Aboriginal Diabetes Education Project, 2009/2010 Summative Report

Transcription

1 Aboriginal Diabetes Education Project, 2009/2010 Summative Report Prepared by Shelley Gonneville (Aboriginal Diabetes Education Program Coordinator) and Mario R. Gravelle (Chronic Disease Surveillance Coordinator) May, 2010

2 2 Aboriginal Diabetes Education Project 2009/2010: Goal and Design. The Métis Nation of Ontario Health Branch undertakes a yearly Aboriginal Diabetes Education Program (AB DEP) funded by Ontario s Ministry of Health and Long-Term Care. This initiative is dedicated to informing the Métis people of Ontario about the risk factors for developing diabetes and its complications. The AB DEP 2009/2010 included a special initiative tailored to provide participants personal health evaluation as a means of discussing these important issues. Once they received this information, comprehensive educational content about diabetes risk factors and complications from diabetes was offered via presentation from healthcare professionals personnel from the Canadian Diabetes Association, dieticians, and foot care specialists. These presentations outlined the importance of a proper diet and using exercise to reduce susceptibly to diabetes and its complications. They also stressed that vigilance is a key factor in staving off this disease and its complication. Participants of the Aboriginal Diabetes Education Project, 2009/2010 (AB DEP 2009/2010) also received various diabetes information materials from the Métis Nation of Ontario, the Canadian Diabetes Association, and Health Canada. Aboriginal Diabetes Education Project 2009/2010: Details. The AB DEP 2009/2010 included two phases. During Baseline sessions participants were offered a Basic Health Assessment height, weight, waist-to-hip measurement and Blood Pressure measurement and a scan using the ES TECK Complex. The latter is a Health Canada certified Class II and Class III medical device that offers data about Body Composition (Body Fat Mass, Fat Free Mass, Total Body Water), General Metabolic Functions related to Insulin Resistance and Digestive System Analysis pertaining to liver, gallbladder as well as pancreas conductivity. This information was coupled with specific diet and exercise recommendations. Follow-up sessions were held in January to track the progress of participants who may have embarked on lifestyle changes as a result of the information they received at the Baseline sessions in October/November.

3 3 Communities with a high concentration of Métis people were targeted. These included Bancroft, Chapleau, Cochrane, Dryden, Fort Frances, Kenora, North Bay, Midland, Ottawa, Sault Ste. Marie, Sudbury, Thunder Bay and Welland. Sessions at each site were divided into four two-hour periods accommodating a maximum of ten participants respectively. These two-hour blocks included five minutes dedicated to the Basic Health Assessment, five minutes for the ES TECK Complex scan, a seventy-five minute information session, and a thirty minute group meeting to discuss the results of the personal health assessments. A group meeting approach was employed to promote a discussion about lifestyle choices for wellness promotion. Aboriginal Diabetes Education Project 2009/2010: Presentation of Findings. The following report provides an overview of some of the statistical findings gathered from the Basic Health Assessment, ES TECK Complex Scan, Health and Lifestyle Survey completed by participants at the Baseline session, and the AB DEP 2009/10 Report Card filled out by those who attended a Follow-up session. The diet and lifestyle indicators presented from the Basic Health Assessment, ES Teck Complex Scan and Health Lifestyle Survey are relevant to risk factors for diabetes or complications from this disease. In order to protect the identity of participants, data is not presented in cases where there were fewer than five cases per category.

4 4 Aboriginal Diabetes Education Project 2009/2010: Participation. Baseline session: A total of 645 participants attended a Baseline session in October/November or January. This group included 393 Métis and 252 non-métis. Participants Métis non-métis Bancroft Chapleau Cochrane Dryden Fort Frances Kenora Midland North Bay Ottawa Sault Ste. Marie Sudbury Thunder Bay Timmins Welland Total Follow-up session: Of the 491 who attended a Baseline session in October/November, 277 returned for a Follow-up session held in January. This group included 195 Métis and 82 non-métis. Participants Métis non-métis Bancroft Chapleau Cochrane Dryden Fort Frances Kenora Midland North Bay Ottawa Sault Ste. Marie Sudbury Thunder Bay Timmins Welland Total

5 Aboriginal Diabetes Education Project 2009/2010: Findings from the Basic Health Assessment and ES TECK Complex scan conducted at Baseline sessions (393 Métis participants). Body Fat Mass: Your body fat percentage is simply the percentage of fat your body contains. A certain amount of fat is essential to bodily functions. An acceptable percentage of Body Fat Mass for women is 25-31% while the acceptable range for men is 18-25%. Below Bancroft Female (24) Male (7) Chapleau Female (17) Male (7) Cochrane Female (14) Male (2) Dryden Female (12) Male (4) Fort Frances Female (24) Male (9) Kenora Female (21) Male (7) Midland Female (39) Male (13) North Bay Female (14) Male (7) Ottawa Female (18) Male (8) Sault Ste. Marie Female (14) Male (5) Sudbury Female (13) Male (15) Thunder Bay Female (16) Male (13) Timmins Female (19) Male (13) Welland Female (27) Male (11)

