Evaluation of Cultural Competency in Type 2 Diabetes Mellitus (T2DM) Intervention Programs in Saskatoon for Saskatchewan Métis
Métis people in Canada experience Type 2 Diabetes Mellitus (T2DM) at a rate that is substantially higher than the general Canadian population, and therefore require medical and public healthcare for diabetes complications. Despite a growing literature examining Aboriginal health, little is known about how diabetes healthcare interventions are being delivered to the Métis in Canada. Culturally competent medical and public health interventions, those that are sensitive to the culture, history and the beliefs people hold, are known to produce better patient outcomes. These interventions are also known to deliver greater patient satisfaction, and may reduce existing health inequities. This thesis explores the extent to which community-level diabetes healthcare interventions in Saskatoon are being delivered to the Métis people in a manner that is appropriate and sensitive to their culture. Data were collected using semi-structured in-depth interviews with seven Métis participants living with diabetes. Structured in-depth interviews were conducted with one key informant from Central Urban Métis Federation Inc. (CUMFI), and five healthcare practitioners tasked with providing T2DM interventions. Observations and documentary materials were used to supplement the interview data for the study. The study identified two main community-level diabetes healthcare interventions in Saskatoon with a series of activities organized under them. Although the study found no Métis specific T2DM healthcare intervention, participants identified that Métis cultural activities such as jigging and community gardening were incorporated into some of the interventions. However, language, Métis traditional foods, and traditional approaches to teaching were not incorporated into these programs. These omissions, coupled with barriers such as limited spatial accessibility, lack of funding and community poverty have repercussions on participation levels, participant retention and health outcomes for participants living with diabetes. Respondents are less inclined to participate if interventions are generic (non-Métis specific), which are considered less satisfactory. In turn, this may affect the sustainability of the healthcare program resulting in poor health outcomes. In this way the Métis continue to struggle with these community-level diabetes healthcare intervention programs. This study supports the need for Métis-specific community-level diabetes healthcare interventions as a means of improving health outcomes for the fight against T2DM among Métis people.
Aboriginal people, health intervention, diabetes, cultural competency, Métis
Master of Arts (M.A.)
Geography and Planning