Closing the Indigenous Health Gap in Canada: Results from the TransFORmation of IndiGEnous PrimAry HEAlthcare Delivery (FORGE AHEAD) Program

Abstract Aims TransFORmation of IndiGEnous PrimAry HEAlthcare Delivery (FORGE AHEAD) partnered with local clinical and community teams in 11 First Nations (FN) communities across Canada to develop quality improvement (QI) initiatives aimed at improving T2DM. Methods Pre-post mixed-methods case study design was used. The 18-month intervention included community and clinical readiness, development of a community diabetes registry and clinical system, and QI activities. Participants consisted of community members, 18 yrs and older, with diabetes. Changes in clinical outcomes and clinical practice guideline (CPG) recommendations were assessed pre and post intervention using multilevel regression (patients nested within communities) adjusted for individual and community baseline characteristics. Results No significant change in HbA1c or sBP, but a small reduction in dBP (-0.75mmHg, p Conclusions FORGE AHEAD is the first Canadian study to demonstrate that a FN community-led QI intervention can lead to diabetes improvements.