An environmental scan is research method that broadly investigates all the factors that can affect outcomes for a health issue.
An environmental scan was conducted across Sioux Lookout Area regarding the state of diabetes and healthcare delivery. Data was collected between June 2015 and June 2016, via surveys and interviews, and 111 participants, including patients, providers, and community leaders throughout the Sioux Lookout Area. The aim was to get a snapshot of the current state of diabetes care in Sioux Lookout Area from different sources and perspectives, particularly of patients.
The environmental scan was in direct response to Chief’s Resolution #13-07, Community-Based Diabetes Strategy and Programming.
Interviews were conducted with 22 patients living with Type 2 Diabetes, 19 health care service providers and 10 community leaders. Two standard, globally-used surveys were also completed by patients: the Diabetes Distress Scale (to measure emotional stress associated with having diabetes) and the Assessment of Care for Chronic Conditions (to assess current levels of care received by those with any chronic disease). A customized Health Care Experience survey, adapted from the CAHPS American Indian Survey and the first of its kind to be used in the Sioux Lookout Area, explored patient experience with the healthcare system, including but not limited to access to care and patient-provider dynamics.
There was a perceived fragmentation and lack of integration of diabetes care at community and regional levels. Patients want more in-person supports and resources closer to their homes.
CHWs were regarded as the most appropriate providers to bridge the gap between the clinic and the community. One of the greatest perceived strengths of the CHWs, from the perspective of community leaders, was that CHWs are accountable to the community, are integrated, culturally aware, and speak traditional languages. However, participants felt CHWs were underutilized, under trained and under supported, but there was potential to build capacity amongst CHWs and for CHWs to assist clients in the community with diabetes. Most of the reported work done by the CHWs (regardless of title), was aimed at individuals, although there was an emerging theme that CHWs should have more of a presence in the community.
The detailed final report will be made available in Spring 2017.