Kahnawake Schools Diabetes Prevention Project 1994 - present

2. Kahnawake Schools Diabetes Prevention Project (KSDPP) Getting started Creating and maintaining a partnership Facilitators and barriers Successes Partnership evaluation

11. Interface with University Ethics Boards Proposed research first reviewed by Community Advisory Board (CAB) CAB gives ethics approval certificate Researcher includes certificate and KSDPP Code of Research Ethics with university application

12. School and Community Interventions Schools Health Education Program Grades 1- 6 developed by community delivered by teachers Mohawk and English Teachers extra activities Parent events Schools Nutrition Policy bans �junk food� evolves into �wellness policy� Community Community wide events for extended families - opportunities for healthy eating, increased physical activity Links body-mind-spirit Building on community strengths and pre-existing events Partnering with other organizations - meeting community requests Community dissemination New recreation path

13. Evaluations and Successes School program evaluated intensively .. improved nutrition but overweight & obesity continue to rise Toddlers eating environments Process evaluations (teachers, interventions, nutritional habits of normal and overweight children) Stable incidence and prevalence type 2 diabetes in adults 1986-2003 Successes�. Positive ecological changes Enhanced understanding of diabetes KSDPP as case study Capacity building for many roles (includes 2 masters and one PhD, KSDPP staff in new positions, summer students, CAB members present internationally) Code of Research Ethics adopted /adapted by others Paradis G, et al. Pediatrics 2005;115(2):333-339 Receveur O et al. J Am Diet Assoc 2008;108(2):362-6 Horn O, et al. Incidence and Prevalence of type 2 diabetes in Kahnawake 1986-2003 CJPH 2007;98(6):438-43 Delormier T et al. Food and eating as social practice� Sociology of Health & Illness 2009;31(2):215�228

14. Facilitators Internal Factors identification of diabetes as a community health issue community self-efficacy community grassroots support for diabetes prevention efforts CAB members dedication as change agents Strong partnership with Code of Research Ethics Mutual respect combining scientific rigor with community relevance External factors academic expertise respect for community leadership funding external recognition ongoing evaluation & dissemination increases translational science

15. Barriers Time, time, time���. Coping with funding �bumps� Competing community issues Different timelines for intervention and research Researcher and community turnover

16. Can the democratic ideal of participatory research be achieved? Cross sectional data collected from partners 1996, 1999 and 2004 for perceived level of influence over different aspects of KSDPP. In 2004 overall perceived ownership was by KSDPP Community Advisory Board. �KSDPP with a model of community-directed research suggests that equitable participation - as distinct from democratic or equal participation - is reflected by indigenous community partners exerting greater influence than academic partners in decision making.� (and researchers support this model) 51 stakeholders interviewed.51 stakeholders interviewed.

17. What supports successful participatory research partnerships?A focused literature review steering or advisory committee researchers working or volunteering in community utilizing pre-existing community resources dissemination of results through community mechanisms and meetings Parry D, Pluye P, Salsberg J, Herbert C, Macaulay AC � Review of practices that promote Participatory Research- for submission