Project Overview: Type 2 diabetes (T2D) is a chronic disease that significantly impacts communities worldwide, with specific communities experiencing disproportionate effects. The persistence of T2D risk across generations can be attributed to multi-level health determinants, including lifestyle, race and ethnicity, genetics, and broader socio-economic factors, such as access to care, racism and systemic discrimination. Research indicates that individuals from Black, African and Caribbean (BAC) communities face a higher risk of T2D than White individuals, along with higher prevalence rates and greater complications, such as end-stage kidney disease, retinopathy, and cardiovascular diseases.
Project Goal: The goal of this 3-year project is to co-design culturally sensitive T2D prevention interventions by centering the experiences and voices of BAC family caregivers (i.e., those who provide direct, ongoing and unpaid care for family members, broadly defined) in Peel region through a community-based participatory research (CBPR) approach.
Objectives: The specific objectives include: 1) Mapping the existing evidence on community-based and family-focused T2D prevention interventions for BAC communities; 2) Gathering the experiences and knowledge of factors influencing T2D-related health behaviours among BAC family caregivers in the Peel Region to identify community-based and family-focused T2D prevention interventions; 3) Engage BAC caregivers, service providers, researchers, and clinicians in knowledge exchange activities to generate ideas and co-design community-based and family-focused and culturally sensitive interventions for T2D prevention for BAC communities; 4) Conduct a multi-stage process evaluation to explore the impacts and relevance of the study research activities for BAC caregivers, community research partners and peer research assistants.
Methodology: Using a CBPR approach, study activities will take place over two phases. Phase 1 involves the following three activities: 1) Establishing a Community Advisory Board (CAB) to engage BAC-identifying caregivers, service providers, researchers, and community partners to guide all project activities; 2) Conducting a Scoping Review of community-based and family-focused interventions to prevent T2D in BAC communities, and; 3) Photovoice Workshops to provide opportunities for BAC participants to use photography to document and reflect on their experiences related to T2D prevention. Phase 2 involves three additional activities: 1) Community Knowledge Exchange & Priority-Setting event with BAC community members, clinicians, researchers, and community partners to exchange knowledge and prioritize actions for T2D prevention; Co-design Workshops to co-design T2D interventions and ideas for feasibility trials with outcomes relevant to BAC families, and; 3) End-of-grant activities including disseminating findings across local and regional networks, media and public events and co-authoring a community report and peer-reviewed manuscript.
Significance: The project is an opportunity to prioritize and co-design meaningful community-based and family-focused interventions for T2D to support the wellness of BAC families. Findings will support ongoing advocacy and activism to create more equitable and inclusive approaches to T2D prevention. The co-designed interventions can be tested in future feasibility trials and adapted to other jurisdictions in Ontario and across Canada. By the project’s end, we will have identified and prioritized intervention opportunities that can support the health and wellness of BAC families nationwide.
