INMD Researcher profile: Dr. Stewart Harris

Researcher profiles

Project title

The FORGE AHEAD Program: Transforming Indigenous Primary Healthcare Delivery

Who

Dr. Stewart Harris at the University of Western Ontario has more than 20 years experience working with First Nations (FN) communities, including previous research projects that involved partnering with FN communities (e.g. CIRCLE study, Sandy Lake Health and Diabetes Project, FNDSS project, etc.). As part of the FORGE AHEAD program, he will be leading a research team with extensive expertise in multi-disciplinary and multi-institutional collaboration in the fields of diabetes care, participatory action research, and knowledge translation. The FORGE AHEAD team spans nine provinces and represents a wide variety of voices, including First Nations community representatives, Indigenous and non-Indigenous health care providers, clinician scientists, academic researchers, representatives from the Assembly of First Nations (AFN), representatives from the First Nations and Inuit Health Branch (FNIHB) of Health Canada, representatives from the Canadian Diabetes Association (CDA), and representatives from the Heart & Stroke Foundation).

Issue

In Canada, significant health disparities exist between Indigenous peoples and the general population, particularly for chronic diseases such as diabetes. FN individuals have amongst the highest reported rates of type 2 diabetes mellitus and have alarmingly high rates of diabetes-related complications and premature mortality. FN individuals with diabetes often receive inconsistent care, leading to significantly worse outcomes compared to the general population.

Approach

Dr. Harris is dedicated to addressing the pressing need for new diabetes care delivery systems with a focus on continuity and integration of care in the FN community setting and cultural context.

Funded by the CIHR Roadmap Signature Initiative in Community-Based Primary Health Care, the overarching goal of the FORGE AHEAD program is to develop and evaluate community-driven primary health care delivery models that enhance chronic disease management with appropriate access to available services in FN communities. Through a series of 10 inter-related and progressive projects, the FORGE AHEAD team has five objectives:

  1. To assess the current health care delivery, funding models and best practices used in FN communities in Canada;
  2. To assess community and clinical readiness;
  3. To enhance patient access to available community resources;
  4. To implement and evaluate community and clinic quality improvement initiatives (diabetes registries, web-based surveillance, and a community-driven quality improvement intervention); and,
  5. To develop sustainment strategies and scale-up toolkits.

Impact

The FORGE AHEAD Program is a research initiative founded in participatory action research principles to ensure culturally appropriate implementation and integrate knowledge translation. It was designed with and for FN communities to improve care for individuals with type 2 diabetes, improve equity, and ultimately reduce the clinical and financial burden of diabetes and diabetes-related complications for FN individuals.

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