Diabetes risk evaluation and microalbuminuria (DREAM) studies: ten years of participatory research with a First Nation's home and community model for type 2 diabetes care in Northern Saskatchewan.
OBJECTIVE
To review the DREAM studies and the role of participatory research using a Home and Community Care model in treating First Nations diabetes.


METHODS
Population survey, pilot and prospective randomized trial


METHODS
Review documented history of these studies since inception. Collation of all data from the DREAM studies from 1998 to the present, including interviews with all providers and many of the participants.


RESULTS
The DREAM studies were a participatory process providing a needs assessment and became the foundation for this First Nation's Home and Community Care team involvement in providing community-based chronic-disease management. The findings motivated the community to find a process that would lead to needed changes. This participatory research enabled a culturally tailored algorithm of evidence-based management of hypertension and disease management strategies for people with diabetes. These studies demonstrated that in this community the Home and Community Care team could work together with primary care physicians and specialists to prevent the complications of diabetes.


CONCLUSIONS
The DREAM studies demonstrated in the first controlled trial that with participatory research a systems change is possible; a chronic-disease management model utilizing a trained multidisciplinary Home and Community Care team and informed patients can lead to lower blood pressure in a Canadian First Nations population with diabetes.
Pylypchuk
George
G
Sunnybrook Health Science Centre, Toronto, Ontario, Canada.
Vincent
Lloyd
L
Wentworth
Joan
J
Kiss
Alexander
A
Perkins
Nancy
N
Hartman
Susan
S
Ironstand
Laurie
L
Hoppe
Jacqueline
J
Tobe
Sheldon W
SW