1. Community Facilitator Introduction to FORGE AHEAD
FORGE AHEAD Program:
Community Facilitator
Remote Training
Module 1:
Introduction to FORGE AHEAD

2. Why is FORGE AHEAD Important?

3. Diabetes and Indigenous Peoples
There are more people with diabetes in First Nations communities compared to the rest of Canada
First Nations people get diabetes at a younger age
Studies have reported higher rates of diabetes complications (amputation, blindness, kidney disease)
Death due to type 2 diabetes is higher for First Nations peoples compared to the general population

4. Factors Influencing Health
Reasons why Indigenous peoples may suffer from poor health:
Historical, political and psycho-social factors
Higher unemployment rates, poor living conditions, less education
Unhealthy foods and not enough exercise
Heredity (children get the same diseases as their parents)
Quality of healthcare (example: high staff turnover)

5. Healthcare in the Community
There could be more communication between the doctors, nurses, diabetes educators, homecare workers, and community program leaders to provide better care for people with diabetes
This way everyone understands what the patient needs and they can work together to provide the best care

6. The FORGE AHEAD Research Program

7. FORGE AHEAD: Our Team
Strong team with different experiences and expertise:
First Nations community representatives
Indigenous and non-Indigenous healthcare providers
Clinician scientists
Academic researchers reflecting a wide variety of disciplines from across Canada
Assembly of First Nations (AFN)
First Nations and Inuit Health Branch (FNIHB) of Health Canada
Canadian Diabetes Association
Heart & Stroke Foundation
Wave 1 Communities

8. Main Goal of FORGE AHEAD
To work with community healthcare providers and community members to improve the way care is being provided to people with diabetes

9. Main Goal of FORGE AHEAD
The research team will work with communities in a respectful way to:
make sure changes reflect the culture and needs of the community, and
make sure the community can make decisions about why, how and by whom information is collected, used or shared (as described by the OCAP principles which were developed by First Nations peoples – more information at

10. Principles
Communities will hold joint decision-making power in planning
Communities will assert ownership over all aspects of data collected manage and make decisions regarding access to their data
Communities will share control over the data and its current and future use
Communities and FORGE AHEAD will have possession of data
Note: For the community profile survey (Project #1), which is national scope and different from the rest of the projects in FORGE AHEAD, the FORGE AHEAD team will work with regional First Nations organizations to ensure compliance with OCAP principles (see Project #1 Questions and Answers
Communities will select one representative for the FORGE AHEAD Advisory Board to provide overall guidance for the research program related to cultural knowledge, data and information, as well as research and information management processes that impact First Nation Peoples;
Communities will select one representative for the FORGE AHEAD Steering Committee to be involved in all aspects of the research with joint decision-making power in the overall planning of interventions, data collection, data interpretation, and dissemination of results;
Communities will select one representative for each of the Working Groups (Participatory Research; Knowledge Translation and Policy Relevance; Methods and Analysis; Mentoring and Training; and Readiness Consultations) to be involved in all aspects of the research with joint decision-making power in the development of project specific materials, data collection, data interpretation, and dissemination of results. Because there are multiple working groups, the representative on each group can be a different person.
Communities will be encouraged to establish a local Community Advisory Board (CAB) that will be responsible for facilitating on-going community engagement, making community-level decisions on things such as access to medical records and participation in specific projects. Also, the CABs will ensure that community and Indigenous values, culture and practices are respected; help to identify, prevent and resolve problems that may arise; and guide implementation and knowledge translation to meet community needs;
Communities will develop a community research agreement with the research team that articulates the details about how ownership, access and possession and control will occur.
Communities will assert ownership over all aspects of data collected from their individual community. Individual community data are strictly confidential and will not be shared with other communities or agencies. Individual communities and the principal investigator will share control over the data and its current and future uses.
First Nations communities will manage and make decisions regarding access to their collective information. Access to the data will be limited to the principal investigator and approved members of the community (as per the recommendations of the established CAB) and research staff members at Western University who have a legitimate reason to do so in order to accomplish the program’s goals. Possession of individual community data will remain with the FORGE AHEAD research team and co-possession plans will be developed, and;
Communities will determine dissemination and implementation strategies within their own stakeholder groups and to a broader audience. Project implementation and results will be continually shared with all key stakeholders through community gatherings, presentations to Chief and Councils and at Steering Committee meetings. Knowledge translation plans will be developed in collaboration with each community through CABs and across communities to evaluate barriers, optimize facilitators, knowledge sharing and
discussion.

11. Community Participation
Each community will have a number of people and teams that are part of the FA program.
These include:
Community Advisory Board
Community Key Contact
Community Facilitator
Community Data Coordinator
Clinical Team
Community team

12. Community Facilitator
The role of the Community facilitator is to work with the community team and the clinical team to implement ways for improving care for peoples with diabetes
The Community Facilitator will guide, lead, and help the teams as they work to improve care for peoples with diabetes

13. Program Activities
There will be 2 teams of people participating in the program, one is a community team and the other is a clinical team.
The teams will complete questionnaires and participate in workshops to:
identify the community or clinic needs, strengths and challenges
find new ways to care for people with diabetes
The next step is for each team to then implement new ways to care for people with diabetes in the community and clinic

14. Community Team
The community team will work to improve awareness of diabetes and healthy lifestyles in the community
The community team will have 3-5 people, including:
Elders
People with diabetes
Community leaders
People working in community diabetes programs

15. Clinical Team
The clinical team will work together to improve the care of community members with type 2 diabetes
The clinical team will have 3-5 people, including:
Nurses
Family physicians
Community health representatives
Administrative staff

16. Program Activities Timeline
Months
Months
Workshop #1
Action period #1
Workshop #2
Workshop #3
Action Period #2
Action period #3
Months
Wrap-up Activities:
Readiness Questionnaire
Interviews
Complete Readiness questionnaire

17. Program Activities Readiness Questionnaires
The community team and clinical team will answer a questionnaire to assess readiness. The results can help the team to plan improvements to care for peoples with diabetes
Workshops
Each team will attend workshops that will help guide them through the FORGE AHEAD program

18. Program Activities Action Periods
Each team will work in their community or clinic to make improvements to care for peoples with diabetes
Wrap-Up Activities
Each team, and the community facilitator, will be involved in questionnaires and discussions on how the FORGE AHEAD program went

19. For More Information Website:
The National Diabetes Management Strategy
Facebook:
Program Coordinator:
Mariam Naqshbandi Hayward, Mariam.Naqshbandi-
General Inquiries:
Telephone (toll free):
Fax (toll free):