Tompkins Jordan W, Mequanint Selam, Barre Douglas Edward, Fournie Meghan, Green Michael E, Hanley Anthony J, Hayward Mariam Naqshbandi, Zwarenstein Merrick, Harris Stewart B
Centre for Studies in Family Medicine, Western Centre for Public Health and Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1511 Richmond Street, London, ON, N6K 3K7, Canada.
Department of Health Sciences and Emergency Management, School of Professional Studies, Cape Breton University, Sydney, NS, Canada.
BMC Health Serv Res. 2018 Nov 1;18(1):828. doi: 10.1186/s12913-018-3578-8.
There is a significant deficiency of national health information for Indigenous peoples in Canada. This manuscript describes the Community Profile Survey (CPS), a community-based, national-level survey designed to identify and describe existing healthcare delivery, funding models, and diabetes specific infrastructure and programs in Indigenous communities.
The CPS was developed collaboratively through FORGE AHEAD and the First Nations and Inuit Health Branch of Health Canada. Regional and federal engagement and partnerships were built with Indigenous organizations to establish regionally-tailored distribution of the 8-page CPS to 440 First Nations communities. Results were collected (one survey per community) and reported in strata by region, with descriptive analyses performed on all variables. Results were shared with participating communities and regional/federal partners through tailored reports.
A total of 84 communities completed the survey (19% response rate). The majority of communities had a health centre/office to provide service to their patients with diabetes, with limited on-reserve hospitals for ambulatory or case-sensitive conditions. Few healthcare specialists were located on-site, with patients frequently travelling off-site (> 40 km) for diabetes-related complications. The majority of healthcare professionals on-site were Health Directors, Community Health Nurses, and Home Care Nurses. Many communities had a diabetes registry but few reported a diabetes surveillance system. Regional variation in healthcare services, diabetes programs, and funding models were noted, with most communities engaging in some type of innovative strategy to improve care for patients with diabetes.
The CPS is the first community-based, national-level survey of its kind in Canada. Although the response rate was low, the CPS was distributed and successfully administered across a broad range of First Nations communities, and future considerations would benefit from a governance structure and leadership that strengthens community engagement, and a longitudinal research approach to increase the representativeness of the data. This type of information is important for communities and regions to inform decision making (maintain successes, and identify areas for improvement), strengthen health service delivery and infrastructure, increase accessibility to healthcare personnel, and allocate funding and/or resources to build capacity and foster a proactive chronic disease prevention and management approach for Indigenous communities across Canada.
Current ClinicalTrial.gov protocol ID NCT02234973 . Registered: September 9, 2014.
加拿大缺乏针对原住民的国家健康信息。本手稿介绍了社区概况调查（CPS），这是一项基于社区的国家级调查，旨在识别和描述原住民社区现有的医疗服务提供、资金模式以及糖尿病特定基础设施和项目。
CPS由“携手向前”组织与加拿大卫生部第一民族和因纽特人健康处合作开发。与原住民组织建立了区域和联邦层面的合作关系，以便将8页的CPS根据地区情况分发给440个第一民族社区。收集了结果（每个社区一份调查问卷），并按地区分层报告，对所有变量进行了描述性分析。通过定制报告与参与社区以及区域/联邦合作伙伴分享了结果。
共有84个社区完成了调查（回复率为19%）。大多数社区设有健康中心/办公室为糖尿病患者提供服务，而在保留地内，用于门诊或病情较重情况的医院有限。现场的医疗专家很少，患者经常前往外地（超过40公里）治疗糖尿病相关并发症。现场的大多数医疗专业人员是健康主任、社区健康护士和家庭护理护士。许多社区有糖尿病登记册，但很少有社区报告有糖尿病监测系统。注意到医疗服务、糖尿病项目和资金模式存在地区差异，大多数社区都在采用某种创新策略来改善糖尿病患者的护理。
CPS是加拿大此类首个基于社区的国家级调查。尽管回复率较低，但CPS已在广泛的第一民族社区中分发并成功实施，未来的考虑将受益于加强社区参与的治理结构和领导力，以及采用纵向研究方法来提高数据的代表性。这类信息对于社区和地区进行决策（保持成功并确定改进领域）、加强医疗服务提供和基础设施建设、增加获得医护人员的机会以及分配资金和/或资源以建设能力并为加拿大各地的原住民社区培育积极主动的慢性病预防和管理方法非常重要。
当前ClinicalTrial.gov方案识别号NCT02234973。注册时间：2014年9月9日。
