Project 449118

Diabetes is a common chronic disease affecting 10% of people worldwide, and its rate is increasing. Diabetes in pregnancy is an important risk factor for type 2 diabetes (T2D) in women and their offspring. First Nations (FN) people have a higher risk for diabetes in pregnancy and in youths compared to non-FN population, especially for FN people live in rural areas. Our recent study demonstrated that a community-driven remote prenatal education improved participation in the prenatal program and breastfeeding in FN women in rural or remote communities, but the outcome was affected by the availability of high-speed Wi-Fi service and postpartum supports. We propose to develop a new type of multi-format prenatal education in partnership with the regional health authority of remote communities by providing pre-delivery prenatal in person or online when pregnant women come to the city waiting for labor, and an improved radio/TV broadcasting for prenatal education to help pregnant women without mobile device or living in communities without optimal Wi-Fi service. Culturally safe education and eco-friendly activities will be organized for pregnant women in rural or remote communities by FN Elders and community assistants. Postpartum support teams will be established or expanded to provide home visits to participants to promote breastfeeding. The impact of program improvement on participation, diabetes and breastfeeding will be compared to historical records in the communities. Our team is composed of Indigenous Principal Applicants, Elders, Knowledge Users, community collaborators and multidisciplinary researchers with experience in Indigenous research. The project will be conducted following the guidelines for Indigenous health research. The proposed studies will reduce inequity in prenatal education and the risk for T2D in women and children in remote or rural FN communities. The outcome can be scaled up to other Indigenous communities for diabetes prevention in Canada.