Co-Leads: Alex Otsehtokon McComber (Kanien’kehá:ka), Jon McGavock
Co-Investigators: Caroline Chartrand, Barry Lavallee, Nancy Young, Mary Jo Wabano, Marie-Claude Tremblay
Project Manager: Pusha Sadi
Rippling out the Aboriginal Youth Mentorship Program (AYMP) to the Inner-City
Not too long ago all it was almost unheard of for a child to develop what has traditionally been an adult onset condition, that of T2D. Yet T2D is the fastest growing pediatric chronic condition, with Indigenous populations among the most affected. In Canada, nearly half of new cases of T2D reported in endocrinology clinics are among Aboriginal youths and this trend is expected to continue unless changes in lifestyles and environments are achieved. Indigenous and Aboriginal health strategies are a top priority of federal and provincial policy makers, as Canadian agencies seek to address concerns articulated in the Truth and Reconciliation Commission of Canada: Calls to Action. Many programs exist to engage youths in activities that promote healthy lifestyles, however not all are suited to the unique needs and traditions of Indigenous Peoples. This is what inspired the development of the Aboriginal Youth Mentorship Program (AYMP). This resilience-based approach to wellness was co-developed with Indigenous youth and leaders in Winnipeg and northern Manitoba along with a group of researchers and community members, currently under the direction of Dr. Jon McGavock from the University of Manitoba. Delivered by Indigenous adolescents for Indigenous children in their communities, the AYMP builds on the strengths of its participants and helps to create healthy inclusive communities. It is guided by an Indigenous medicine wheel concept of health called the Circle of Courage from Lakota scholar Dr. Martin Brokenleg and consists of four elements; belonging, independence, mastery and generosity. The program includes after-school peer-led physical activities, healthy snacks, games, and education and leadership activities for elementary school-aged students. Each community has the opportunity to tailor components of the program to meet its own unique needs, teachings and cultural values.
The AYMP is currently offered in twelve Indigenous communities across Canada. Initial results have shown that children and youths that participated in the program experience increased self-esteem, reduced weight gain and healthier dietary choices, compared to those not in the program. Initial evaluation of the program indicated up to a 12% reduction in the incidence of T2D. Given this success, it is the mission of both Diabetes Action Canada and AYMP to ripple out this program more broadly in Indigenous and First Nations communities. With the help of philanthropic donors, Diabetes Canada and Manulife Financial, we are one-step closer to accomplishing this goal. With the funding received by these partners ($200,000) we have opened another AYMP site at the First Nations School in Toronto – the first inner-city urban site. Once the effectiveness of this program is evaluated we plan to open additional sites in Northern Ontario in 2018-19. As we plan for the future of AYMP we must consider the challenge of oversight and capacity, as this program is led by part-time youth leaders and volunteers. To sustain this program, the mentorship opportunities and experience of empowerment must continue and resources must be planned accordingly to deliver this program in a manner that encourages continued involvement of its participants and evaluation of outcomes.
Prevention of diabetes and its complications in Indigenous populations is a serious health concern and top priority for our governments and health care systems. The unique AYMP relationship-based mentorship approach that encourages culturally sensitive healthy living among children and youth to prevent T2D has meaningful impact related to the Quadruple Aim indicators and addresses a top priority to promote Indigenous health in Canada. Diabetes Action Canada will continue to work with partners to ripple out this successful program to ensure the Indigenous and Aboriginal Youths are exposed to opportunities to establish health lifestyles that will prevent diabetes.
Indigenous medicine wheel concept of health called the Circle of Courage. This model of positive youth development was first described in the book Reclaiming Youth at Risk, co-authored by Larry Brendtro, Martin Brokenleg, and Steve Van Bockern. The model integrates Native American philosophies of child-rearing, the heritage of early pioneers in education and youth work, and contemporary resilience research. The Circle of Courage is based in four universal growth needs of all children: belonging, mastery, independence, and generosity.
Our Indigenous Peoples Patient Circle co-develops a respectful engagement approach to patient-oriented research
In collaboration with Can-SOLVE CKD (SPOR Chronic Disease Network in Chronic Kidney Disease) and their Indigenous Patient Engagement and Research Council, our Indigenous Peoples Patient Circle members are creating a new training platform to enable respectful partnerships with Indigenous People in Research. This learning pathway, named Wabishki Bizhiko Skaanj (wah-bish-kih biish-ih-goo skaa-nch) aims to enhance the Indigenous perspective and support partnerships that consider existing racial biases, Indigenous voices and stories, the impact of colonization on Indigenous health, and culturally safe health research practices. This learning pathway will ultimately change the way that researchers approach and engage members of the Indigenous Community and it is expected to be adopted by Canadian Institutes of Health Research (CIHR) to augment the existing Patient Engagement curriculum.
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