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  • What We've Learned
The use of Case Managers for arthritis care in First Nations communities
Everyday-Living-3.0-1-1
Scientific Study Title:
Case Managers to Improve wellness in First Nations people who have Arthritis and other chronic conditions – Haida Gwaii and Siksika
Start Date:
  • 2015
End Date:
  • 2018
Research Category
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Why did we do this research?

  • C ompared to other populations within Canada, Indigenous communities have more people living with chronic diseases, including inflammatory diseases. 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 relevancy or are not consistent with their cultural values. The objective of our research is to study a new model of care for First Nations people living with arthritis as well as other chronic conditions, using a Case Manager residing in their community. This study will assess how well the Case Manager model of care meets people’s needs, impacts care and supports peoples’ health behaviours.
  • Chronic conditions that will be looked at in this study include: inflammatory diseases,diabetes, obesity, hypertension, cardiovascular diseases, chronic obstructive pulmonary disease (COPD i.e. chronic lung disease), and osteoporosis.
  • We think the Case Manager model of care will:
  • improve the use of available health care services by First Nations people who are living with both arthritis and another chronic condition;
  • improve culturally-relevant patient-centered care plans;
  • help patients follow care plans developed with the case manager;
  • promote health behavioural and lifestyle changes.
  • Our research will create new knowledge by evaluating how well the Case Manager approach improves the health care experience and health behaviors of people with arthritis and other chronic conditions. An important aspect of our research is that we will assess whether this model of care meets patients’ expectations of culturally relevant care. By improving the management of arthritis and other chronic conditions associated with arthritis, our research has the potential to improve health outcomes, and also to generally improve the quality of life of First Nations people living with arthritis.

What did we find?

This Case Manager project is being developed with community engagement input to see how the Case Manager model of care can be relevant in their community (Phase 1), and will be pilot tested by introducing a Case Manager in Old Massett, Haida Gwaii, BC and Siksika, Alberta (Phase 2).

Phase 1: Community engagement to design the Case Manager model. Building on our current ties with people in Old Massett and Siksika, we engaged health service providers, administration, Band Council members, and people living with arthritis in various meetings to:

  • Identify community needs and desires;
  • Finalize case manager responsibilities and logistics;
  • Explore how to integrate the Case Manager role with existing health services.
  • Phase 2 : Pilot Study. Using a mixed-methods design, we will see how well the Case Manager model of care works for First Nations people who have both arthritis and one or more chronic conditions.

The Research Team

Principal Investigator

  • Diane Lacaille, MDCM, MHSc, FRCPC, Scientific Director, Arthritis Research Canada (University of British Columbia)

Co-investigators

  • Cheryl Barnabe, MD, MSc, FRCPC, Senior Scientist, Rheumatology, Arthritis Research Canada (University of Calgary)
  • Adalberto Loyola-Sanchez, MD, MSc, PhD, Postdoctoral Scholar, Cummings School of Medicine, (University of Calgary)
  • Helen Brown, BSN MSN PhD, Associate Professor, Nursing, (University of British Columbia)
  • Linda Li, BSc(PT), MSc, PhD, FCAHS, Senior Scientist, Implementation Science, Arthritis Research Canada (University of British Columbia); Lynden (Lindsay) F.J. Crowshoe, MD, Associate Professor, Department of Family Medicine, Cumming School of Medicine (CSM), (University of Calgary).

Research Staff

  • June Kaminski, RN MSN PhD(c), Research Coordinator, Arthritis Research Canada
  • Tessa Kleissen, RN BSN CCRP, Research Coordinator, Cumming School of Medicine, Rheumatology, (University of Calgary)
  • Valene Bear Chief, Arthritis Liaison, Siksika

Collaborators

  • Monica Brown, Health Director, Haida Health Centre
  • Old Massett
  • May Russ, Band Council Member and Health Committee member, Old Massett Village Council

Who Funded This Research?

This program is funded by the Canadian Institutes of Health Research (CIHR), with partner funding from the Canadian Rheumatology Association and the Arthritis Society, BC/Yukon Division.

How Can People Get Involved?

  • Twenty-five participants will be recruited based on the expected case load for a full-time Case Manager. Selection criteria include:
  • age 19 years or older,
  • living on-reserve,
  • having arthritis, systemic autoimmune rheumatic deseases (SARDs) or psoriasis and at least one of the following conditions: diabetes, obesity, hypertension, cardiovascular diseases, COPD, or osteoporosis, diagnosed by a health professional.

Participants will be recruited through health centre staff and community advertisements in Haida Gwaii and Siksika.

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