Co-Principal Investigators: Ploeg, J., Markle-Reid, M., Valaitis, R.

Principal Applicants: Dicerni, P., Fisher, K., Ganann, R., Graham, P., Gruneir, A., Johnson, B., Légaré, F., Mansell, L., Montelpare, W., Reid, P., Tang, F., Upshur, R.

Co-Applicants: Ben Charif, A., Blais, J., Eurich, D., Gafni, A., Lewis, G., MacCallum, L., MacIntyre, J., Paquette, J-S., Pritchard, J., Riveroll, A., Sadowski, C., Sherifali, D., Thabane, L., & Williamson, T.

Project Coordinator: Tracey Chambers


The Aging, Community and Health Research Unit has recently been funded by CIHR SPOR PIHCI Network Grant and Diabetes Action Canada for a multi-site site study entitled, “ACHRU Community Partnership Program for Diabetes Self-Management for Older Adults – Canada”.


  • Background: The Aging, Community and Health Research Unit (ACHRU) Diabetes Community Partnership Program (Diabetes-CPP) is a 6-month self-management intervention for older adults with diabetes and other chronic conditions and their family/friend caregivers designed to improve Quadruple Aim outcomes: 1) population health, 2) patient/caregiver experience, 3) provider experience, and 4) cost. The research program builds on evidence of Diabetes-CPP feasibility and effectiveness from our prior work and is designed with scale-up in mind.
  • Study Aim: To test the Diabetes-CPP in diverse primary care and community settings, with diverse populations and across jurisdictions, and plan for scale-up.
  • Study Design: A multi-site, pragmatic, randomized controlled trial with equal emphasis on examination of implementation and effectiveness of the Diabetes-CPP.
  • Settings: The Diabetes-CPP will be implemented in primary care settings or diabetes education centres in Ontario, Quebec and Prince Edward Island (2 sites per province, 6 sites in total), in partnership with community partners (e.g., YMCA, seniors centres).
  • Timeline: The intervention period will be April, 2019 to May, 2020 (13 months).
  • Community Advisory Boards: Each site will have a Community Advisory Board including patients and caregivers, community representatives (e.g., providers, managers, policy makers) to help support the study.


Potential benefits

  • Positioning sites and staff as leaders in scaling up an evidence-based, innovative, and integrated model of care.
  • Enhancing health outcomes of older adults with diabetes and multiple chronic conditions across Canada.
  • Fostering new partnerships within the primary health care team, as well as across sites in the region, community health and social services in the region, and with the local community partner to support the care of community-living older adults.