained that the work requires a great team, respectful engagement with all community partners, Knowledge Keepers, youth and adults.

“We are just grateful to have these relationships to be able to build on and I just want to recognize and acknowledge the critical importance of community input and engagement that we’ve been very privileged to have had leading up to building the grant. It will lead to maintaining and nurturing strong relationships across diverse communities,” Oosman said.

She added that they are grateful for the Knowledge Keepers who guide them as a team.

“We couldn’t be doing this work without that critical piece,” she said.

Oosman co-leads this interdisciplinary project with Dr. Shelley Spurr (PhD) and Dr. Jill Bally (PhD) from the College of Nursing, Dr. Amanda Froehlich Chow (PhD) from the School of Public Health, and Knowledge Keepers Gilbert Kewistep and Larocque.