6 6 Fat Free Mass: It is comprised of the non-fat components of the human body. It can refer to any body tissue that does not contain fat (skeletal muscle, bone and water). Below Bancroft Female (24) Male (7) Chapleau Female (17) Male (7) Cochrane Female (14) Male (2) Dryden Female (12) Male (4) Fort Frances Female (24) Male (9) Kenora Female (21) Male (7) Midland Female (39) Male (13) North Bay Female (14) Male (7) Ottawa Female (18) Male (8) Sault Ste. Marie Female (14) Male (5) Sudbury Female (13) Male (15) Thunder Bay Female (16) Male (13) Timmins Female (19) Male (13) Welland Female (27) Male (11) 9 2 0

7 Total Body Water: Includes the intracellular water and the extracellular water, the latter consisting of the interstitial or tissue fluid and the intravascular fluid or plasma. The extracellular fluids also contain the transcellular fluids that are formed by active transport processes and include saliva, cerebrospinal fluid, and the fluids of the eye and the secretory glands and so on. It may be ingested water or water produced by the body's metabolic processes (metabolic water). Below Bancroft Female (24) Male (7) Chapleau Female (17) Male (7) Cochrane Female (14) Male (2) Dryden Female (12) Male (4) Fort Frances Female (24) Male (9) Kenora Female (21) Male (7) Midland Female (39) Male (23) North Bay Female (14) Male (7) Ottawa Female (18) Male (8) Sault Ste. Marie Female (14) Male (5) Sudbury Female (13) Male (15) Thunder Bay Female (16) Male (13) Timmins Female (19) Male (13) Welland Female (27) Male (11)

8 General Metabolic Function Insulin Resistance: Insulin resistance is a condition in which the body produces insulin but does not use it properly. When people are insulin resistant, their muscle, fat, and liver cells do not respond properly to insulin. Insulin resistance increases the chance of developing type 2 diabetes. Excess weight and lack of physical activity also contribute to insulin resistance. Below Bancroft Female (24) Male (7) Chapleau Female (17) Male (7) Cochrane Female (14) Male (2) Dryden Female (12) Male (4) Fort Frances Female (24) Male (9) Kenora Female (21) Male (7) Midland Female (39) Male (13) North Bay Female (14) Male (7) Ottawa Female (18) Male (8) Sault Ste. Marie Female (14) Male (5) Sudbury Female (13) Male (15) Thunder Bay Female (16) Male (13) Timmins Female (19) Male (13) Welland Female (27) Male (11)

9 9 Digestive System Analysis Liver and Gallbladder Conductivity: The conductivity of the liver and gallbladder are measured by observing the ease of energy flow through the interstitial fluid. Should there be a toxic condition, the area will show signs of distress and should be addressed. One of the first areas to show signs of distress is that of the Liver / Gallbladder. Below Bancroft Female (24) Male (7) Chapleau Female (17) Male (7) Cochrane Female (14) Male (2) Dryden Female (12) Male (4) Fort Frances Female (24) Male (9) Kenora Female (21) Male (7) Midland Female (39) Male (13) North Bay Female (14) Male (7) Ottawa Female (18) Male (8) Sault Ste. Marie Female (14) Male (5) Sudbury Female (13) Male (15) Thunder Bay Female (16) Male (13) Timmins Female (19) Male (13) Welland Female (27) Male (11) 3 7 1

10 Digestive System Analysis Pancreas Conductivity: Interstitial fluids are measured to observe the conductivity at the cellular level of the sodium and microchondria of the cells in this organ. Low activity will indicate the possible misuse of insulin by the pancreas or in fact a very low count altogether and calls for further investigation. Below Bancroft Female (24) Male (7) Chapleau Female (17) Male (7) Cochrane Female (14) Male (2) Dryden Female (12) Male (2) Fort Frances Female (24) Male (9) Kenora Female (21) Male (7) Midland Female (39) Male (13) North Bay Female (14) Male (7) Ottawa Female (18) Male (8) Sault Ste. Marie Female (14) Male (5) 1 4 Sudbury Female (13) Male (15) Thunder Bay Female (16) Male (13) Timmins Female (19) Male (13) Welland Female (27) Male (11)

