Exploring quality improvement for diabetes care in First Nations communities in Canada: a multiple case study

Area of Science:

• Public Health
• Health Services Research
• Indigenous Health

Background:

• Indigenous peoples in Canada face disproportionately higher rates of diabetes and poorer health outcomes.
• Addressing health inequities and enhancing access to quality diabetes care are critical public health priorities.
• The FORGE AHEAD Research Program investigates quality improvement (QI) in Indigenous primary healthcare settings.

Purpose of the Study:

• To explore the QI process undertaken by two primary healthcare teams in First Nations communities.
• To understand how knowledge and context influenced the development and implementation of diabetes care strategies.
• To identify factors that supported or hindered the QI process in improving diabetes care.

Main Methods:

• A community-based participatory qualitative case study methodology was employed.
• Analysis of multiple qualitative data sources was conducted.
• The study focused on understanding knowledge utilization, contextual influences, and facilitators/barriers to QI.

Main Results:

• Teams effectively integrated diverse knowledge sources into their QI initiatives.
• Strengthening community relationships and partnerships was crucial for success.
• Organizational support and capacity significantly influenced the QI process and outcomes.

Conclusions:

• This research provides insights into the process and influencing factors of QI strategy implementation within Indigenous communities.
• Findings can inform community-led actions and guide the future development and scale-up of QI programs.
• The study contributes to global efforts to improve diabetes care in Indigenous populations through enhanced quality improvement strategies.