Preventing Complications in an Indigenous Community: Improving Quality of Care


*Please note: This study is no longer recruiting participants.* precision_logo


A sub study of PRECISION: Preventing Complications from Inflammatory Skin, Joint and Bowel Conditions


Project Leads: Diane Lacaille MD, MHSc, FRCPC. Professor, Division of Rheumatology, Department of Medicine, University of British Columbia Cheryl Barnabe MD, MSc, FRCPC. Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary


For a list team members involved in this study click here.


Study Start Date: 2015 Study End Date: 2020  


Why do this research?

Indigenous communities have more people living with chronic diseases, including inflammatory diseases, compared to other populations within Canada. They also have poorer health, shorter life expectancy, and more difficulty accessing health care services. Indigenous people report feeling powerless during health care appointments that lack cultural safety or are not consistent with cultural values. In this sub-project of the PRECISION study, we will evaluate:

  1. If the use of a nurse case manager in a First Nations community can help to carry out care that is appropriate, respectful, and culturally relevant to improve care for individuals living with multiple chronic diseases, including inflammatory diseases.

These changes are predicted to help individuals follow health recommendations and promote lifestyle changes which prevent complications of inflammatory skin, joint, and bowel diseases.  


What will be done?

The role of nurse case manager is being designed in collaboration with the health committee, band council, health centre administration, and community members from the First Nations community of Old Massett on the island of Haidi Gwaii in British Columbia. A case manager will also be hired in the Siksika Nation community in Alberta, based on 26 in-depth interviews conducted to stakeholders and patients living with arthritis and other chronic diseases. After the nurse case manager role is established and the case managers are hired, patients will evaluate the quality of their health care experience with the nurse case manager. Some of the participants will also complete interviews to reflect the impact of this project on their experience with health care, behaviours, lifestyle, and well-being.  


Who is involved?

Twenty-five participants aged 19 years or older, living on reserve, with arthritis, SARDs, or psoriasis and at least one other chronic disease (diabetes, obesity, or CVD), will be recruited through health care staff and community advertisements. Throughout the project, our team will work closely with the people of Old Masset and Siksika Nation to ensure the program meets the community’s needs and is sustainable. The Old Masset community has worked with members of the PRECISION team before to conduct arthritis research, and have long shown a desire for this project.  


Who is funding this research?

  • Canadian Institute for Health Research
  • Crohn’s and Colitis Canada
  • Canadian Initiative for Outcomes in Rheumatology cAre (CIORA)
  • The Arthritis Society