11 11 Aboriginal Diabetes Education Project 2009/2010: Comparison of indicators for the 395 Métis who attended a Baseline session and a Follow-up session. Body Fat Mass Below Baseline 2.57% 24.2% 73.2% Follow-Up 3% 24.1% 72.8% Fat Free Mass Below Baseline 69.6% 27.8% 2.6% Follow-Up 69% 28.2% 3% Total Body Water Below Baseline 52.6% 43.8% 3.6% Follow-Up 48.7% 47.7% 0% General Metabolic Function Insulin Resistance Below Baseline.5% 95.4% 4.1% Follow-Up 1% 90.3% 8.7% Digestive System Analysis Liver and Gallbladder Conductivity Below Baseline 16.9% 68.6% 14.4% Follow-Up 8.2% 59.5% 32.3% Digestive System Analysis Pancreas Conductivity Below Baseline 15.5% 76.2% 8.2% Follow-Up 11.3% 69.2% 19.5%

12 12 Aboriginal Diabetes Education Project 2009/2010: Health and Lifestyle Survey. Participants were asked during the Baseline session to complete a Health and Lifestyle survey about social determinants of health (education, labour activity, income, living conditions), lifestyle choices (including diet and exercise), health status and access to health services. 580 surveys were collected from the 645 people who attended an AB DEP 2009/2010 Baseline session. Of these 580 respondents, 64.1% (362) identified themselves as Métis. Below is a sample of some of the data gathered from these Métis respondents. Perceptions of Health Do you think you are Overweight Just Right Underweight Female 77.1% 21.1% 1.8% Male 68.3% 28.7% 3% In general, would you say your health is Excellent Very Good Good Fair Poor Female.9% 14% 39.4% 33% 12.7% Male 2.8% 9.3% 45.8% 31.8% 10.3% Self-Reported Diabetes Is there a history of diabetes in your family? Yes No Female 74.8% 25.2% Male 62.1% 37.9% Have you been told be a doctor, nurse or other health professional that you have diabetes? Yes No Female 25.6% 74.4% Male 26.2% 73.8% Have you been told by a doctor, nurse or other health professional that you are prediabetic or borderline diabetic? Yes No Female 22.5% 77.5% Male 19.6% 80.4%

13 13 Activity In a typical week, how many times do you do any physical activity outside of work resulting in an increase in your heart rate and breathing? 1 to 3 times 4 to 7 times 8 to 10 times More than 10 times Female 71.6% 20.1% 4.1% 4.1% Male 62.2% 24.5% 7.1% 6.1% In a typical week, how much time do you spend doing physical activities outside of work that results in an increase in your heart rate and breathing? None 1 to 2 Hours 3 to 4 Hours 5 to 6 Hours 7 to 10 Hours 11 or more Hours Female 25.9% 42.5% 15.1% 9% 5.2% 2.4% Male 21.6% 43.1% 13.7% 12.7% 1.% 7.8% Diet Last week, how many days did you consume the following foods and beverages? Never 1 or 2 days 3 or 4 days 5 or 6 days Every Day Milk 12.8% 21.9% 13.7% 8.2% 43.5% Cheese and other milk products 4% 30.3% 18.3% 12.4% 35% Eggs 10.7% 54.6% 18.1% 12% 4.6% 100% fruit juices 21% 30.3% 14.3% 9.6% 24.8% Fruit 8.3% 26.4% 20.7% 11.1% 33.4% Green Salad 11.1% 37.8% 27.4% 13.8% 9.8% Potatoes 6.2% 38.5% 31.1% 14.2% 10.2% Other vegetables 3% 22.8% 26.3% 20.4% 27.5% Bread 3.3% 17.3% 19.4% 17.6% 42.4% Processed meat 34.3% 42.8% 10.8% 7.8% 4.2% Store bought meat 2.4% 24.6% 25.8% 26.1% 21% Fish and Seafood 22.9% 53.3% 13% 9.5% 1.3%

14 On average, how often do you eat or drink the following foods? Never/Hardly ever Less than once a A few times a Soft drinks or pop 14 Once a Several day times a day week week 37.2% 16.4% 19.5% 16.7% 10.2% Fast food 35.3% 44.2% 17.5% 1.8% 1.2% Cakes, pies, candy, chocolate French fries, potato chips, pretzels 20.1% 32.3% 34.1% 9.0% 4.5% 26.6% 37.3% 28.1% 5.2% 2.8% Added salt 41.9% 12.1% 17.7% 17.7% 10.6% Added sugar 48.3% 8.6% 11.4% 14.2% 17.5% In the past 12 months, how often have you eaten the following traditional foods? Not at all A few times Often Land based animals 47.6% 36.3% 16.1% Fresh water fish 23.3% 50.2% 26.6% Game birds 67.4% 26.4% 6.2% Small game 84.1% 12.8% 3.1% Berries or other wild vegetation 27% 45.6% 27.4% Bannock or fry bread 58% 37.5% 4.4%

15 15 Aboriginal Diabetes Education Project 2009/2010: Participant Satisfaction. Participants who returned for a Follow-up session in January were asked to complete an AB DEP 2009/10 Report Card survey. This questionnaire sought to ascertain how the information they received at the AB DEP 2009/10 affected them. It also allowed us to gather feedback on this initiative as a means of determining satisfaction. 267 surveys were collected from the 277 people who attended a Follow-up session in January. Of these 267 respondents, 71.7% (190) identified as Métis. Below is a sample of some of the data gathered from these Métis respondents. Basic Health Assessment Receiving a Basic Health Assessment (height, weight, waist-to-hip ratio and Blood Pressure) was a useful component of the MNO s Aboriginal Diabetes Education Project 2009/2010? Strongly Agree 78% Moderately Agree 19.9% Mildly Agree 2.2% Mildly Disagree 0% Moderately Disagree 0% Strongly Disagree 0% The link between my Basic Health Assessment results and diabetes risk factors and/or complications from diabetes was clear. Strongly Agree 62.9% Moderately Agree 34.4% Mildly Agree 2.7% Mildly Disagree 0% Moderately Disagree 0% Strongly Disagree 0%

16 Future Follow-Up visits tracking my Basic Health Assessment (height, weight, waist-tohip ratio, and Blood Pressure) would help me avoid diabetes risk factors and/or complications from diabetes. Strongly Agree 77.2% Moderately Agree 19.6% Mildly Agree 3.3% Mildly Disagree 0% Moderately Disagree 0% Strongly Disagree 0% 16 ES TECK Complex scan Undertaking the ES TECK Complex scan was a useful component of the MNO s Aboriginal Diabetes Education Project 2009/10. Strongly Agree 79.3% Moderately Agree 17.4% Mildly Agree 2.7% Mildly Disagree 0% Moderately Disagree 0% Strongly Disagree 0% The link between my ES TECK Complex scan results and diabetes risk factors and/or complications from diabetes was clear. Strongly Agree 69% Moderately Agree 24.5% Mildly Agree 6% Mildly Disagree 0% Moderately Disagree 0% Strongly Disagree 0%

17 17 Future Follow-Up visits tracking my ES TECK Complex scan results would help me avoid diabetes risk factors and/or complications from diabetes. Strongly Agree 75.3% Moderately Agree 19.9% Mildly Agree 4.8% Mildly Disagree 0% Moderately Disagree 0% Strongly Disagree 0% Lifestyle Changes Did you make any changes in the following categories as a result of the diabetes information, Basic Health Assessment, and ES TECK Complex scan provided at the MNO "Aboriginal Diabetes Education Project 2009/10" session? Dietary 59.9% Physical Activity 63.6% Use of supplements 27.8% No changes 11.8% Broadcast Did you speak to family and/or friends about diabetes risk factors and/or complications from diabetes as a result of the MNO s Aboriginal Diabetes Education Project 2009/10 session? Yes 80.7% No 19.3%

18 18 Aboriginal Diabetes Education Project 2009/2010: Conclusions. The Métis Nation of Ontario is pleased to report that the AB DEP 2009/2010 was met with overwhelming enthusiasm and embraced by the Métis community. The goal for the Baseline sessions was originally set at 500 participants. This target was surpassed as 645 people took part. Participant satisfaction is evident as over 50% of those who attended a Baseline session returned in January for a Follow-up session. This is especially remarkable when considering that scheduling restrictions did not allow us to provide a choice of dates for those who were interested in attending a Follow-up session. Participants noted in the AB DEP 2009/2010 Report Card survey that using personal health information as part of this initiative was quite beneficial. For example, 78% answered strongly agree when asked if the Basic Health Assessment was a useful component of the sessions. The ES TECK Complex scan surpassed this mark at 79.3%. Similarly, participants who answered a survey at a Follow-up session noted emphatically that both components would be beneficial in helping them avoid diabetes risk factors and/or complications from diabetes. While 77.2% strongly agreed that the Basic Health Assessment was a useful component, 75.3% thought the same of the ES TECK Complex scan. Feedback from the AB DEP 2009/2010 Report Card survey also offers a glimpse about the effectiveness of this Project. For instance, nearly 90% reported having changed either their diet, level of physical activity, or supplement use as a result of the information they received at their Baseline session. We were pleased that over 80% stated that they had shared the information they learned at their Baseline session with someone. As the previous content shows, the MNO s AB DEP 2009/2010 met with all the signposts of a successful initiative as expected participation rates were surpassed while the approach was well received by the participants leading to tangible attitudinal changes. As a consequence, we are convinced that the AB DEP 2009/2010 effectively met its mandate at educating the Métis about the risk factors for diabetes and diabetes complications.